Imaging of maxillofacial and skull base trauma

Deformation of nasal septum during nasal trauma

BACKGROUND

Injury to the nasal septum is commonly found in most nasal fractures. The nasal septum deforms and crumples, leading to nasal deviation and internal nasal obstruction.

AIM

This study aims to identify the main areas of high stress concentration when a dynamic anteroposterior load is applied to the nasal tip, simulating nasal trauma. We wish to determine if the nasal septum acts as a crumpled zone, and deforms significantly during nasal trauma.

MATERIALS AND METHODS

An idealized and a patient-specified finite element model have been generated for the present study. Several models with various combinations of narrower angle at the Vomer Ethmoidal Junction (VEJ) are also constructed from this septum model. Finite element analyses are carried out to determine the deformation and stress distribution in the nasal septum when a dynamic anteroposterior load is applied to the nasal tip.

CONCLUSIONS

The maximum stress areas in the nasal septum are in the vicinity of the bony-cartilaginous (BC) junction and the anterior nasal spine (ANS), which are consistent with clinical experience. A larger anteroposterior load, a longer loading duration, and a more acute VEJ angle would result in higher maximum stresses. The observations were identical in both idealized and patient-specific models. The findings of this analysis also suggest that the septum does function as a crumpled zone, absorbing a significant amount of stress before it is transmitted to the skull.