Authors: Rami K. Batniji, M.D. F.A.C.S., and Stephen W. Perkins, M.D.
In this chapter, we review the management of the acute nasal fracture. The nasal bones are the most commonly fractured bones in the face. Acute nasal fracture may result in both nasal deformity and nasal airway obstruction. However, some controversy still surrounds the management of acute nasal fractures. A review of the literature demonstrates a lack of consensus about the timing of repair of the acute nasal fracture, the anesthesia used during the repair, and the type of procedure performed. Furthermore, the frequency of post-reduction nasal deformities reportedly requiring subsequent rhinoplasty or septo-rhinoplasty ranges from 14% to 50%. A thorough history of the mechanism of injury and a detailed physical examination guide the surgeon in deciding how to treat the acute nasal fracture, with special attention dedicated to the septum, because improper reduction of the injured septum is the usual cause for the high incidence of postreduction nasal deformities.