Objective Outcomes of Closed Reduction According to the Type of Nasal Bone Fracture

Kang, Chang Min; Han, Dong Gil

doi:10.7181/acfs.2017.18.1.30

Cited by 14 publications

(15 citation statements)

References 5 publications

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“…This study represents one of the largest retrospective reviews on nasal bone fracture and closed nasal reduction outcomes, especially within the United States at a regional level 1 trauma center. 2,6,19,26 Other studies have similarly found assault to be the most common etiology of nasal bone fracture, especially in urban populations. 27,28 Of the patients who underwent CT evaluation, associated facial fractures tended to be in the midface region.…”

Section: Epidemiologymentioning

confidence: 92%

“…A majority (58.2%) (n = 74) of patients who had CNR followed up in the clinic an average of 11.8 days after the procedure. In follow-up, 19.4% (n = 26) had complaints of nasal obstruction and 14.9% (n = 20) had complaints of nasal deviation. On physical exam, 22.3% (n = 30) had nasal dorsum deviation, and 17.9% (n = 24) had septal deviation.…”

Section: Septal Fracturementioning

confidence: 99%

“…Yet, other large studies have found patient satisfaction rates over 85% . In many of these studies, all procedures are performed by a single surgeon . Revision surgery rates after CNR have been reported to be as high as 50%, but more recently, studies reported rates between 5.5% and 11% …”

Section: Introductionmentioning

confidence: 99%

“…6,18 In many of these studies, all procedures are performed by a single surgeon. 6,16,17,[19][20][21] Revision surgery rates after CNR have been reported to be as high as 50%, but more recently, studies reported rates between 5.5% and 11%. 6,20,[22][23][24][25] Given the wide range of patient outcomes and study designs in the literature, this study sought to determine the outcomes of patients with displaced nasal bone fractures after CNR, particularly those with concurrent septal fractures.…”

Section: Introductionmentioning

confidence: 99%

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Septal fractures predict poor outcomes after closed nasal reduction: Retrospective review and survey

2018

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Objectives/Hypothesis To determine outcomes of patients with displaced nasal bone fractures after closed nasal reduction (CNR). Study Design Retrospective patient review. Methods Review of all patients presenting to the emergency department of a tertiary‐care, level 1 trauma hospital with a nasal bone fracture over a 2‐year period, followed by telephone survey after CNR. Results Six hundred seven patients presented to the emergency department in 2015 and 2016 with a diagnosis of nasal bone fracture. Of these, 134 patients met inclusion criteria and underwent CNR without septal reduction. Those with sports‐related injuries and those with a septal fracture identified on computed tomography imaging were significantly more likely to undergo CNR. Ninety‐one patients completed the post‐CNR telephone survey. Over 90% of patients were satisfied with the procedure. However, patients with septal fractures reported worse outcomes, as 53.6% versus 24.1% (P = .0025) disagreed that CNR improved nasal breathing. Of all patients, 11 (2%) eventually underwent septorhinoplasty, with the presence of septal fracture on imaging a significant risk factor. Conclusions Nasal bone fractures are a common injury, often managed initially with CNR. Patients with septal fractures should be counseled on the high risk of posttraumatic nasal deformity and obstruction despite CNR. In addition, addressing a septal fracture found on imaging may be warranted with either closed septal reduction or early aggressive management given the poorer outcomes seen in the present study. Although these patients are more likely to have definitive treatment, many forego later intervention despite persistent symptoms, emphasizing the need for early intervention or close follow‐up. Level of Evidence 3Laryngoscope, 129:1784–1790, 2019

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Section: Epidemiologymentioning

confidence: 92%

Section: Septal Fracturementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Septal fractures predict poor outcomes after closed nasal reduction: Retrospective review and survey

2018

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“…Depending on the type of nasal fracture and the situation in which surgery is being conducted, the surgeon will determine which surgical tools to use [4][5][6][7][8]. Walsham forceps, Asch forceps, and Boies elevators are widely known surgical instruments that are inserted into nasal openings to lift the fracture site for reduction.…”

