Reduction Of Nasal Bone Fracture Research Articles

Comparison of Polyvinyl Alcohol Sponge and Gauze Packing for Nasal Fracture Treatment: An Efficacy and Safety Analysis.

Nasal fractures are commonly treated using nasal packing as an internal splint after performing closed reduction. Although gauze and polyvinyl alcohol sponge (PVAS) are both commonly used for packing, few reports have compared their efficacy and safety in nasal fracture treatment. Therefore, in this study, the authors, aimed to retrospectively compare the efficacy and safety of gauze packing in 208 patients and PVAS packing in 225 patients who underwent closed reduction at our hospital. The proportions of patients requiring revision surgery did not differ significantly between the PVAS and gauze groups ( P =0.627). However, in comparison to the gauze group, the PVAS group displayed significantly fewer instances of uncontrolled epistaxis following packing removal, as well as fewer occurrences of dropout and loss of packing ( P =0.023, P =0.007, and P <0.001, respectively). The results of logistic regression analysis adjusted for confounding factors also showed that compared with the gauze group, the PVAS group was significantly less likely to experience packing dropout (odds ratio=0.13; 95% confidence interval, 0.06-0.29, P <0.001) for which younger and older age and allergic rhinitis were independent risk factors. In conclusion, both gauze and PVAS are effective packing materials as internal splints after closed reduction of nasal bone fractures. Specifically, PVAS utilization warrants consideration in pediatric and geriatric populations, individuals with allergic rhinitis, and those at elevated risk of bleeding.

A COMPARATIVE STUDY ON NASAL BONE FRACTURE ASSOCIATED WITH SEPTAL DEVIATION CORRECTED WITH SEPTOPLASTY VERSUS CLOSED REDUCTION

Objective: The dorsum of the nose formed by nasal bones helps to maintain the airway and esthetic appearance of the nose. Faciomaxillary trauma is associated with a nasal bone fracture with or without nasal septal fractures. Nasal bone fractures can lead to deviation of the external nose and nasal obstruction. The management includes correction of nasal bone deformity with either septoplasty or reduction of nasal septal deviation by the non-surgical method. A study was conducted to compare the results of septal deviation corrected by septoplasty and non-surgical reduction of septal deviation combined with nasal bone fracture reduction.The aim of this study was to compare the results of septal deviation corrected by septoplasty and non-surgical reduction of septal deviation combined with nasal bone fracture reduction. Materials: Sixty-two patients with nasal bone fractures with varying degrees of external nose deformity and nasal septal deviation were divided into two groups. Group A consisted of patients treated with septoplasty and nasal bone fracture correction and Group B consisted of patients treated with non-surgical reduction of septal deviation and nasal bone fracture correction. Type I, II, and II nasal bone fractures were included with all types of septal deviations. The subjective improvement in nasal obstruction was assessed using the visual analog scale in both groups. Results: There were 26 males (81.25%) and 06 (18.75%) females in Group A and 25 (83.33%) males and 05 (16.67%) females in Group B. In Group A, 12 (37.5%) patients were aged between 18 and 27 years, 10 (31.25%) patients were aged between 28 and 27 years, 07 (21.87%) patients were aged between 38 and 47 years, and 03 (09.37%) patients were aged between 48 and 57 years. The mean age was 23.54±2.30 years. Conclusion: Nasal bone fractures cause not only esthetic facial deformity but also functional airway obstruction. A thorough clinical examination, computed tomography scan, and patient counseling are necessary. There is no statistically significant difference in the final outcome between the septoplasty and closed reduction of the septal deviation undertaken to relieve nasal obstruction in patients with associated nasal bone fractures.

Comparison Of Outcomes Between Early And Delayed Reduction Of Nasal Bone Fractures

Objective: To determine the outcomes of early versus delayed reduction of nasal bone fractures in terms of patient satisfaction and postoperative pain. Study Design: Comparative study. Study Setting &amp; Duration: Department of Otorhinolaryngology, at Rawalpindi Teaching Hospital, Rawalpindi. The duration of the study was 6 months after approval by the Ethical Committee from February 2023 to July 2023. Materials and Methods: A total of 96 patients were selected. The study participants were individuals who, according to operational definitions, had nasal bone fractures and presented for evaluation at the Department of Otorhinolaryngology, Head &amp; Neck Surgery at Rawalpindi Teaching Hospital, Rawalpindi. Patients were divided into two groups. Patients who underwent early reduction (within 2 weeks of trauma) were included in Group A while those who underwent delayed reduction (more than 2 weeks) were included in Group B. They also met all inclusion and exclusion criteria requirements and these requirements were strictly adhered to to control confounders and bias. Patients were chosen via a series of non-probability sampling. SPSS 28 was used to determine the frequencies in the data. Results: A total of 96 patients were included in this study. Out of which 52(54.17 %) were males and 44(45.8 %) were females. Patients who underwent early reduction had higher mean satisfaction scores on the seventh and fourteenth postoperative day (4.22 ± 0.75 and 4.60 ± 0.49 respectively) than those who underwent Delayed reduction (2.41± 0.82 and 2.93 ± 0.80 respectively). Patients who underwent early reduction had a better mean Pain Intensity score at 0(2.37 ± 0.81)3rd (1.37 ± 0.81), and 7th-day (0.58 ± 0.49) than the Delayed reduction, at 0(5.83 ± 1.20), 3rd (5.08 ± 0.67), and 7th-day (4.31 ± 0.58). Patient discomfort was more intense in the delayed reduction group than in the early reduction group. Early reduction led to higher patient satisfaction and a better mean pain intensity score. Conclusion: The results of nasal fractures between the early and delayed reduction groups did differ statistically significantly. Early reduction decreased pain intensity and increased patient satisfaction. Keywords: early reduction, delayed reduction, nasal bone fractures, Nasal bone.

A case of nasal bone fracture with septal fracture reduction via closed reduction of nasal bone fracture and endoscopic septoplasty

A case of nasal bone fracture with septal fracture reduction via closed reduction of nasal bone fracture and endoscopic septoplasty

9. ASSESSMENT OF THE TREATMENT RESULTS OF NASAL BONE FRACTURES AT 103 MILITARY HOSPITAL

Objectives: Assessment of the results of reduction for patients with nasal bone fractures. &#x0D; Subjects and methods: A prospective and case-by-case descriptive study with clinical intervention was undertaken. The study includes 51 patients with nasal bone fractures undergoing surgery at 103 Military Hospital from March 2022 to September 2023.&#x0D; Results: Male patients account for a higher proportion of 66.7% while female patients account for that of 33.3%, and most are at the age of 16–30 (at 54.9%). Traffic accidents are the major causes with 58.8%. Concerning clinical symptoms: 100% of patients with pain, bruising, and swelling in the nose area; 78.4% of patients with post-traumatic epistaxis; 88.2% of patients with nose deformity; 78.4% of patients with a sharp pain nose fracture score and signs of bone crunching in the nasal bone; 52.9% of patients with combined other injuries, in which type II nasal bone fractures accounting for the highest proportion at 54.9%. Results after treatment: the qualified proportion after 1 month is 88.2%, and after 3 months is 96.1%.&#x0D; Conclusion: Research results show that nasal bone fractures are common in males, mainly caused by traffic accidents. Common clinical symptoms are pain, epistaxis, and nasal pyramid deformity. Reduction of nasal bone fractures is a treatment method that allows the restoration of both aesthetic and physiological functions of the nose.

Comparison of Post Operative Aesthetic Outcome Between Local and General Anesthesia after Close Reduction for Nasal Bone Fracture

Background: Nasal bone fractures are commonest type of facial bone fractures and 3rd most common among all body fractures. Objective: To compare the post operative aesthetic outcome after close reduction of fractured nasal bone when performed under local anesthesia and general anesthesia. Study Design: Randomized control trial. Settings: Department of ENT, Mayo Hospital Lahore Pakistan. Duration: From September 2018 to December 2020. Methods: Seventy patients with diagnosis of nasal bone fracture were included. Patients were randomized into two groups by random number table. Close reduction of Group A was done under local anesthesia and group B under general anesthesia. Pre and post operative aesthetic outcomes were measured by Likert score and nasal angles. Results: Mean age of patients was 23.8 ± 8.59 years. 90% patients were males and 10% were females. Statistically significant difference in aesthetic outcome was present between general and local group at 1st and 3rd month of follow up. Conclusion: In patients of fractured nasal bone post operative aesthetic outcome after close reduction are better under general anesthesia at 1st and 3rd month of follow up. However, at 6th month of follow up results are not statistically significant for reduction under both types of anesthesia.

