Nasal fractures and anesthetic applications

Abstract

Objective: The aim of this study was to review and compare the demographic characteristics, radiological findings, pain scores and the level of satisfaction of patients who underwent nasal fracture reduction (NFR) under sedation anesthesia (SA), infiltrative anesthesia (IA) or topical anesthesia (TA). Patients and Methods: Sixty patients were included in the study according to the types of anesthesia applied: SA group , IA group and TA group. Demographic data (age, gender, etiology, duration and time to NFR), radiological findings (presence of septal fracture, hematoma), pain scores, nasal patency and cosmetic satisfaction levels were analyzed. Results: The mean age of patients was 23.8 ± 19.3. The mean age of females was 23 (38.3%) and mean age of males was 37 (61.7%). The mean age of the SA group was 6.1±4. The most common etiology was falls, (39 patients 65%). Duration of the operation was higher in patients (TA group) who had closed reduction. Pain score was lowest at 0 hour in the IA group (open reduction), while it was lowest at 48 hours in the TA group. Cosmetic satisfaction level was high in the SA group (p<0.05). Septal fracture was detected in 95% of the patients and septal hematoma in 36% of the patients in tomographic evaluation. Conclusion: Sedation anesthesia was applied mostly to children, whereas, IA and TA were mostly applied to adult patients due to patient compliance. Short operation time and immediate pain control were advantages of IA.TA was preferred when cosmetic expectations were low in adults. Septal fracture and hematoma that cause nasal deformations, frequently seen in nasal fracture, may be missed by physical examination but can easily be detected by tomographic examination, but the risks of tomography should be noted.