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Clinical Note
April 2003

A Complication From Neurocranial Restructuring: Nasal Septum Fracture

Author Affiliations

From the Department of Otolaryngology–Head and Neck Surgery (Drs Davis, Yueh, and Weymuller) and Health Services (Dr Yueh), University of Washington, Seattle; and Health Services Research and Development, Veterans Affairs Puget Sound Health Care System, Seattle (Drs Davis and Yueh). Dr Murphy is in private practice in Walnut Creek, Calif. The authors have no relevant financial interest in this article.

Arch Otolaryngol Head Neck Surg. 2003;129(4):472-474. doi:10.1001/archotol.129.4.472

We report a case of nasal septum fracture after a complementary and alternative medicine procedure called neurocranial restructuring (NCR) that was used to treat a patient with chronic sinusitis. We initially evaluated this patient, obtained a computed tomographic scan, and recommended frontal sinus obliteration. The patient opted to see an alternative medicine practitioner, who performed NCR. This treatment involves the expansion of endonasal balloons in the nasopharynx that are used to "alter the skeletal structure." During the NCR procedure, the patient experienced severe midface pain and a crunching sound. Because of persisting pain, she presented to the emergency department, at which time another computed tomographic scan showed new septal fractures. The patient ultimately received a frontal sinus obliteration, bilateral revision antrostomies, and repositioning of her nasal septum. To our knowledge, this is the first published case report of a complication from NCR.

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