Section: Introductionmentioning

confidence: 99%

The clinical usefulness of closed reduction of nasal bone using only a periosteal elevator with a rubber band

Park

Ryu

Kwon

et al. 2019

Arch Craniofac Surg

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Background: Closed reduction of nasal fracture with various instrument is performed to treat nasal fracture. Depending on the type of nasal fracture and the situation in which it is being operated, the surgeon will determine the surgical tool. The objective of this study was to investigate whether a periosteal elevator (PE) was a proper device to perform closed reduction for patients with simple nasal fractures. Methods: From March 2018 to December 2018, 50 cases of simple nasal bone fracture underwent closed reduction performed by a single surgeon. These patients were divided into two groups randomly: nasal bone reduction was performed using only PE (freer) and nasal bone reduction was performed using Walsham, Asch forcep, and Boies elevator (non-freer, non-PE). Results: The paranasal sinus computed tomography was performed on patients before and after operation to carry out an accurate measurement of reduction distance at the same level. According to the results, the interaction between instruments and fracture types had a significant influence on reduction distance (p = 0.021). To be specific, reduction distance was significantly (p = 0.004) increased by 2.157 mm when PE was used to treat patients with partial displacement compared to that when non-PEs were used. Conclusion: Closed reduction using PE and other elevator is generally an effective treatment for nasal fracture. In partial-displacement type of simple nasal fracture, closed reduction using PE can have considerable success in comparison with using classic instruments.

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Early Septoplasty Versus Closed Reduction for Acute Nasoseptal Fracture: A Systematic Review and Meta‐analysis

Wadsworth,

Duckett,

Nguyen

et al. 2024

Otolaryngol.--head neck surg.

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ObjectiveAccurate management of acute nasoseptal fractures can mitigate cosmetic and functional complications. There is a lack of consensus on the ideal approach to manage acute nasoseptal fractures, which are often addressed with closed nasal and/or septal reduction (CN/SR) but sometimes addressed using an open approach with septoplasty. We aimed to systematically assess and compare outcomes of CN/SR versus open approaches to treat acute nasoseptal fractures.Data SourcesPubMed, Scopus, and CINAHL.Review MethodsStudies evaluating outcomes of adults with acute nasoseptal fractures treated within 3 weeks of injury with either CN/SR or open approach were included. Meta‐analysis was performed to examine the pooled frequency of complications including persistent obstruction, cosmetic deformity, and need for revision surgery.ResultsOf 1630 unique articles identified, 27 were included (63% retrospective, 29.6% prospective, 7.4% randomized controlled trial). Data included 1117 patients (n = 712 CN/SR, n = 423 open approach), with a mean age of 30.5 years. Patients who underwent CN/SR only were more likely to experience persistent obstruction compared to patients who underwent open approach (22.2% [95% confidence interval, CI, 8.7%‐39.5%] vs 5.9% [95% CI, 2.4%‐10.7%], P < .0001). Patients who underwent CN/SR were more likely to require revision surgery within 3 years (30.9% [95% CI, 15.8%‐48.4%] vs 6.0% [95% CI, 3.3%‐9.9%], P < .0001.ConclusionPatients with nasoseptal fractures who underwent open septoplasty in the acute period were less likely to experience complications. Prospective trials are needed to confirm results of this meta‐analysis.

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Objective Outcomes of Closed Reduction According to the Type of Nasal Bone Fracture

Cited by 14 publications

References 5 publications

Septal fractures predict poor outcomes after closed nasal reduction: Retrospective review and survey

Septal fractures predict poor outcomes after closed nasal reduction: Retrospective review and survey

The clinical usefulness of closed reduction of nasal bone using only a periosteal elevator with a rubber band

Early Septoplasty Versus Closed Reduction for Acute Nasoseptal Fracture: A Systematic Review and Meta‐analysis

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