More than 25% unhappy with broken nose repair

Many patients who undergo the standard procedure for fixing a broken nose are not satisfied with the results, a new study from Hong Kong shows.

Typically, broken noses are treated with closed reduction, in which the nasal area is anesthetized, and a surgeon realigns misplaced cartilage and bone to restore a more normal appearance and help patients breathe more easily. This procedure is generally performed within seven days of the injury in children and within 10 days for adults, Dr. Terry Hung and colleagues from the Prince of Wales Hospital in Shatin, Hong Kong write.

There is increasing evidence, Hung and his colleagues add, that closed reduction does not always provide adequate correction of deformities caused by nasal fracture. To understand satisfaction with the procedure from patients' point of view, the researchers surveyed 62 patients who had undergone the procedure at their hospital.

Eighteen, or 29 percent, said they were unhappy with how their nose looked after closed reduction, while 13 (21 percent) were dissatisfied with the openness of their nasal passages after the procedure. Twenty-nine percent said that they would want to undergo additional surgery to address their concerns.

However, the researchers found, not all patients who were dissatisfied with the results of closed reduction said they wanted additional surgery, while some who were satisfied also said they wanted more surgery. Most commonly, patients who were dissatisfied but didn't want another operation said this was because they were afraid of undergoing general anesthesia.

Based on the findings, Hung and colleagues suggest that doctors should carefully assess patients before treating nasal fractures, and if their assessment suggests closed reduction won't adequately correct deformities, they should offer patients the choice of having a type of surgery called septorhinoplasty, which may provide better aesthetic results.

SOURCE: Archives of Facial Plastic Surgery, January/February 2007.