Featured Research

from universities, journals, and other organizations

Study Examines Treatment And Outcomes For Nasal Fractures

Date:
September 21, 2009
Source:
JAMA and Archives Journals
Summary:
Both minimally invasive and traditional open approaches can successfully repair nasal fractures, provided the procedure is matched to the individual fracture, according to a new report. A treatment algorithm based on factors such as fracture type and degree of septal deviation (displacement of the bone and cartilage separating nostrils) may help surgeons choose the appropriate treatment.

Both minimally invasive and traditional open approaches can successfully repair nasal fractures, provided the procedure is matched to the individual fracture, according to a report in the September/October issue of Archives of Facial Plastic Surgery, one of the JAMA/Archives journals. A treatment algorithm based on factors such as fracture type and degree of septal deviation (displacement of the bone and cartilage separating nostrils) may help surgeons choose the appropriate treatment.

Nasal fractures are common, but treatment of these injuries remains controversial among surgeons, according to background information in the article. Some recommend no intervention at all, whereas others favor extensive open surgery using rhinoplasty techniques. Treatment is typically divided into closed reduction (minimally invasive repair) or open reduction techniques. "Closed reduction is a relatively simple procedure, at times producing acceptable outcomes," the authors write. "However, advocates of open reduction purport better cosmetic results and a high likelihood that closed reductions will eventually need a second operation using an open reduction technique."

"Deciding which technique to use for a given nasal fracture can be challenging. Not all fractures can be treated using closed techniques and, conversely, not all fractures require the time and expense of an open reduction," they continue. Michael P. Ondik, M.D., and colleagues at Penn State Hershey Medical Center, Hershey, Pa., studied 86 patients who received treatment for nasal fractures (41 who had closed treatments and 45 who had open treatments) at the facility between 1997 and 2007. Fractures were classified as one of five types, revision rates were calculated for each group, pre- and post-operative photographs were rated and available patients were interviewed about aesthetic, functional and quality of life issues.

The revision rate for all fractures was 6 percent, including 2 percent for closed treatment and 9 percent for open treatment. Many closed treatment cases were classified as type II fractures, or simple fractures that included septal deviation, whereas most open treatment cases were classified as type IV fractures (severely deviated nasal and septal fractures). "There was no statistical difference in revision rate, patient satisfaction or surgeon photographic evaluation scores between the closed and open treatment groups when fractures were treated in the recommended fashion," the authors write.

A treatment algorithm that considers fracture type, whether the fracture is impacted (in which bone fragments are wedged together) or incomplete, the degree of septal deviation and whether previous treatments have failed could help surgeons determine the best approach to each individual fracture, the authors note.

"A successful management algorithm should provide each patient with an aesthetically and functionally superior repair, leaving the most invasive repairs for only those patients who require it and allowing simple fractures to be managed relatively conservatively. Our results validate this approach and effectively 'even out' the outcomes between the open and closed groups," they conclude. "We believe that our classification system and management algorithm represent a new paradigm in nasal fracture management."


Story Source:

The above story is based on materials provided by JAMA and Archives Journals. Note: Materials may be edited for content and length.


Journal Reference:

  1. Michael P. Ondik; Lindsay Lipinski; Seper Dezfoli; Fred G. Fedok. The Treatment of Nasal Fractures: A Changing Paradigm. Arch Facial Plast Surg, 2009; 11 (5): 296-302 [link]

Cite This Page:

JAMA and Archives Journals. "Study Examines Treatment And Outcomes For Nasal Fractures." ScienceDaily. ScienceDaily, 21 September 2009. <www.sciencedaily.com/releases/2009/09/090921161809.htm>.
JAMA and Archives Journals. (2009, September 21). Study Examines Treatment And Outcomes For Nasal Fractures. ScienceDaily. Retrieved October 21, 2014 from www.sciencedaily.com/releases/2009/09/090921161809.htm
JAMA and Archives Journals. "Study Examines Treatment And Outcomes For Nasal Fractures." ScienceDaily. www.sciencedaily.com/releases/2009/09/090921161809.htm (accessed October 21, 2014).

Share This



More Health & Medicine News

Tuesday, October 21, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

How Nigeria Beat Its Ebola Outbreak

How Nigeria Beat Its Ebola Outbreak

Newsy (Oct. 20, 2014) The World Health Organization has declared Nigeria free of Ebola. Health experts credit a bit of luck and the government's initial response. Video provided by Newsy
Powered by NewsLook.com
Another Study Suggests Viagra Is Good For The Heart

Another Study Suggests Viagra Is Good For The Heart

Newsy (Oct. 20, 2014) An ingredient in erectile-dysfunction medications such as Viagra could improve heart function. Perhaps not surprising, given Viagra's history. Video provided by Newsy
Powered by NewsLook.com
Ebola Worries End for Dozens on U.S. Watch Lists

Ebola Worries End for Dozens on U.S. Watch Lists

Reuters - US Online Video (Oct. 20, 2014) Forty-three people who had contact with Thomas Eric Duncan, the first person diagnosed with Ebola in the U.S., were cleared overnight of twice-daily monitoring after 21 days of showing no symptoms. Rough Cut (no reporter narration). Video provided by Reuters
Powered by NewsLook.com
CDC Calls for New Ebola Safety Guidelines

CDC Calls for New Ebola Safety Guidelines

AP (Oct. 20, 2014) Centers for Disease Control and Prevention Director Dr. Tom Frieden laid out new guidelines for health care workers when dealing with the deadly Ebola virus including new precautions when taking off personal protective equipment. (Oct. 20) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins