Facial Plast Surg 2023; 39(06): 630-637
DOI: 10.1055/a-2152-8670
Original Article

The Management of Posttraumatic Nasal Deformities

W. Katherine Kao
1   Department of Otolaryngology, University of Texas Health Science Center at Houston, Houston, Texas
,
Tang Ho
1   Department of Otolaryngology, University of Texas Health Science Center at Houston, Houston, Texas
› Author Affiliations
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Abstract

Nasal bone fractures are the most common fractures of the facial skeleton and are often accompanied by bony, cartilaginous, and soft tissue injuries. These injuries are often complex, and when untreated or inadequately treated, can lead to posttraumatic nasal deformity. The most common deformities are the crooked nose and the saddle nose. Both deformities may result in significant cosmetic and functional concerns. The treatment of these deformities can be complex, requiring careful evaluation of the nose and thoughtful planning to correct the cosmetic deformity and restore functional integrity. The rhinoplasty surgeon will benefit from having a large repertoire of techniques to achieve these repairs. In this article, we discuss the options and concepts for the management of nasal bone fractures as well as complicated posttraumatic nasal deformity. Level of evidence is not available.

Keywords

posttraumatic nasal deformity - rhinoplasty - nasal bone fracture


Publication History

Accepted Manuscript online:
11 August 2023

Article published online:
14 September 2023

© 2023. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Basheeth N, Donnelly M, David S, Munish S. Acute nasal fracture management: a prospective study and literature review. Laryngoscope 2015; 125 (12) 2677-2684
    CrossrefPubMedGoogle Scholar
  • 2 Kucik CJ, Clenney T, Phelan J. Management of acute nasal fractures. Am Fam Physician 2004; 70 (07) 1315-1320
    PubMedGoogle Scholar
  • 3 Dong SX, Shah N, Gupta A. Epidemiology of nasal bone fractures. Facial Plast Surg Aesthet Med 2022; 24 (01) 27-33
    CrossrefPubMedGoogle Scholar
  • 4 Maliniac J. Rhinoplasty and Restoration of Facial Contour: With Specific Reference to Trauma. Boca Raton, FL: FA Davis; 1947
    Google Scholar
  • 5 Rohrich RJ, Adams WPJ, Ahmad J, Gunter JP. Dallas Rhinoplasty: Nasal Surgery by the Masters. Whitefish, MT: CRC Press; 2014
    Google Scholar
  • 6 Mondin V, Rinaldo A, Ferlito A. Management of nasal bone fractures. Am J Otolaryngol 2005; 26 (03) 181-185
    CrossrefPubMedGoogle Scholar
  • 7 Kurihara K, Kim K. Open reduction and interfragment wire fixation of comminuted nasal fractures. Ann Plast Surg 1990; 24 (02) 179-185
    CrossrefPubMedGoogle Scholar
  • 8 Yilmaz MS, Guven M, Varli AF. Nasal fractures: is closed reduction satisfying?. J Craniofac Surg 2013; 24 (01) e36-e38
    CrossrefPubMedGoogle Scholar
  • 9 Crowther JA, O'Donoghue GM. The broken nose: does familiarity breed neglect?. Ann R Coll Surg Engl 1987; 69 (06) 259-260
    PubMedGoogle Scholar
  • 10 Murray JA, Maran AG. The treatment of nasal injuries by manipulation. J Laryngol Otol 1980; 94 (12) 1405-1410
    CrossrefPubMedGoogle Scholar
  • 11 Murray JA, Maran AG, Mackenzie IJ, Raab G. Open v closed reduction of the fractured nose. Arch Otolaryngol 1984; 110 (12) 797-802
    CrossrefPubMedGoogle Scholar
  • 12 Renner GJ. Management of nasal fractures. Otolaryngol Clin North Am 1991; 24 (01) 195-213
    CrossrefPubMedGoogle Scholar
  • 13 Pollock RA. Nasal trauma. Pathomechanics and surgical management of acute injuries. Clin Plast Surg 1992; 19 (01) 133-147
    PubMedGoogle Scholar
  • 14 Harrison DH. Nasal injuries: their pathogenesis and treatment. Br J Plast Surg 1979; 32 (01) 57-64
    CrossrefPubMedGoogle Scholar
  • 15 Hester TO, Campbell JP. Diagnosis and management of nasal trauma for primary care physicians. J Ky Med Assoc 1997; 95 (09) 386-392
    PubMedGoogle Scholar
  • 16 Rubinstein B, Strong EB. Management of nasal fractures. Arch Fam Med 2000; 9 (08) 738-742
    CrossrefPubMedGoogle Scholar