Effectiveness of out-fracture of the inferior turbinate with reduction nasal bone fracture.

The nasal bone, being the most protruding bone in the center of the facial bones, is particularly susceptible to damage. Nasal bone fractures can often result in secondary deformation and dysfunction of the nose, including septal fractures. Studies on functional or intra-nasal complications have been rarely reported after nasal bone fracture reduction. To evaluate the severity of nasal obstruction and its improvement following nasal bone fracture reduction using inferior turbinoplasty. We conducted a retrospective review of data from 50 patients with symptomatic nasal obstruction between January to December 2010. All patients underwent preoperative Computed tomography evaluation, and symptom changes and nasal cavity volume were analyzed using a visual analog scale and acoustic rhinometry before and after surgery. Closed reduction and out-fracture of both inferior turbinates performed by the same surgeon. Treatment outcomes were assessed by comparing changes in the nasal airway volume measured using acoustic rhinometry before and after surgery. The minimal cross-sectional area (MCA) was also analyzed based on the Stranc classification. Before reduction, the mean MCA for all cases was 0.59 ± 0.06 cm2, which represented an 11% decrease compared to the average size of a Korean adult (0.65 ± 0.03 cm2). The MCA for frontal impact was 0.60 ± 0.02 cm2 and for lateral impact, it was 0.58 ± 0.03 cm2. After reduction via inferior turbinoplasty, the MCA improved to 0.64 ± 0.04 cm2. This study suggests that turbinoplasty is helpful in addressing nasal obstruction. Out-fracture of the inferior turbinate is an effective and durable technique that can be easily performed to enlarge the nasal airway with minimal morbidity.

Perfecting the Outcome of Nasal Bone Fracture in the Pediatric Population With a Navigation System.

The trend of using navigation systems for treating facial bone fractures is increasing. Nevertheless, any detailed recommendation on using a navigation system to treat nasal bone fracture has never been discussed. Plastic surgeons are prone to do closed reduction of nasal bone fractures with remnant posttraumatic edema in the pediatric population. This study hypothesized that the navigation system benefits this population's treatment of nasal bone fractures. The authors evaluated the medical records, plain x-ray, and facial computed tomography scans of 44 pediatric patients (below the age of 18) with nasal bone fractures treated with a closed reduction from May 2021 to December 2022. Preoperative and postoperative computed tomography scan were used to assess the outcome. The average age for 44 pediatric nasal bone fracture patients was 10. Fifteen were female, while males were 29. All cases were successfully corrected clinically and radiologically without noticeable complications. Using navigation systems to correct nasal bone fractures provides additional benefits for the pediatric population. This technique is especially useful if the fracture is located at the junction between the nasal bone and nasal process of the maxilla and is combined with concurrent old nasal bone fractures.

Nasal Bone Fracture Reduction Under Local Anaesthesia: A Holistic Approach to Nasal Blocks and a Comparison with General Anaesthesia.

To compare the pain scores in closed reduction of nasal bone fractures under local anaesthesia (LA) and general anaesthesia (GA), and to outline the blocks that should be used for the same based on their nerve supply. A prospective study was conducted with 40 patients with Class 1 and 2 nasal bone and septal fracture. 20 patients underwent the procedure under LA and 20 under GA. The local blocks that should be used based on the complete nerve supply of the nose has been tabulated. Pain scores were recorded immediately after the procedure and 6h later. Additionally, all the patients undergoing reduction under LA were asked, if given the choice again, if they would prefer to undergo the procedure under LA or GA. The overall difference in the pain scores calculated by T-test showed a p-value of 0.08807 (the result was not significant at p < .05) in the immediate post operative period. At the 6h post operative period, overall difference in the pain scores showed a p-value of 0.384972 (not significant at p < .05). Of the patients who underwent the procedure under LA, 18 of 20 (90%) said that if given a choice again, they would undergo the procedure under LA, while 2 said they would prefer GA. Based on the pain score in the La vs. GA groups, there is no significant difference in the pain scores whether closed reduction is done under local or general anaesthesia. If all the blocks are given keeping the nerve supplies in mind, and both externally, and with pledgets, the entire nerve supply of the nose can be blocked.

