Patterns of referral for fractured nose during major sporting events: a 10-year follow up

Abstract

Introduction Nasal fracture is a common form of ear, nose and throat (ENT) trauma with prompt referral required for assessment and potentially manipulation of nasal bones. The aetiology of nasal fracture is multifactorial, and injury occurs across all ages. Previous study has suggested a temporal relationship between nasal injury and major sporting events. Methods A total of 1966 adult patients with nasal injuries referred to emergency clinics across three London ENT centres between September 2016 and August 2019 were analysed. Results The majority of those referred were male (66.58%). Mean age at referral was 36.29±18.38 in males and 49.14±21.43 in females; 10.27% were 75 years and over. Incidence was highest during April–September 2018 (p=0.02). Mean incidence was higher in this period in the male 16–35 subgroup (p=0.039), with 53.1% of their injuries concentrated between Friday and Sunday. Conclusions Most nasal injuries occurred in young males. Mean age at referral was higher in females, and there was slightly increased incidence in over-75s, predominantly females. This incidence could be due to increased longevity or greater tendency to injury in females of this age. The injury patterns across the week also differed, with males injured proportionately more at the weekend. Nasal injury referrals of young men increased around the 2018 summer period, coinciding with the 2018 FIFA World Cup. This lends support to the association between major sporting events and the incidence of nasal injury, particularly in young males.

Manipulation under anaesthesia of fractured nasal bones – a 10-year retrospective study

“…Our study demonstrates that this is more likely to be within the two-week window following injury, during which nasal bones are most mobile and easily reduced. 1 We describe a large cohort of patients compared to other studies of manipulation under LA conducted since the start of the Covid-19 pandemic. [7][8][9] We also present a long review period of up to 10 years for our GA cohort.…”

“…Our study demonstrates that this is more likely to be within the two-week window following injury, during which nasal bones are most mobile and easily reduced. 1…”

“…These fractures are traditionally managed with closed manipulation under general anaesthesia (GA) performed within two weeks of injury, with the aim of restoring nasal anatomy prior to the formation of fracture callus. 1,2 Nasal deformities associated with poor cosmesis or nasal obstruction can be assessed post-injury, and the need for septoplasty or septorhinoplasty can be determined. 1 Outcomes used to assess the success of manipulation under anaesthesia include patient satisfaction and the need for future surgery.…”

“…1,2 Nasal deformities associated with poor cosmesis or nasal obstruction can be assessed post-injury, and the need for septoplasty or septorhinoplasty can be determined. 1 Outcomes used to assess the success of manipulation under anaesthesia include patient satisfaction and the need for future surgery. 3,4 Previous studies have shown persistent nasal deformities in 14–50 per cent of patients following manipulation under anaesthesia, with 3 per cent requiring further surgery.…”

“…Nasal bone fractures are a common emergency presentation seen in Otorhinolaryngology departments and account for up to 50% of facial fractures. These fractures are traditionally managed with closed manipulation (MUA) under general anaesthetic (GA) within two weeks of injury, with the aim of restoring nasal anatomy prior to the formation of fracture callus 1,2 .…”