Acute Management of Nasal Bone Fractures: A Systematic Review and Practice Management Guideline.

Journal: The American surgeon
Published Date:

Abstract

Nasal bone fractures represent the most common facial skeletal injury, challenging both function and aesthetics. This Preferred Reporting Items for Systematic Reviews and Meta-Analyses-based review analyzed 23 studies published within the past 5 years, selected from 998 records retrieved from PubMed, Embase, and Web of Science. Data from 1780 participants were extracted, focusing on diagnostic methods, surgical techniques, anesthesia protocols, and long-term outcomes. Ultrasound and artificial intelligence-based algorithms improved diagnostic accuracy, while telephone triage streamlined necessary encounters. Navigation-assisted reduction, ballooning, and septal reduction with polydioxanone plates improved outcomes. Anesthetic approaches ranged from local nerve blocks to general anesthesia with intraoperative administration of lidocaine, alongside techniques to manage pain from nasal pack removal postoperatively. Long-term follow-up demonstrated improved quality of life, breathing function, and aesthetic satisfaction with timely and individualized treatment. This review highlights the trend toward personalized, technology-assisted approaches in nasal fracture management, highlighting areas for future research.

Authors

  • Ethan D Paliwoda
    Division of Plastic Surgery, Department of Surgery, Albany Medical Center, Albany, NY, USA.
  • Harry Newman-Plotnick
    Division of Plastic Surgery, Department of Surgery, Albany Medical Center, Albany, NY, USA.
  • Anthony J Buzzetta
    Division of Trauma and Surgical Critical Care, Department of Surgery, Albany Medical Center, Albany, NY, USA.
  • Nicole K Post
    Division of Trauma and Surgical Critical Care, Department of Surgery, Albany Medical Center, Albany, NY, USA.
  • Justin R LaClair
    Department of Otolaryngology-Head and Neck Surgery, Albany Medical Center, Albany, NY, USA.
  • Mathew Trandafirescu
    Division of Plastic Surgery, Department of Surgery, Albany Medical Center, Albany, NY, USA.
  • Neil Gildener-Leapman
    Division of Otolaryngology Head and Neck Surgery, Albany Medical College, Albany, NY, 12208, USA.
  • Dzifa S Kpodzo
    Division of Plastic Surgery, Department of Surgery, Albany Medical Center, Albany, NY, USA.
  • Kurt Edwards
    Division of Trauma and Surgical Critical Care, Department of Surgery, Albany Medical Center, Albany, NY, USA.
  • Marcel Tafen
    Division of Trauma and Surgical Critical Care, Department of Surgery, Albany Medical Center, Albany, NY, USA.
  • Benjamin J Schalet
    Division of Plastic Surgery, Department of Surgery, Albany Medical Center, Albany, NY, USA.

Keywords

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