Cosmetic Open Rhinoplasty in Acute Nasal Bone Fracture With Pre-Existing Deformity.

The simultaneous reduction of nasal bone fracture and cosmetic rhinoplasty is a challenging procedure, because of fracture severity and skeletal instability. Our aim was to investigate the surgical strategy and outcomes of cosmetic rhinoplasty according to the pre-existing nasal deformity when performing simultaneous reduction of nasal bone fracture and cosmetic rhinoplasty. In total, 71 patients who underwent cosmetic rhinoplasty were included. All patients were categorized according to pre-existing deformity, dorsal hump and irregularities, and deviation of the nose, wide nose, and flat nasal dorsum. The authors performed individual maneuvers to correct each deformity. Autologous tissue was used in all maneuvers for graft. Photoanalysis was performed to measure the deviation, nasal length, radix height, dorsal height, tip projection, nasofrontal angle, and nasolabial angle. Subjective evaluation of the functional and esthetic problems was confirmed through rhinoplasty outcome evaluation. In the analysis of the photographs, most patients presented improved scores ( P <0.05). The scores of satisfaction were significantly higher in the postoperative state ( P <0.05). As a postoperative complication, 2 cases of deviated tip occurred due to septal instability and were successfully revised with septoplasty and columellar strut graft. The authors created a harmonious face by evaluating, categorizing, and treating each deformity of the nose in patients with nasal fractures according to our algorithm.

Retrospective Analysis of Otorhinolaryngology Related Elective Surgeries Performed in a Tertiary Care Centre, North Kerala, India

Introduction: Due to a better understanding of the disease process, surgical workshops, conferences, and better patient awareness, the trend of Ear Nose Throat (ENT) related surgeries has changed significantly over the years. Aim: To analyse the profile of various ENT-related elective surgeries performed over three years in a tertiary care centre. Materials and Methods: This retrospective observational study was conducted in the Department of ENT, in a tertiary care centre, North Kerala, India. Patients of both sexes and of all age groups who underwent elective ENT surgeries in the Department from January 2017- December 2019 were included in the study. Data analysis was done from 1/12/2020 to 1/6/2021 period. Emergency surgeries were excluded from the study. Data was collected from hospital records and analysed using appropriate statistical methods. Results: A total of 2895 patients underwent various major and minor procedures in the period of January 2017 to December 2019 in the study institute. The majority of procedures were tympanomastoid surgeries (n=896, 30.94%), which were followed by sinonasal surgeries including advanced endoscopic surgeries (n=670, 23.14%), tonsilloadenoid surgeries (n=550, 18.98%) and excision of various solid and cystic lesions from head and neck region (n=310, 10.70%). The remaining number contributed by various other procedures like laryngeal surgeries (n=99, 3.4%) and other miscellaneous procedures (n=370, 12.78%) which include preauricular sinus excision, punch biopsies, tongue tie release, styloidectomy, excision of rhinosporidiosis from nose and nasopharynx, nasal bone fracture reduction and young’s operation. Conclusion: The most common elective procedures performed in the study period were tympanomastoid surgeries. In the present study, there was an increasing trend of all major and minor surgeries in the department in subsequent years.

Efficacy of closed reduction of nasal fractures—a retrospective analysis with focus on factors affecting functional and aesthetic outcomes

Nasal bone fractures are the most common type of facial bone fractures. While the nasal anatomy and closed reduction techniques of nasal fractures are well described, there is a paucity of data reporting on the need for revision rhinoplasty. The objective of this study is to analyze the factors affecting the outcome and need for revision rhinoplasty in patients who underwent closed reduction for nasal bone fracture. From 2010 to 2020, a total of 417 consecutive patients underwent closed nasal reduction. Medical files of the patients were reviewed retrospectively. The rate of rhinoplasty after fracture consolidation was determined. Factors influencing the need for revision rhinoplasty were assessed using univariable and multivariable logistic regression analyses. Forty-seven patients (11.3%) required revision rhinoplasty after fracture healing. Patients who had suffered an additional septum fracture were more likely to undergo rhinoplasty. The risk of the need for open revision rhinoplasty after fracture healing was increased for patients complaining of airway obstruction at the time of cast removal after closed reduction. A certain number of patients will require secondary revision rhinoplasty after closed reduction of a nasal fracture. Subjective airway obstruction at the time of cast removal after closed reduction is a predictor for revision rhinoplasty. Prospective studies are required to support the findings of this investigation.

