Complications of Nasal Bone Fractures.

The aim of this study was to perform a systematic review of the treatment of nasal bone fractures. The search terms ("nasal bone fracture" AND complication) and ("nasal bone fracture" AND [anosmia OR olfaction OR olfactory nerve OR smell]) and (anosmia AND ["nasal preparation" OR "nasal antiseptics"]) were used to search PubMed and SCOPUS. Of the 500 titles, 40 full papers were reviewed. One paper was excluded, and 3 mined papers were added. Ultimately, 12 papers were analyzed. The overall deformity rate was 10.4% +/- 4.8%. No significant differences were found between patients who underwent closed reduction (14.7% +/- 7.3%) and those who underwent open reduction (9.4% +/- 4.4%), between those who underwent local anesthesia (5.8% +/- 4.5%), and those who underwent general anesthesia (8.8% +/- 3.8%), or between those who received timely treatment (5.7%) and those whose treatment was delayed (9.0%). Septal deviation occurred in 10.0% of patients as a sequela of nasal bone fracture. The nasal obstruction rate was 10.5% +/- 5.3%. Fewer patients of nasal obstruction occurred in the open reduction patients (6.9% +/- 4.4%) than in the closed reduction patients (15.2%). One patient of epiphora and 1 patient of diplopia were reported Among the 77 patients with nasal bone fractures, 29 (37.7% +/- 11.3%) complained of olfactory disturbances. No significant associations were found between the type of fracture and the presence of olfactory disturbances. It is recommended for providers to explain to patients that approximately one-tenth of nasal bone fractures exhibit deformity, septal deviation, or nasal obstruction after surgery. Surgeons should take considerable care to avoid the olfactory mucosa during reduction surgery. (C) 2017 by Mutaz B. Habal, MD.

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