title: Satisfaction with cosmesis following nasal manipulation: do previous fractures matter?
abstract: OBJECTIVE
  To determine if patients who have had multiple previous nasal fractures and who undergo manipulation of fractured nasal bones under general anaesthetic (MUA) are as likely to be satisfied with their post-operative nasal cosmesis as patients who have only sustained a single injury.
  
  
  METHODS
  Telephone survey.
  
  
  METHODS
  District general hospital.
  
  
  METHODS
  Adult patients who had undergone MUA over the preceding three years.
  
  
  METHODS
  Patient satisfaction with nasal cosmesis and nasal airway and willingness to consider corrective surgery.
  
  
  RESULTS
  One hundred and two patients were contacted. Overall patient satisfaction with cosmesis and nasal airway was 82 and 77 per cent, respectively, with 15 per cent willing to consider a procedure to improve their nasal cosmesis and 12 per cent willing to consider a procedure to improve nasal airway. Twenty-three (22.5 per cent) gave a history of one or more nasal bone fractures, either treated or untreated, prior to the most recently treated injury. Patient satisfaction with cosmesis in this group was 65 per cent, compared with 87 per cent satisfaction in the single injury group (p = 0.03). No statistically significant differences were demonstrated when comparing these groups for: satisfaction with nasal airway (70 vs 80 per cent, p = 0.46); willingness to consider a procedure to improve cosmesis (26 vs 11 per cent, p = 0.16); and willingness to consider a procedure to improve nasal airway (17 vs 10 per cent, p = 0.46).
  
  
  CONCLUSIONS
  A history of multiple previous nasal fractures does appear to alter patient satisfaction with the cosmetic outcome of nasal manipulation. These patients should be informed that they have a decreased chance of attaining a cosmetically acceptable result.
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Raigmore Hospital, Inverness, Scotland, UK.
authors.forename: M
authors.initials: M
authors.lastname: Supriya
authors.forename: W A
authors.initials: WA
authors.lastname: Clement
authors.forename: F
authors.initials: F
authors.lastname: Ahsan
authors.forename: A J
authors.initials: AJ
authors.lastname: Cain
mesh_terms: D000293:Adolescent; D000328:Adult; D016009:Chi-Square Distribution; D004954:Esthetics; D005260:Female; D005592:Fracture Fixation / Q000379:methods*; D017102:Fracture Healing; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000601:surgery*; D009295:Nasal Bone / Q000293:injuries* / Q000601:surgery*; D015508:Nasal Obstruction; D017060:Patient Satisfaction; D012008:Recurrence; D012306:Risk