ASSESSMENT OF POST- SURGICAL OUTCOME OF NASAL BONE FRACTURE REDUCTION

INTRODUCTION: Nose is most commonly injured structure in facial fractures. Depending on its mode of injury, it can be of communited or non-communited fracture. Most of the non communited fractures require closed reduction. AIM:To determine post-surgical outcome of closed reduction of nasal bone fracture, based on cosmetic and functional results. STUDYDESIGN: Prospective analytical study MATERIALS AND METHODS: A Prospective study in patients with nasal bone fracture, who underwent closed surgical reduction between June 2017 to December 2019. Patients were followed for a period of 2 months to assess the outcome of cosmetic and functional aspects. RESULTS: Out of 42 patients, 41 were satised in terms of cosmetic aspect, 41 were satised in term with functional aspects. CONCLUSION: Patients treated with closed surgical reduction had highly satisfactory functional and cosmetic outcome

Comparison of the Efficacy of Ivalon® Nasal Pack and Ribbon Gauze Pack Following Nasal Surgeries- A Randomised Clinical Trial

Introduction: Nasal bleeding is one of the Ear, Nose and Throat (ENT) emergencies which are usually managed by the Hippocratic maneuver. Anterior nasal packing is unavoidable after nasal surgeries and refractory anterior nasal bleeding. There are wide variety of newer nasal packs available and easily acceptable by the patients. The most commonly used nasal packs in day to day practices are Ivalon® and vaseline soaked ribbon gauze pack. Aim: To compare the difference between Ivalon® nasal pack with a traditional ribbon gauze pack in terms of efficacy, feasibility, patient comfort, cost and need for repacking postremoval in patients undergoing nasal surgeries. Materials and Methods: This randomised clinical trial involved 144 patients who required nasal packing after nasal surgeries, like septoplasty, Functional Endoscopic Sinus Surgery (FESS) and nasal bone fracture reduction in the Department of ENT, Head and Neck surgery at a Tertiary Care Centre, Chennai, India. Patients were categorised into two groups- Ribbon gauze group and Ivalon® group. The patient’s comfort was quantified based on nasal discharge, pain on removing the pack, stuffiness of the nose, and irritability were compared. After pack removal, mucosal oedema, congestion, and synechiae formation were assessed by using a diagnostic nasal endoscopy after 1 week. Results: Out of 144 patients, in Ivalon® group, 37 (51.4%) were males and 35 (48.6%) were females. The incidence of nasal symptoms with nasal surgery i.e nasal discharge was significantly higher in the ribbon gauze packing group (68.1%) compared to Ivalon® pack (31.9%) (p-value=0.044). Pain on pack removal was also more in the former (76.4%) compared to Ivalon® group (23.6%) which were statistically significant (p-value=0.005). Pain on pack removal was significantly more in the former (76.4%) compared to Ivalon® group (23.6%). Other symptoms like anxiety, discomfort, stuffiness, local irritation, and congestion were lesser in the Ivalon® group. Mucosal oedema was higher in ribbon gauze group (59.7%) compared to Ivalon® pack (40.3%) which was statistically significant (p-value= 0.019). Conclusion: As a postnasal surgery pack, Ivalon® pack is a better option due to less pain, anxiety, stuffiness, local irritation, congestion, synechiae formation and gives better comfort when compared to the ribbon gauze packs.

Antibiotic use in nasal bone fracture: a single-center retrospective study.

