Etiological Factors, Presentation and Management Outcome of Fracture Nasal Bones; A Study of 70 Patients at Tertiary Care Unit of Jinnah Hospital, Lahore

Abstract

Background: Fracture nasal bones are frequently seen in ENT practice andif not managed adequately, these can lead to problems like external nasal deformity and nasal obstruction. Regarding treatment options, there exists controversy among ENT surgeons. Treatment varies from conservative management to extensive open surgical procedures. This case series was conducted to know the etiology, presentation and outcome.

Study design: Descriptive study

Material and Methods: This retrospective study was conducted at ENTDepartment of Jinnah Hospital, Lahore from 2008 to 2010. Seventy patients (both male and female) of age range 5 60 years with class I and II fracture of the nose were includedto accessoutcomeof various types of management. The diagnosis was based on clinical assessment withradiology requested to rule out other facial fractures and formedico legal cases. Patients were offered various types of managementaccording to their presentation after trauma. Outcome of treatment were noted.

Results: Male to female ratio was 4:1. Main etiological factorswere Road Traffic Accidents (RTA) (54.3%), falls (20%) andfights (15.7%). Incidence of class I fractures was 64.3% and class II was 35.7 %. External nasal deformity (80%), pain & tenderness (76%), soft tissue swelling (55%) and epistaxis (41%) were the main clinical features. Closed reduction in 57.2%, open reductionin 4.2%, rhinoplasty with osteotomies was done in 20% of cases. Those who were managed conservatively were 18.6%. Over all successful management was achieved in 85.7%. Both local and general anesthesia was found almost equally effective.

Conclusion: Fracture nasal bone is seen commonly among young adult male. Road Traffic Accident (RTA) is the main culprit. Successful treatment is possible in majority of cases with multidisciplinary approach.