From the Guidelines
A nasal fracture should be treated with immediate attention to reduce the risk of complications, and the primary treatment approach depends on the severity of the fracture, with conservative management for mild cases and reduction for more severe cases. When considering treatment options for a nasal fracture, it's essential to prioritize morbidity, mortality, and quality of life. The symptoms of a nasal fracture can include nasal obstruction, pain, and bleeding, which can significantly impact a patient's quality of life. According to the clinical practice guideline on nosebleed (epistaxis) 1, nasal packing is a common treatment approach for nasal fractures, and it's crucial to follow the recommended duration of use to minimize the risk of complications. Some key points to consider when treating a nasal fracture include:
- Nasal packing should be used for no longer than 5 days to reduce the risk of infection and other complications 1
- Patients should avoid straining, lifting, bending, and exercising to prevent further bleeding 1
- Acetaminophen (Tylenol) can be used for pain management, but aspirin and ibuprofen should be avoided as they can increase bleeding 1
- Patients should follow up with their clinician to ensure proper healing and to address any concerns or complications that may arise 1 The most critical aspect of treating a nasal fracture is to prioritize prompt evaluation and treatment to prevent permanent deformity, breathing problems, or septal perforation. In terms of treatment options, conservative management may be appropriate for mild fractures, while more severe fractures may require reduction, either closed or open, depending on the complexity of the fracture. It's also essential to consider the potential complications associated with nasal packing, such as infection, septal perforation, and scar bands, and to take steps to minimize these risks, including keeping the nose and packing moist with nasal saline sprays and following strict adherence to follow-up instructions 1.
From the Research
Symptoms of Nasal Fractures
- Nasal trauma is common in both children and adults 2
- Septal hematomas are not uncommon following nasal fracture and should be treated as soon as detected 2
- The most common long-term sequela of nasal trauma is septal deviation with partial obstruction of the airway 2
- Nasal fractures can result in secondary nasal deformities and chronic obstructions if not promptly diagnosed and treated 3
Treatment Options for Nasal Fractures
- Closed reduction provides satisfactory treatment in the majority of nasal fractures 4
- Open reduction often is a more appropriate choice for certain injuries 4
- The decision by the surgeon regarding the surgical approach should be based on the degree of injury, the presence of concomitant facial injuries, patient compliance, training of the surgeon, and the presence and degree of septal injury 5
- Manipulation under local anesthesia is an effective first-line treatment for simple nasal fractures 3
- Open treatment of isolated nasal fractures is a particularly controversial subject 6
- Adequate follow-up is essential for proper management of nasal fractures 3