BackgroundProphylactic antibiotics are used to prevent surgical wound infection; however, proper indications must be followed with careful consideration of the risks and benefits, especially in clean or clean-contaminated wounds. Nasal bone fractures are the most common type of facial bone fracture. The most common method for treating nasal bone fracture is closed reduction, which is performed inside the nasal cavity without an incision. The purpose of this study was to determine the need for antibiotic use in the closed reduction of nasal bone fractures.MethodsA retrospective study was conducted using data from the National Insurance Service Ilsan Hospital of the Republic of Korea between 2016 and 2018. The records of patients who underwent closed reduction of nasal bone fracture were reviewed and classified according to sex, age, comorbidities, perioperative antibiotic usage, postoperative complications, nasal packing, anesthesia type, surgeon’s specialty, and operation time.ResultsAmong the 373 patients studied, the antibiotic prescription rate was 67.3%. Just 0.8% of patients were prescribed preoperative antibiotics only, 44.0% were prescribed postoperative antibiotics only, and 22.5% were prescribed both preoperative and postoperative antibiotics. There were no cases that satisfied the definition of “surgical site infection.” Furthermore, 2.1% of infection-related complications (e.g., mucosal swelling, synechia, and anosmia) occurred only in the antibiotic usage group. The use of nasal packing, anesthesia type, and surgeon’s specialty did not show any difference in infection-related complication rates.ConclusionAccording to the study findings, the routine use of perioperative antibiotics is not recommended in uncomplicated nasal bone fracture surgery.

Antibiotic use in nasal bone fracture: a nationwide population-based cohort study in Korea.

BackgroundProphylactic antibiotics are commonly used in craniofacial surgeries. Despite the low risk of surgical site infection after nasal surgery, a lack of consensus regarding the use of antibiotic prophylaxis in the closed reduction of nasal bone fractures has led to inappropriate prescribing patterns. Through this study, we aimed to investigate the status of prophylactic antibiotic use in closed reductions of nasal bone fractures in Korea.MethodsThis retrospective cohort study was conducted using data from the National Health Insurance Service-National Sample Cohort of Korea from 2005 to 2015. We analyzed the medical records of patients who underwent closed reduction of nasal bone fractures. The sex, age, region of residence, comorbidities, and socioeconomic variables of the patients were collected from the database. Factors that affect the prescription of perioperative antibiotics were evaluated using multivariate logistic regression analysis.ResultsA total of 3,678 patients (mean± standard deviation of age, 28.7± 14.9 years; 2,850 men [77.5%]; 828 women [22.5%]) were included in this study. The rate of antibiotic prescription during the perioperative period was 51.4%. Approximately 68.8% of prescriptions were written for patients who had received general anesthesia. The odds of perioperative prophylactic antibiotic use were significantly higher in patients who received general anesthesia than who received local anesthesia (odds ratio, 1.59). No difference was found in terms of patient age and physician specialty. Second-generation cephalosporins were the most commonly prescribed antibiotic (45.3%), followed by third- and first-generation cephalosporins (20.3% and 18.8%, respectively). In contrast, lincomycin derivatives and aminoglycosides were not prescribed.ConclusionThe findings of this study showed that there was a wide variety of perioperative antibiotic prescription patterns used in nasal bone surgeries. Evidence-based guidance regarding the prescribing of antimicrobial agents for the closed reduction of nasal bone fractures should be considered in future research.

Overcorrection of Nasal Bone Fracture Reduction Can Be Minimized by Packing Removal.

We experienced 16 cases of overcorrection among 524 cases of packing following nasal bone fracture (NBF) reduction. In these cases, the packing was removed immediately.From July 2017 to October 2020, 535 cases of NBF were reduced by closed reduction. Nasal packing was applied in 524 cases (97.9%). In all cases, postoperative X-rays (both nasal bone lateral view and Water's view) were taken. The degree of overcorrection was measured in the nasal bone lateral views.Among the 524 patients who underwent nasal packing, overcorrection was noted in 16 cases (3.1%). The average degree of overcorrection was 2.09 ± 0.70 mm. In these patients, the packing was removed immediately and X-rays were taken directly after packing removal. The degree of overcorrection decreased; however, no significant difference was found (1.83 ± 0.71 mm, P = 0.081, [paired t test]).In this study, overcorrection was noted in 3.1% of patients in whom nasal packing was applied. After packing removal, the degree of overcorrection decreased but was not significant. Postoperative X-rays should be taken after reduction of NBF and nasal packing, and if overcorrection is noticed, the packing should be removed immediately.

