title: Acute nasal fracture management: A prospective study and literature review.
abstract: OBJECTIVE
  Functional and cosmetic deformities are common after nasal injuries and at times necessitate advanced surgery to reverse the effects of trauma. This study was designed to study the factors related to nasal injury and patient parameters in influencing the acute management of nasal injuries and its outcome.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  Nasal injuries from County Waterford in Southeast Ireland were referred to a new Cost-Neutral Nasal Fracture Clinic. The first 400 patients from this prospective audit, referred to Waterford Regional Hospital from August 2009 through December 2010, were included in this study. Twenty-one variables, including satisfaction scores using Visual Analog Scale (VAS), were studied. Data was obtained at each stage of management, from initial assessment in ears, nose, and throat (ENT) casualty to being seen and further reviewed in consultant-based specialty clinic.
  
  
  RESULTS
  Men outnumbered women 72: 28, and the mean age was 26.89 (0.4 years-87 years). Patients presenting time to the ENT casualty after the injury ranged between 1 and 90 days (mean 10.5 days). The interval between injury and intervention was on an average 6.1 days. Accident (41%) and soccer (46%), among the sports group, were predominantly related to nasal injury. The overall satisfaction rate was 77.5% for breathing and 85.6% for cosmesis. One hundred twenty-seven (31.8%) patients were referred to and managed from the septorhinoplasty clinic. Overall, 11% required septorhinoplasty. Patient satisfaction was seen in manipulation performed up to 5 weeks postinjury.
  
  
  CONCLUSIONS
  Our databank is the largest prospectively studied series of nasal-fracture management from Ireland. The incidence of nasal fracture in the southeast of Ireland is 0.37%. Age, gender, mode of injury, and type of sport influenced the satisfaction rates in this study. This type of service may not be practical in all ENT departments, but a regional center may be an idea worth considering.
authors.affiliation: Department of Otorhinolaryngology, Waterford Regional Hospital, Waterford, Ireland.
authors.forename: Naveed
authors.initials: N
authors.lastname: Basheeth
authors.affiliation: Department of Otorhinolaryngology, Waterford Regional Hospital, Waterford, Ireland.
authors.forename: Martin
authors.initials: M
authors.lastname: Donnelly
authors.affiliation: Department of Otorhinolaryngology, Waterford Regional Hospital, Waterford, Ireland.
authors.forename: Smyth
authors.initials: S
authors.lastname: David
authors.affiliation: Department of Otorhinolaryngology, Waterford Regional Hospital, Waterford, Ireland.
authors.forename: Shandilya
authors.initials: S
authors.lastname: Munish
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001265:Athletic Injuries / Q000523:psychology / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007494:Ireland / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009295:Nasal Bone / Q000293:injuries*; D009667:Nose Deformities, Acquired / Q000453:epidemiology / Q000523:psychology* / Q000601:surgery; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012225:Rhinoplasty / Q000379:methods / Q000523:psychology; D012887:Skull Fractures / Q000453:epidemiology / Q000523:psychology* / Q000601:surgery; D061665:Time-to-Treatment / Q000706:statistics & numerical data; D064232:Visual Analog Scale; D055815:Young Adult
keywords: Nasal fracture; VAS; deformity; nasal manipulation; patient satisfaction