  • 17 Rohrich RJ, Adams Jr WP. Nasal fracture management: minimizing secondary nasal deformities. Plast Reconstr Surg 2000; 106 (02) 266-273
    CrossrefPubMedGoogle Scholar
  • 18 Ridder GJ, Boedeker CC, Fradis M, Schipper J. Technique and timing for closed reduction of isolated nasal fractures: a retrospective study. Ear Nose Throat J 2002; 81 (01) 49-54
    CrossrefPubMedGoogle Scholar
  • 19 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 (04) 343-346
    CrossrefPubMedGoogle Scholar
  • 20 Waldron J, Mitchell DB, Ford G. Reduction of fractured nasal bones; local versus general anaesthesia. Clin Otolaryngol Allied Sci 1989; 14 (04) 357-359
    CrossrefPubMedGoogle Scholar
  • 21 Watson DJ, Parker AJ, Slack RW, Griffiths MV. Local versus general anaesthetic in the management of the fractured nose. Clin Otolaryngol Allied Sci 1988; 13 (06) 491-494
    CrossrefPubMedGoogle Scholar
  • 22 Fernandes SV. Nasal fractures: the taming of the shrewd. Laryngoscope 2004; 114 (03) 587-592
    CrossrefPubMedGoogle Scholar
  • 23 Rengaraja D, Jagade M, Kale V. et al. As the nasal spine goes, so goes the septum. J Clin Diagn Res 2016; 10 (11) MC04-MC06
    PubMedGoogle Scholar
  • 24 Parsa FD. Intraoral versus intranasal approach to lateral osteotomy. Plast Reconstr Surg 1992; 90 (02) 341
    CrossrefPubMedGoogle Scholar
  • 25 Gryskiewicz JM, Gryskiewicz KM. Nasal osteotomies: a clinical comparison of the perforating methods versus the continuous technique. Plast Reconstr Surg 2004; 113 (05) 1445-1456 , discussion 1457–1458
    Google Scholar
  • 26 Rohrich RJ, Minoli JJ, Adams WP, Hollier LH. The lateral nasal osteotomy in rhinoplasty: an anatomic endoscopic comparison of the external versus the internal approach. Plast Reconstr Surg 1997; 99 (05) 1309-1312 , discussion 1313
    CrossrefPubMedGoogle Scholar
  • 27 Kim DW, Toriumi DM. Management of posttraumatic nasal deformities: the crooked nose and the saddle nose. Facial Plast Surg Clin North Am 2004; 12 (01) 111-132
    CrossrefPubMedGoogle Scholar
  • 28 Paul MA, Kamali P, Chen AD. et al. Assessment of functional rhinoplasty with spreader grafting using acoustic rhinomanometry and validated outcome measurements. Plast Reconstr Surg Glob Open 2018; 6 (03) e1615
    CrossrefPubMedGoogle Scholar
  • 29 Sadooghi M, Ghazizadeh M. Extended osteocartilaginous spreader graft for reconstruction of deviated nose. Otolaryngol Head Neck Surg 2012; 146 (05) 712-715
    CrossrefPubMedGoogle Scholar
  • 30 Kim MH, Choi JH, Kim MS, Kim SK, Lee KC. An introduction to the septal extension graft. Arch Plast Surg 2014; 41 (01) 29-34
    Article in Thieme ConnectPubMedGoogle Scholar
  • 31 Swanepoel PF, Fysh R. Laminated dorsal beam graft to eliminate postoperative twisting complications. Arch Facial Plast Surg 2007; 9 (04) 285-289
    CrossrefPubMedGoogle Scholar
  • 32 Kim DW, Shah AR, Toriumi DM. Concentric and eccentric carved costal cartilage: a comparison of warping. Arch Facial Plast Surg 2006; 8 (01) 42-46
    CrossrefPubMedGoogle Scholar
  • 33 Erol OO. The Turkish delight: a pliable graft for rhinoplasty. Plast Reconstr Surg 2000; 105 (06) 2229-2241 , discussion 2242–2243
    CrossrefPubMedGoogle Scholar
  • 34 Daniel RK, Calvert JW. Diced cartilage grafts in rhinoplasty surgery. Plast Reconstr Surg 2004; 113 (07) 2156-2171
    CrossrefPubMedGoogle Scholar
  • 35 Calvert JW, Brenner K, DaCosta-Iyer M, Evans GR, Daniel RK. Histological analysis of human diced cartilage grafts. Plast Reconstr Surg 2006; 118 (01) 230-236
    CrossrefPubMedGoogle Scholar
  • 36 Heidari MB, Rasti M, Nadri S, Roozbehani A, Farhang Fallah A, Mahmoudvand H. Comparison between wrapping dice cartilage with temporal fascia and wrapping in alloderm for dorsal nasal augmentation. World J Plast Surg 2020; 9 (02) 160-165
    CrossrefPubMedGoogle Scholar
  • 37 Tasman AJ, Diener PA, Litschel R. The diced cartilage glue graft for nasal augmentation. Morphometric evidence of longevity. JAMA Facial Plast Surg 2013; 15 (02) 86-94
    CrossrefPubMedGoogle Scholar