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Factors Related to Successful Closed Nasal Bone Reduction: A Longitudinal Cohort Study Publisher Pubmed



Erfanian R1 ; Farahbakhsh F1 ; Firouzifar M1 ; Sohrabpour S1 ; Irani S1 ; Heidari F1
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Authors Affiliations
  1. 1. Otolaryngology Head and Neck Surgery, Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran

Source: British Journal of Oral and Maxillofacial Surgery Published:2022


Abstract

Fracture of the nasal bone is the most common facial fracture because the nose is the most protruding part of the facial skeleton. Standard treatment is nasal reduction, which may cause patients significant pain and stress. Closed nasal reduction may be unsuccessful because of old fractures, despite physical examination being compatible with a new fracture. This study aimed to investigate factors influencing the success of closed nasal reduction. A total of 80 patients with isolated nasal bone fractures who opted for closed reduction under local anaesthesia were included. Demographic features, days from trauma, and findings of physical examination and lateral nasal X-rays were assessed. Significant nasal bone movement with significant improvement in the deformity was considered a successful reduction. An absence of, or minimal, nasal bone movement was considered unsuccessful. The mean (SD) age of the patients was 28.4 (11.5) the youngest being 15. A total of 56 patients had successful nasal reduction. Younger age (p = 0.021), absence of periorbital ecchymosis (p = 0.042), and no fracture line on lateral nasal X-ray (p = 0.000), were associated with unsuccessful reduction. Although lateral nasal X-ray is not considered a good instrument for diagnosis of a nasal fracture, this study has shown that the absence of a fracture line on a lateral nasal X-ray can be a predictor for unsuccessful reduction in patients older than 15 years. © 2022 The British Association of Oral and Maxillofacial Surgeons