Reduction of nasal fractures under local anaesthesia: an acceptable practice?

Wild, DC; Alami, Masoomeh; Conboy, Peter

doi:10.1016/s1479-666x(03)80009-4

Cited by 20 publications

(16 citation statements)

References 3 publications

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“…Nasal fracture outcomes are variable due to the subjective nature of measuring cosmesis and nasal breathing. However, patient satisfaction is ultimately the most important outcomes measure . Previous studies have found patient satisfaction rates anywhere between 33% and 85% .…”

Section: Discussionmentioning

confidence: 99%

“…However, patient satisfaction is ultimately the most important outcomes measure. 30 Previous studies have found patient satisfaction rates anywhere between 33% and 85%. 6,15,16,18 The present study reports a high rate of patient satisfaction of 91% with the procedure itself, although fewer patients agreed that CNR helped with the appearance of their nose (65.5%) or nasal breathing (49.0%), which may be due to recall bias.…”

Section: Cnr Outcomesmentioning

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: Discussionmentioning

confidence: 99%

Section: Cnr Outcomesmentioning

confidence: 99%

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

2018

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“…Various studies have employed different tools of satisfaction assessment, but no standardized system has been applied . Patient satisfaction rates following manipulation are variable, ranging between 68% and 87% for nasal cosmesis and 64% and 86% for nasal breathing . Objective tools pertaining to patient's cosmesis and nasal breathing are difficult to design.…”

Section: Discussionmentioning

confidence: 99%

“…Objective tools pertaining to patient's cosmesis and nasal breathing are difficult to design. Patient satisfaction remains the most important measure of outcome . Visual Analog Scale scoring is a very efficient scoring tool, especially when used along with a 4‐point Likert scale.…”

Section: Discussionmentioning

confidence: 99%

Acute nasal fracture management: A prospective study and literature review

et al. 2015

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“…Digital manipulation of fractured nasal bones is a common ENT procedure. Previous studies showed that manipulation under local anaesthesia can be successfully carried out and is acceptable to patients 1–4 …”

mentioning

confidence: 99%

Nasal fracture manipulation under local anaesthetic without injections

Spielmann

2007

Clinical Otolaryngology

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Reduction of nasal fractures under local anaesthesia: an acceptable practice?

Cited by 20 publications

References 3 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

Acute nasal fracture management: A prospective study and literature review

Nasal fracture manipulation under local anaesthetic without injections

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