Background: The optimal timing, patient selection, and
surgical technique for the management of nasal trauma are not
yet clearly established. The choice of surgical technique also
varies depending on the severity of the injury, the patient's individual
anatomy, surgeon selection and expertise.
Objective: To review previous studies discussing the treatment
of acute nasal fractures in adults.
Methods: A systematic review and meta-analysis was conducted
in March 2022 for papers published between 2002 and
2022. To compare the outcomes of closed nasal bone reduction,
septal reduction to other treatments as open reduction, limited
septoplasty, septorhinoplasty, and delayed rhinoplasty for nasal
bone fractures. Also, to assess how reduction type, type of
anesthesia, presence of septal fractures and the time interval
between injury and treatment could affect patient satisfaction
post operatively, rate of complications, revisional surgeries and
olfactory dysfunction.
Results: A meta-analysis of 19 studies found that reduction
type and timing interval between injury and treatment had a significant
impact on patient satisfaction. Reduction type and the
type anesthesia also had a significant impact on post-operative
complication rates.
Conclusion: Open nasal reduction (ONR) is associated with
higher patient satisfaction, however, closed nasal reduction may
be safer. Patients with septal fractures are less satisfied with
their results. General anesthesia has higher satisfaction rates and
lower complication rates than local anesthesia. Early surgical
intervention within 2 weeks of trauma is recommended.