Semin Plast Surg 2010; 24(4): 339-347
DOI: 10.1055/s-0030-1269763
© Thieme Medical Publishers

Evaluation and Reduction of Nasal Trauma

Brian P. Kelley1 , Cara R. Downey1 , Samuel Stal1
  • 1Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas
Further Information

Publication History

Publication Date:
29 December 2010 (online)

ABSTRACT

Nasal trauma plays a large and important role in the field of craniofacial trauma. The resulting aesthetic, structural, and functional sequelae associated with these injuries necessitate a thorough understanding of the topic. This includes an appreciation for the unique anatomic features of the region, the important aspects of the initial history and examination, nasal injury classification, and subsequent treatment timing and options. While a large body of literature has accumulated on the topic, the purpose of this article is to focus on both clinically relevant information and pearls of management. Additionally, age-specific concerns, secondary procedures, and nasal fracture grafting, will be addressed as well.

REFERENCES

  • 1 Renner G J. Management of nasal fractures.  Otolaryngol Clin North Am. 1991;  24 195-213
  • 2 Dingman R O, Natvig P. The nose. In: Natvig P, ed. Surgery of Facial Fractures. Philadelphia, PA: Saunders; 1969: 267
  • 3 Murray J A, Maran A G. The treatment of nasal injuries by manipulation.  J Laryngol Otol. 1980;  94 1405-1410
  • 4 Crowther J A, O'Donoghue G M. The broken nose: does familiarity breed neglect?.  Ann R Coll Surg Engl. 1987;  69 259-260
  • 5 Waldron J, Mitchell D B, Ford G. Reduction of fractured nasal bones; local versus general anaesthesia.  Clin Otolaryngol Allied Sci. 1989;  14 357-359
  • 6 Bailey B J, Tan L KS. Nasal and frontal sinus fractures. In: Bailey B J, ed. Head and Neck Surgery–Otolaryngology. 2nd ed. Philadelphia, PA: Lippincott-Raven; 1998: 1007-1031
  • 7 Azevedo A B, Trent R B, Ellis A. Population-based analysis of 10,766 hospitalizations for mandibular fractures in California, 1991 to 1993.  J Trauma. 1998;  45 1084-1087
  • 8 Anderson P J. Fractures of the facial skeleton in children.  Injury. 1995;  26 47-50
  • 9 Türegün M C, Zins J E. Maxillofacial fractures in weightlifters: a report of two cases.  J Oral Maxillofac Surg. 1999;  57 626-628
  • 10 Perkins S W, Dayan S H, Sklarew E C, Hamilton M, Bussell G S. The incidence of sports-related facial trauma in children.  Ear Nose Throat J. 2000;  79 632-634, 636, 638
  • 11 Canty P A, Berkowitz R G. Hematoma and abscess of the nasal septum in children.  Arch Otolaryngol Head Neck Surg. 1996;  122 1373-1376
  • 12 Fry H. Nasal skeletal trauma and the interlocked stresses of the nasal septal cartilage.  Br J Plast Surg. 1967;  20 146-158
  • 13 Vora N M, Fedok F G. Management of the central nasal support complex in naso-orbital ethmoid fractures.  Facial Plast Surg. 2000;  16 181-191
  • 14 Verwoerd C D. Present day treatment of nasal fractures: closed versus open reduction.  Facial Plast Surg. 1992;  8 220-223
  • 15 Rohrich R J, Adams Jr W P. Nasal fracture management: minimizing secondary nasal deformities.  Plast Reconstr Surg. 2000;  106 266-273
  • 16 Higuera S, Lee E I, Cole P, Hollier Jr L H, Stal S. Nasal trauma and the deviated nose.  Plast Reconstr Surg. 2007;  120 (7, Suppl 2) 64S-75S
  • 17 Cox III A J. Nasal fractures—the details.  Facial Plast Surg. 2000;  16 87-94
  • 18 Murray J A. Management of septal deviation with nasal fractures.  Facial Plast Surg. 1989;  6 88-94
  • 19 Murray J A, Maran A G, Busuttil A, Vaughan G. A pathological classification of nasal fractures.  Injury. 1986;  17 338-344
  • 20 Olsen K D, Carpenter III R J, Kern E B. Nasal septal injury in children. Diagnosis and management.  Arch Otolaryngol. 1980;  106 317-320
  • 21 Hinderer K H. Nasal problems in children.  Pediatr Ann. 1976;  5 499-509
  • 22 Hatef D A, Cole P D, Hollier Jr L H. Contemporary management of pediatric facial trauma.  Curr Opin Otolaryngol Head Neck Surg. 2009;  17 308-314
  • 23 Stal S. Septal deviation and correction of the crooked nose. In: Daniel R K, ed. Aesthetic Plastic Surgery Rhinoplasty. Boston, MA: Little, Brown; 1993: 723-737
  • 24 Logan M, O'Driscoll K, Masterson J. The utility of nasal bone radiographs in nasal trauma.  Clin Radiol. 1994;  49 192-194
  • 25 Stranc M F, Robertson G A. A classification of injuries of the nasal skeleton.  Ann Plast Surg. 1979;  2 468-474
  • 26 Verwoerd C D, Verwoerd-Verhoef H L. Rhinosurgery in children: basic concepts.  Facial Plast Surg. 2007;  23 219-230
  • 27 Cook J A, McRae R D, Irving R M, Dowie L N. A randomized comparison of manipulation of the fractured nose under local and general anaesthesia.  Clin Otolaryngol Allied Sci. 1990;  15 343-346
  • 28 Watson D J, Parker A J, Slack R W, Griffiths M V. Local versus general anaesthetic in the management of the fractured nose.  Clin Otolaryngol Allied Sci. 1988;  13 491-494
  • 29 Wang T D, Facer G W, Kern E B. Nasal fractures. In: Gates G A, ed. Current Therapy in Otolaryngology: Head and Neck Surgery. Philadelphia, PA: B. C. Decker; 1990: 105-109
  • 30 Cook J A, Murrant N J, Evans K, Lavelle R J. Manipulation of the fractured nose under local anaesthesia.  Clin Otolaryngol Allied Sci. 1992;  17 337-340
  • 31 Anderson J R. A personal technique of rhinoplasty.  Otolaryngol Clin North Am. 1975;  8 559-562
  • 32 Converse J M. Corrective surgery of nasal deviations.  AMA Arch Otolaryngol. 1950;  52 671-708
  • 33 Goodman W S. External approach to rhinoplasty.  Can J Otolaryngol. 1973;  2 207-210
  • 34 Doyle D E, House L F, Hall W P. Description of a new device: an intranasal airway/splint.  Laryngoscope. 1977;  87 (4 Pt 1) 608-612
  • 35 Repanos C, McDonald S E, Sadr A H. A survey of postoperative nasal packing among UK ENT surgeons.  Eur Arch Otorhinolaryngol. 2009;  266 1575-1577
  • 36 Fairbanks D N. Complications of nasal packing.  Otolaryngol Head Neck Surg. 1986;  94 412-415
  • 37 Stucker F J, Ansel D G. A case against nasal packing.  Laryngoscope. 1978;  88 (8 Pt 1) 1314-1317

Samuel StalM.D. 

Professor and Chief, Division of Plastic Surgery

Baylor College of Medicine, 6621 Fannin Street, Houston, TX 77030

Email: sstal@bcm.edu