Facial Plast Surg 2019; 35(06): 590-601
DOI: 10.1055/s-0039-1700801
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Nasal Fractures: The Role of Primary Reduction and Secondary Revision

1  Department of Otolaryngology, University of Rochester Medical Center, Rochester, New York
Thomas Lee
2  Department of Otolaryngology, Howard Hughes Medical Institute, Virginia Commonwealth University School of Medicine, Richmond, Virginia
Scott Kohlert
3  Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, Texas
Sameep Kadakia
4  Department of Surgery, Wright State University, Dayton, Ohio
Yadranko Ducic
3  Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, Texas
› Author Affiliations
Further Information

Publication History

Publication Date:
29 November 2019 (online)


The nasal bones are among the most commonly fractured bones in the facial skeleton. Proper management of nasal trauma acutely is important in minimizing secondary deformities and impaired function with nasal airway obstruction. Septal hematoma, if present, should be drained right away. Acutely closed nasal reduction and limited septoplasty can be performed. Unrecognized septal fracture may play a role in the failure of closed nasal reduction of fractured nasal bones. Complex nasoorbitoethmoid fractures are approached openly and treated with rigid fixation. Primary use of open rhinoplasty in an acute setting is debated, and there are no clearly accepted indications for timing, patient selection, and surgical technique. However, open septorhinoplasty is more commonly used in a delayed fashion to provide definitive correction of any residual cosmetic or functional problems. Recent algorithms provide a systematic approach to nasal trauma and may improve secondary deformity rates following closed reduction.