Facial Plast Surg 2015; 31(03): 183-193
DOI: 10.1055/s-0035-1555618
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

An Algorithm for the Initial Management of Nasal Trauma

John F. Hoffmann
1   Department of Otolaryngology, University of Washington, Spokane, Washington
› Author Affiliations
Further Information

Publication History

Publication Date:
30 June 2015 (online)

Abstract

Nasal fractures are the most common of all facial skeletal injuries. Untreated, these fractures frequently lead to functional and aesthetic problems. Careful history and physical assessment are critical to determine the extent of injury and to determine proper management. Critical aspects of assessment are discussed, as is the role of imaging in management. The unique aspects of pediatric nasal fractures and their management are reviewed. Fractures are classified based on the degree of injury and the involvement of the septum. A simple treatment algorithm is provided to help guide the selection of optimal treatment techniques. A review of instrumentation and treatment techniques is provided. The goal of treatment is to restore the nose to its preinjury shape and function and to minimize the need for secondary septorhinoplasty.

 
  • References

  • 1 Gilman GS, Rivera-Serrano CM. Nasal fractures. In: Johnson JT, Rosen CA, eds. Bailey's Head and Neck Surgery—Otolaryngology. Philadelphia, PA: Wolters Kluwer; 2014: 1241-1254
  • 2 Reilly MJ, Davison SP. Open vs closed approach to the nasal pyramid for fracture reduction. Arch Facial Plast Surg 2007; 9 (2) 82-86
  • 3 Rhee SC, Kim YK, Cha JH, Kang SR, Park HS. Septal fracture in simple nasal bone fracture. Plast Reconstr Surg 2004; 113 (1) 45-52
  • 4 Murray JA, Maran AG, Mackenzie IJ, Raab G. Open v closed reduction of the fractured nose. Arch Otolaryngol 1984; 110 (12) 797-802
  • 5 Jaberoo MC, Joseph J, Korgaonkar G, Mylvaganam K, Adams B, Keene M. Medico-legal and ethical aspects of nasal fractures secondary to assault: do we owe a duty of care to advise patients to have a facial x-ray?. J Med Ethics 2013; 39 (2) 125-126
  • 6 Higuera S, Lee EI, Cole P, Hollier Jr LH, Stal S. Nasal trauma and the deviated nose. Plast Reconstr Surg 2007; 120 (7) (Suppl. 02) 64S-75S
  • 7 Rohrich RJ, Adams Jr WP. Nasal fracture management: minimizing secondary nasal deformities. Plast Reconstr Surg 2000; 106 (2) 266-273
  • 8 Ondik MP, Lipinski L, Dezfoli S, Fedok FG. The treatment of nasal fractures: a changing paradigm. Arch Facial Plast Surg 2009; 11 (5) 296-302
  • 9 Alcaraz N, Lawson W. Trauma of the nose and nasoethmoid complex in children and adolescents. Facial Plast Surg Clin North Am 1999; 7: 175-183
  • 10 Wright RJ, Murakami CS, Ambro BT. Pediatric nasal injuries and management. Facial Plast Surg 2011; 27 (5) 483-490
  • 11 Ferreira P, Marques M, Pinho C, Rodrigues J, Reis J, Amarante J. Midfacial fractures in children and adolescents: a review of 492 cases. Br J Oral Maxillofac Surg 2004; 42 (6) 501-505
  • 12 Staffel JG. Optimizing treatment of nasal fractures. Laryngoscope 2002; 112 (10) 1709-1719
  • 13 Atighechi S, Baradaranfar MH, Akbari SA. Reduction of nasal bone fractures: a comparative study of general, local, and topical anesthesia techniques. J Craniofac Surg 2009; 20 (2) 382-384