Optimal timing for nasal fracture manipulation—Is a 2‐week target really necessary? A single‐centre retrospective analysis of 50 patients

Perkins, V.; Vijendren, Ananth; Egan, Matt; McRae, D.

doi:10.1111/coa.12883

Cited by 5 publications

(5 citation statements)

References 10 publications

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“…Despite the general consensus in the United Kingdom for a 2-week window to perform a satisfactory procedure, some authors have shown good outcomes when performing MUA #nasal bones under GA, beyond this window, as late as one month. 18,19 On the contrary, Sharma et al have shown that earlier manipulation confers greater satisfaction rates postoperatively. 20 Multiple other factors may influence outcome, including previous trauma, degree of deviation, and patient expectations.…”

Section: Average Time Framesmentioning

confidence: 99%

How COVID-19 Changed Our Management of Nasal Bone Fractures and Its Impact on Patient Outcomes—A Retrospective Study

et al. 2020

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Objectives: Nasal bone fractures are a common presentation to the Ear, Nose and Throat (ENT) surgeon. Simple, closed fractures are assessed and considered for closed manipulation under anesthesia (MUA #nasal bones). Most departments perform this under general anesthesia (GA). Our protocol changed in the face of COVID-19, where procedures were alternatively performed under local anesthesia (LA) in the clinic, to cope with lack of elective theater capacity during the pandemic, while still allowing a nasal fracture service to take place. We present postoperative patient outcomes on breathing and shape, comparing GA versus LA. Methods: Patient records retrospectively analyzed (January 2020-August 2020), and patients undergoing MUA #nasal bones interviewed by telephone after one month. Exclusion criteria were open injuries or depressed nasal bones requiring elevation. Breathing and shape scores were evaluated subjectively using a Likert scale (1 = very unsatisfied, 5 = very satisfied). Results: Two hundred five nasal injury referrals were made (21 MUA #nasal bones under GA and 27 under LA). Manipulation under anesthesia #nasal bones significantly improved both breathing satisfaction scores (GA; 2.88 ± 0.24 to 4.06 ± 0.23, P < 0.05; LA; 2.86 ± 0.22 to 3.77 ± 0.27, P < 0.05) and aesthetic scores (GA; 2.00 ± 0.21 to 3.94 ± 0.23, P < 0.05; LA; 1.64 ± 0.19 to 3.59 ± 0.28, P < 0.05) in both GA and LA groups. There was no statistically significant difference between LA and GA in postoperative outcomes. There was a trend toward greater satisfaction for GA, though this was not statistically significant and may be impacted by the rate of cartilaginous deformity in the LA group. Both techniques were well tolerated and most patients would repeat the procedure in hindsight. Conclusions: Local anesthesia could provide a safer, cheaper, and satisfactory alternative for performing MUA #nasal bones in the clinic for selected patients, particularly with reduction of elective theater capacity in the event of further COVID-19 surges. We recommend training junior ENT surgeons to perform this procedure under supervision with adequate protective measures.

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Section: Average Time Framesmentioning

confidence: 99%

How COVID-19 Changed Our Management of Nasal Bone Fractures and Its Impact on Patient Outcomes—A Retrospective Study

et al. 2020

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“…[9,10] Although some studies have suggested that the earlier the reduction after trauma, the better functional and anatomic results will be obtained, Perkins et al 's study of the timing of nasal fracture repair did not find any difference in the reduction success at any time within 2 weeks. [11] However, the same study did not mention situations such as septal hematoma and septal fracture accompanying nasal fracture. In our study, the reduction was performed on the sixth day after the fracture.…”

Section: Discussionmentioning

confidence: 98%

Acil servise başvurmuş izole nazal fraktürlü hastaların analizi

Aksakal

Ertaş

2018

Journal of Contemporary Medicine

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The aim of this study is to investigate the relationship between etiologic factors and fracture types of patients underwent nasal fracture reduction due to nasal fracture and applied to emergency service. Methods: In this study, we evaluated 74 patients who underwent nasal fracture reduction due to isolated nasal fracture. Patients were classified as two groups according to Stranc and Robertson classification: Frontal impact group type 1 (FI), Frontal impact group type 2 (FII), Lateral impact group type 1 (LI), Lateral impact group type 2 (LII), Communited fracture group (C). Results: The mean age of the patients was 25.17. The most common types of fractures were FI (n=20), LI (n=20), LII (n=17), C (n=12) and FII (n=5). The most common cause of injury was fights (n=30), falls (n=27), traffic accidents (n=8), sports events (n=6), and occupational accidents (n=3). The two most common symptom findings were swelling (70.2%) and epistaxis (16.2%). Septal fractures were seen in 24.3% of patients and septal hematomas in 35.13%. Discussion and Conclusion: LII type fractures are the most commonly seen in fighting events, LI type is the most common type of fall events, and C type fractures are the most common in traffic accidents and occupational accidents. The fight is also the most common cause of nasal fractures in young patients.

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“…(10)(11)(12) Otros autores, sin embargo, publican que hasta aproximadamente los 30 días los resultados son similares a los obtenidos en menos tiempo. (13,6) Algunos incluso refieren que esperar para realizar la reducción al menos 3 días tras el traumatismo reduce de manera significativa el sangrado (3) y facilita la cirugía al reducir el edema postraumático. (14) En nuestro caso, la mayoría de los pacientes fueron intervenidos en las primeras 24 horas tras la lesión.…”

Section: Discussionunclassified

Factores relacionados con el riesgo de reintervención en pacientes operados de reducción cerrada de fractura de huesos propios

Compaña

Pérez

Sanz

et al. 2021

Cir. plást. iberolatinoam.

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Conflicto de intereses: Los autores declaran no tener ningún interés financiero relacionado con el contenido de este artículo. Financiación: No hubo fuentes externas de financiación para este trabajo. CIRUGÍA PLÁSTICA IBERO-LATINOAMERICANA Original / Series clínicas FACIAL RECONSTRUCTIVA Palabras clave Huesos nasales, Fractura huesos nasales, Reducción cerrada, Anestesia. Nivel de evidencia científica 4c Terapéutico Recibido (esta versión) 25 julio/2020 Aceptado 20 enero/2021

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Optimal timing for nasal fracture manipulation—Is a 2‐week target really necessary? A single‐centre retrospective analysis of 50 patients

Cited by 5 publications

References 10 publications

How COVID-19 Changed Our Management of Nasal Bone Fractures and Its Impact on Patient Outcomes—A Retrospective Study

How COVID-19 Changed Our Management of Nasal Bone Fractures and Its Impact on Patient Outcomes—A Retrospective Study

Acil servise başvurmuş izole nazal fraktürlü hastaların analizi

Factores relacionados con el riesgo de reintervención en pacientes operados de reducción cerrada de fractura de huesos propios

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