Hostname: page-component-848d4c4894-wg55d Total loading time: 0 Render date: 2024-05-09T05:17:54.986Z Has data issue: false hasContentIssue false
  • English
  • Français

Manipulation under anaesthesia of fractured nasal bones – a 10-year retrospective study

Published online by Cambridge University Press:  14 November 2022

S A Gokani Open the ORCID record for S A Gokani [Opens in a new window] ,
H S Sadik ,
A Espehana ,
L Jegatheeswaran Open the ORCID record for L Jegatheeswaran [Opens in a new window] ,
L Luke ,
C Philpott  and
R Nassif
S A Gokani*
Affiliation:
Rhinology and ENT Research Group, Norwich Medical School, University of East Anglia, Norwich, UK
H S Sadik
Affiliation:
Norwich Medical School, University of East Anglia, Norwich, UK
A Espehana
Affiliation:
Rhinology and ENT Research Group, Norwich Medical School, University of East Anglia, Norwich, UK
L Jegatheeswaran
Affiliation:
Department of ENT, Norfolk and Norwich University Hospital, Norwich, UK
L Luke
Affiliation:
Department of ENT, James Paget University Hospital, Great Yarmouth, Norfolk, UK
C Philpott
Affiliation:
Rhinology and ENT Research Group, Norwich Medical School, University of East Anglia, Norwich, UK
R Nassif
Affiliation:
Department of ENT, Norfolk and Norwich University Hospital, Norwich, UK
*
Author for correspondence: Dr Shyam Ajay Gokani, Rhinology and ENT Research Group, Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, UK E-mail: s.gokani@uea.ac.uk
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Nasal bone fractures are treated by manipulation under general or local anaesthesia procedures. Data on long-term benefits of manipulation under local anaesthesia are limited. This study aimed to quantify the proportion of patients requiring septoplasty or septorhinoplasty after manipulation under general and local anaesthesia procedures.

Methods

Anonymised data were collected from electronic records of all patients who underwent manipulation under anaesthesia at our centre over a 10-year period, including demographics, manipulation under anaesthesia timing and further surgery requirements.

Results

The study identified 625 manipulation under general anaesthesia and 52 manipulation under local anaesthesia procedures. Manipulation under local anaesthesia procedures were performed earlier (local anaesthesia = 9 days, general anaesthesia = 15 days; p < 0.05) and were more likely to achieve manipulation (local anaesthesia = 83 per cent, general anaesthesia = 76 per cent; p < 0.05). There was no difference between techniques in the percentage of patients requiring further surgery.

Conclusion

This paper describes a large cohort of patients who underwent manipulation under anaesthesia over a 10-year period. Manipulation under local anaesthesia procedures have increased since the coronavirus disease 2019 pandemic, and the results are comparable to manipulation under general anaesthesia, with reduced delays between injury and manipulation.

Keywords

Nasal BoneFacial InjuriesNasal Surgical Procedures
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 137 , Issue 10 , October 2023 , pp. 1126 - 1129
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Dr S Gokani takes responsibility for the integrity of the content of the paper

Presented at the East of England Otolaryngology Meeting, 19 July 2022, Cambridge, UK.

References

Hamrang-Yousefi, S, Kingsley-Smith, H, Munroe-Gray, T, Anyanechi, M, Rollin, M. Patterns of referral for fractured nose during major sporting events: a 10-year follow up. Ann R Coll Surg Engl 2021;103:282–4CrossRefGoogle Scholar
Repanos, C, Anderson, D, Earnshaw, J, Mitchell, D, Coman, W. Manipulation of nasal fractures with local anaesthetic: a ‘how to do it’ with online video tutorial. Emerg Med Australas 2010;22:236–9CrossRefGoogle Scholar
Basheeth, N, Donnelly, M, David, S, Munish, S. Acute nasal fracture management: a prospective study and literature review. Laryngoscope 2015;125:2677–84CrossRefGoogle ScholarPubMed
Yi, JS, Kim, MJ, Jang, YJ. An Asian perspective on improving outcomes for nasal bone fractures by establishing specific treatment options. Clin Otolaryngol 2017;42:46–52CrossRefGoogle ScholarPubMed
Taghizadeh, R, Lewis, CJ, Stevenson, S, Barnard, A, Erdmann, M. Outcomes following manipulation of nasal fractures—the Durham experience. Eur J Plast Surg 2016;39:7–10CrossRefGoogle Scholar
O'Rielly, C, Ng-Kamstra, J, Kania-Richmond, A, Dort, J, White, J, Robert, J et al. Surgery and COVID-19: a rapid scoping review of the impact of the first wave of COVID-19 on surgical services. BMJ Open 2021;11:e043966CrossRefGoogle ScholarPubMed
Bastianpillai, J, Khan, S, Acharya, V, Tanna, R, Pal, S. How COVID-19 changed our management of nasal bone fractures and its impact on patient outcomes—a retrospective study. Ear Nose Throat J 2022;101:671–6CrossRefGoogle ScholarPubMed
Narang, V, Eswarappa, V, Calder, N. Impact of video clinics in the management of fracture nasal bones in COVID times. Rhinology Online 2021;14:127–30CrossRefGoogle Scholar
Pinto, R, Wright, R, Ghosh, S. Nasal fractures: a dedicated clinic providing reduction under local anaesthesia improves time to manipulation. Ann R Coll Surg Engl 2020;102:418–21CrossRefGoogle ScholarPubMed
Khwaja, S, Pahade, AV, Luff, D, Green, MW, Green, KMJ. Nasal fracture reduction: local versus general anaesthesia. Rhinology 2007;45:83–8Google ScholarPubMed
Chadha, NK, Repanos, C, Carswell, AJ. Local anaesthesia for manipulation of nasal fractures: systematic review. J Laryngol Otol 2009;123:830–6CrossRefGoogle ScholarPubMed
Courtney, MJ, Rajapakse, Y, Duncan, G, Morrissey, G. Nasal fracture manipulation: a comparative study of general and local anaesthesia techniques. Clin Otolaryngol Allied Sci 2003;28:472–5CrossRefGoogle ScholarPubMed
Rajapakse, Y, Courtney, M, Bialostocki, A, Duncan, G, Morrissey, G. Nasal fractures: a study comparing local and general anaesthesia techniques. ANZ J Surg 2003;73:396–9CrossRefGoogle ScholarPubMed