Incidence, evaluation and management of nasal bone fracture: study of 60 cases

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; It was retrospective and prospective study of 60 nasal bone fracture patients we treated at our hospital. We analyzed them for their age and sex incidence, side prevalance, presentation and their treatment option.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; Through history was taken and examination was done and these cases were investigated with CT scan or X-ray than treated period.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Most common involved patients were males (73%) than the females (27%). In our study, most common cause of nasal bone fracture was the road traffic accident (59%) and less common cause of nasal bone fracture was assaulted trauma. Most commonly done about 60% radiological investigation were only X-ray bilateral nasal bone. In this study fracture bone reduction was done under local anesthesia or sedation in 87% of patients and general anesthesia in 13% of patients. Most commonly affected patients of nasal bone fracture had lateral impact injury (70%) than the frontal impact injury. We treated 77% patients of nasal bone fracture by closed reduction and the patients with linear non-displaced nasal bone fracture by medication.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Male were more affected than the female and common age group was 11 to 30 years. Most common cause of nasal bone fracture was the road traffic accident. In nasal bone fracture the lateral impact injury was more common, in treatment of nasal bone fracture simple nasal X-ray were useful tool for management of nasal bone fracture. Closed nasal bone fracture reduction did under local anesthesia in most of patients.&lt;/p&gt;

Precisely Closed Reduction of Nasal Bone Fracture Assisted With Plain Film Measurements Under the Picture Archiving and Communication System.

To prevent aesthetic and functional deformities, precisely closed reduction is crucial in the management of nasal fractures. Plain film radiography (PF), ultrasonography (USG), and computed tomography can help confirm the diagnosis and classification of fractures and assist in performing closed reduction. However, no study in the literature reports on precisely closed reduction assisted with PF measurements under the picture archiving and communication system (PACS). We retrospectively evaluated 153 patients with nasal bone fracture between January 2013 and December 2017. Surgeons conducted precisely closed reduction assisted with PF measurement of the distance between the fracture site and nasal tip under PACS on 34 patients (group A). Another group on 119 patients were reduced under surgeon's experience (group B). No significant differences in age, gender, Arbeitsgemeinschaft fur Osteosynthesefragen (AO) classification, and reduction outcome were observed between group A and group B (P > .05). The operative time of the group A was significantly lower (12.50 ± 4.64 minutes) compared to group B (23.78 ± 11.20 minutes; P < .001). After adjusted age, gender, and AO classification, patients in group A scored 10.46 minutes less on the operative time than those in group B (P < .001). In addition, the severity of nasal bone fracture (AO classification, β = 3.37, P = .002) was positive associated with the operative time. In this study, closed reduction in nasal bone fracture assisted with PF measurements under PACS was performed precisely, thereby effectively decreasing operative time and the occurrence of complications. This procedure requires neither the use of new instruments or C-arm nor USG or navigation experience. Moreover, reduction can be easily performed using this method, and it requires short operative time, helps achieve great reduction, less radiation exposures, and is cost-effective.

Simultaneous Use of Bioabsorbable and Nonbioabsorbable Packing Materials During Closed Reduction of a Nasal Bone Fractures.

The nasal packing material after closed reduction of nasal bone fracture may be bioabsorbable or nonbioabsorbable. To investigate the usefulness of the packing method using bioabsorbable and nonbioabsorbable materials simultaneously, a chart review was retrospectively performed involving 255 patients. Group A (n = 119), Nasopore (bioabsorbable) was cut appropriately and packed, and subsequently, supportive packing with Merocel (nonbioabsorbable) was performed. Group B (n = 78), nasal packing was performed with Vaseline roll gauze. Group C (n = 49), packed only Merocel. Pain and rhinorrhea were significantly lower in Merocel + Nasopore group (P < 0.05). It is thought that rhinorrhea is reduced by less mucosal irritation and maximizing the discharge absorption capacity by using Merocel and Nasopore simultaneously. By packing Nasopore first, pain is thought to be reduced by reducing the contact surface between Merocel and the injured mucosa and preventing a direct force to the fracture site. Therefore, our packing method, which uses Merocel and Nasopore simultaneously, can be recommended because it can provide sufficient support for the reduced fracture site, cause less pain, and maximize discharge absorption.