Current management techniques for acute nasal fractures result in a high incidence of posttraumatic nasal deformity (14 to 50 percent). Associated traumatic edema, preexisting nasal deformity, and occult septal injury account for most of these acute reduction failures. Working with a detailed patient history and a physical examination that included rigid nasal endoscopy, the authors formulated a clinical algorithm for acute nasal fracture management, the use of which can reduce the incidence of posttraumatic nasal deformity. In this article, the authors review the literature, then discuss their management techniques over the past 11 years in 110 cases with a 9 percent nasal revision rate. This low incidence of revision is attributed to complete nasal assessment (bony and septum), use of outpatient controlled general anesthesia, and primary septal reconstruction in cases with severe septal fracture dislocation.
Received for publication June 10, 1999;
revised November 22, 1999.
Rod J. Rohrich, M.D. Department of Plastic and Reconstructive Surgery University of Texas Southwestern Medical Center 5323 Harry Hines Blvd., Suite E7-210 Dallas, Texas 75235-9132 firstname.lastname@example.org