From 2000 to 2008, a total of 297 patients with nasal bone fractures were admitted to our department, and all of them were examined and treated under nasal endoscopy with satisfactory results, which are reported below. 1. Data and methods 1.1 Clinical data: Of the 297 cases, 232 were male and 65 were female, aged 10-60 years, with an average age of 34 years. There were 196 cases of unilateral nasal fractures and 101 cases of bilateral fractures. Among them, 229 were closed fractures, 68 were open fractures, 35 were comminuted fractures, and 72 were combined with nasal septal fractures. All patients underwent lateral X-ray and nasal endoscopic examination of the nasal bone before surgery, and some patients required CT scan of the nasal bone. After the local swelling subsided, nasal fractures were repositioned endoscopically within 7-10 d after the healing of the nasal trauma and removal of stitches. Zhou Anliang, Department of Otolaryngology, Gujiao Mine General Hospital 1 .2 The procedure was performed in a supine head-high, foot-low position, with 1% daccaine plus 1‰ epinephrine swabs for surface anesthesia of the nasal mucosa, and 0° and 70° nasal endoscopy for inspection of the anterior segment of the nasal cavity, with 2% lidocaine for local anesthetic infiltration under the mucosa of the collapsed nasal bone and the surrounding nasal septum and turbinate. The nasal bone repositioner was then placed precisely on the collapsed nasal bone under direct nasal endoscopy to lift and reposition the displaced nasal bone. At this time, the nasal bone repositioning sound can be heard and the deformity of the nasal bone collapse can be seen to disappear, and if the fracture is bilateral, the other side can be done in the same way. In case of combined septal fracture, dislocation or traumatic deviation, the deviation can be repositioned by septal stripper, or if it cannot be repositioned, septal deviation can be corrected. If there is nasal septal hematoma, nasal septotomy and drainage can be performed at the same time to avoid the formation of nasal septal abscess. If there is little bleeding or no septal deviation, a Vaseline gauze can be inserted locally to maintain the nasal ventilation. If there is more intraoperative bleeding or combined with nasal septal deviation, the nasal bone fracture is easily displaced after resetting, unilateral or bilateral local Vaseline gauze filling and total nasal tract polymer sponge filling can be performed to fix the nasal bone and correct the nasal septal deviation. The stuffing was removed 48-60 h after surgery, and the fracture was avoided to be touched for 2-3 weeks after surgery. 2. Results All 297 patients in this group could clearly observe the nasal bone collapse and the changes after repositioning intraoperatively, and could detect and manage the septal lesion at the same time. 278 patients were successfully repositioned at one time with satisfactory shape, and 19 patients were successfully repositioned twice with basically satisfactory shape. All patients had no complications, and 61 cases did not have nasal tamponade. It can be seen that conventional surface anesthesia with local infiltration anesthesia under nasal endoscope is less painful than traditional nasal fracture repositioning, accurate repositioning under direct vision, good effect, less intraoperative bleeding, less injury, avoiding the blindness of traditional surgery, and can manage the comorbidity of nasal fracture at the same time. 3. Discussion Traditional anesthesia for nasal fracture is generally surface anesthesia, except for a few patients who are combined with some maxillofacial and skull base fractures and are under general anesthesia. Patients are often in pain and struggle to undergo the surgery, and the effect of surface anesthesia is short, and the patients start to feel discomfort and pain soon after the nasal cavity is filled. In contrast, local infiltration anesthesia in the collapsed nasal bone and its surrounding tissues under direct nasal endoscopy has satisfactory anesthetic effect, and the patient is less painful and easy to accept and cooperate with the operation. This is the biggest advantage of nasal endoscopic local anesthesia nasal bone repositioning compared with traditional surgery. In general, the diagnosis of nasal bone fracture is based on history, clinical manifestations and imaging examinations, which include X-ray lateral nasal bone radiographs and CT. Many scholars advocate the introduction of nasal endoscopy in the diagnosis of nasal fractures in nasal trauma. First of all, nasal endoscopy provides a direct and clear observation, and can detect injuries that cannot be detected by X-ray or CT. The visualization of the post-traumatic condition helps in its accurate diagnosis and comprehensive evaluation. In clinical cases with nasal fractures and significant deformities, but negative results on lateral nasal radiographs and CT may be due to the overlap of bilateral lateral nasal radiographs and local swelling, making the lateral nasal radiographs overlapping and blurred, and difficult to distinguish [1], as well as the fracture being missed on the C T scan of the nasal bone. Secondly, in clinical practice, there is no lack of patients with no obvious clinical symptoms but suspicious imaging, and even some patients with injuries caused by fights and disputes deliberately exaggerate the symptoms of nasal pain, and in this case, nasal endoscopy is particularly necessary. The application of nasal endoscopy during nasal fracture repositioning can help to find the fracture site accurately, to understand the nasal bone repositioning process clearly, to reduce the blindness of the operation, and to grasp the depth of the striker into the nasal cavity, to avoid injury to the septum and to prevent complications. The operation was performed with little movement and moderate force, and the surgical trauma was mild and the damage to the surrounding tissues was small, so that patients with combined deviated septum, fracture and dislocation could be treated at the same time. During the nasal endoscopy, 72 patients with nasal septal deviation and fracture were found, and the septum was repositioned and the deviation was corrected at the same time.