Int Arch Otorhinolaryngol 2014; 18(03): 266-271
DOI: 10.1055/s-0034-1368138
Original Research
Thieme Publicações Ltda Rio de Janeiro, Brazil

Applicability and Effectiveness of Closed Reduction of Nasal Fractures under Local Anesthesia

Fernando Vilela
1   Department of Otorhinolaryngology, Hospital de Base Brasília, Distrito Federal, Brazil
,
Ronaldo Granjeiro
1   Department of Otorhinolaryngology, Hospital de Base Brasília, Distrito Federal, Brazil
,
Carlos Maurício Júnior
1   Department of Otorhinolaryngology, Hospital de Base Brasília, Distrito Federal, Brazil
,
Patrícia Andrade
1   Department of Otorhinolaryngology, Hospital de Base Brasília, Distrito Federal, Brazil
› Institutsangaben
Weitere Informationen

Publikationsverlauf

31. Oktober 2013

16. November 2013

Publikationsdatum:
13. März 2014 (online)

Abstract

Introduction A significant portion of patients treated in emergency departments have nasal fracture. It is important that the otolaryngologist know how to treat such damage.

Objectives To evaluate the effectiveness of nasal fracture reduction under local anesthesia and tolerance to the procedure.

Methods Twenty-four patients treated in the emergency department with closed reduction under local anesthesia were prospectively followed. Epidemiologic information and data regarding pain and complications during the management were noted. The degree of satisfaction was researched by visual analog scale.

Results The majority of patients were male (75%), and the most common cause of injury was motor vehicle accident. We found a significant association between time to reduction and referred pain during the procedure. In patients in whom the procedure was delayed (over 3 days), there was less pain, and those who bled during the procedure had a shorter average time to reduction than the group of patients who did not bleed. Most patients were very satisfied, with more than 95% of these willing to undergo the same process again, if necessary.

Conclusions The closed approach in the clinic under local anesthesia was effective and safe in restoration of the nose.

 
  • References

  • 1 Illum P, Kristensen S, Jørgensen K, Brahe Pedersen C. Role of fixation in the treatment of nasal fractures. Clin Otolaryngol Allied Sci 1983; 8 (3) 191-195
  • 2 Renner GJ. Management of nasal fractures. Otolaryngol Clin North Am 1991; 24 (1) 195-213
  • 3 Cook JA, McRae RD, Irving RM, Dowie LN. A randomized comparison of manipulation of the fractured nose under local and general anaesthesia. Clin Otolaryngol Allied Sci 1990; 15 (4) 343-346
  • 4 Chadha NK, Repanos C, Carswell AJ. Local anaesthesia for manipulation of nasal fractures: systematic review. J Laryngol Otol 2009; 123 (8) 830-836
  • 5 Cook JA, Murrant NJ, Evans K, Lavelle RJ. Manipulation of the fractured nose under local anaesthesia. Clin Otolaryngol Allied Sci 1992; 17 (4) 337-340
  • 6 Jones TM, Nandapalan V. Manipulation of the fractured nose: a comparison of local infiltration anaesthesia and topical local anaesthesia. Clin Otolaryngol Allied Sci 1999; 24 (5) 443-446
  • 7 Bailey BJ. Head and Neck Surgery-Otolaryngology. Vol. 1. Philadelphia: Lippincott; 2001
  • 8 Murray JAM, Maran AGD. The treatment of nasal injuries by manipulation. J Laryngol Otol 1980; 94 (12) 1405-1410
  • 9 Rajapakse Y, Courtney M, Bialostocki A, Duncan G, Morrissey G. Nasal fractures: a study comparing local and general anaesthesia techniques. ANZ J Surg 2003; 73 (6) 396-399
  • 10 Waldron J, Mitchell DB, Ford G. Reduction of fractured nasal bones; local versus general anaesthesia. Clin Otolaryngol Allied Sci 1989; 14 (4) 357-359
  • 11 Bakardjiev A, Pechalova P. Maxillofacial fractures in Southern Bulgaria—a retrospective study of 1706 cases. J Craniomaxillofac Surg 2007; 35 (3) 147-150
  • 12 Wulkan M, Parreira Jr JG, Botter DA. Epidemiologia do Trauma Facial. Rev Assoc Med Bras 2005; 51 (5) 290-295
  • 13 Mocelin M. Septoplastias. In: Stamm AC, ed. Micro cirurgia naso sinusal. Rio de Janeiro: Revinter; 1995
  • 14 Robinson JM. The fractured nose: late results of closed manipulation. N Z Med J 1984; 97 (755) 296-297
  • 15 Hung T, Chang W, Vlantis AC, Tong MC, van Hasselt CA. Patient satisfaction after closed reduction of nasal fractures. Arch Facial Plast Surg 2007; 9 (1) 40-43
  • 16 Khwaja S, Pahade AV, Luff D, Green MW, Green KM. Nasal fracture reduction: local versus general anaesthesia. Rhinology 2007; 45 (1) 83-88