scholarly journals Effects of the COVID-19 Pandemic on Pediatric Nasal Fractures

2021 ◽  
pp. 014556132110513
Author(s):  
Cigdem Firat Koca ◽  
Turgut Celik ◽  
Sukru Aydin ◽  
Mehmet Kelles ◽  
Seyma Yasar
Keyword(s):  
Motor Vehicle ◽  
Bone Fractures ◽  
Nasal Bone ◽  
Study Data ◽  
Vehicle Accidents ◽  
Nasal Fracture ◽  
First Case ◽  
Training And Research ◽  
Nasal Fractures ◽  
Time Of Intervention

Objectives Nasal bone fracture is a frequent entity consulted to the otolaryngologists, approximately accounting for 39% of all facial bone fractures. The most frequent mechanisms of injury consist of assault, sport-related injuries, falls, and motor vehicle accidents. In this study, we examined the effects of the COVID-19 pandemic on pediatric nasal fractures. Methods Children with nasal fracture who applied to Malatya Training and Research Hospital during the year before the first case and the following year were included in this study. Data of 172 patients for the pre-pandemic period and 79 patients for pandemic were available and included in the study. Demographic information, clinical features, nasal fracture etiology, nasal fracture type, type and time of intervention, and other accompanying pathologies were recorded. Results While falls was the leading cause of fracture etiology before the pandemic (64 patients [37.21%]), assault seems to be the leading cause during the pandemic period (27 children [34.18%]). In the pre-pandemic period, the intervention for patients with nasal fractures was performed on an average of 5 days, while this period was calculated as an average of 6 days during the pandemic period. When the 2 groups are compared in terms of nasal fracture intervention time, it was seen that the intervention time was statistically significantly later in the pandemic period ( P < .001). According to the results of the analysis, the most cases in the pandemic period were seen in the fourth month, which indicated a-month period between 11 June and 11 July. Conclusions In conclusion, our number of nasal fracture cases was decreased during the pandemic period compared to the 1-year period before the pandemic. We observed the most common type IIA nasal fracture. We gave outpatient treatment to most of the patients. Our most common cause of fracture was assault. We intervened in our cases in an average of 6 days and preferred closed reduction most frequently. We could not find any study on the same subject in the literature, and we aimed to contribute to the literature with this study.

The Effect of COVID on Nasal Fracture Management in ENT Emergency Clinics

2021 ◽  
pp. 194338752110150
Author(s):  
Keshav Kumar Gupta ◽  
Vinay Kumar Gupta ◽  
Ranjodh Singh Sanghera ◽  
Karan Jolly ◽  
Lisha McClleland
Keyword(s):  
Bone Fractures ◽  
Management Strategies ◽  
Nasal Bone ◽  
Nasal Fracture ◽  
Number Of Patients ◽  
Fracture Management ◽  
Significant Difference ◽  
The Uk ◽  
Nasal Fractures

Study design: Retrospective cohort study. Objective: Management of nasal fractures is usually in ENT emergency clinics, with our center aiming to assess patients within 10-days. During 2020, there have been numerous lockdowns and social distancing measures implemented in the UK as a result of the coronavirus pandemic (COVID). This study aimed to assess the effect of COVID on nasal fracture management in ENT emergency clinics in terms of number of patients seen, time to follow up and their management strategies. Methods: All patients with suspected or confirmed nasal bone fractures presenting to the emergency department (ED) between January 1, 2019 and December 31, 2020 at our major trauma center were analyzed in 2 groups depending on the year they were seen (2019 vs. 2020). Results: There was a total of 104 patients analyzed, with 51.4% decrease in the number of patients seen in 2020 versus 2019. The mean days to follow up in 2019 was 8.09 days and 7.65 days in 2020 ( P = .37). There was no statistically significant difference in the number of patients seen within the 10-day target between years (2019 = 65.7% vs. 2020 = 76.5%, P = .35). The majority of patients were managed with manipulation under anesthesia (MUA) in 2019 (n = 32, 45.7%) vs. discharge from clinic in 2020 (n = 21, 61.8%). Conclusions: Our study shows a drastic reduction in the number of patients seen in ENT emergency clinic from 2019 to 2020. This is in-keeping with other studies that have shown a reduction in ED attendances, trauma admissions and admissions across other specialties all around the world.

Syncopal Episodes Associated with Cisapride and Concurrent Drugs

1998 ◽  
Vol 32 (6) ◽  
pp. 648-651 ◽  
Author(s):  
Vanessa Seals Gray
Keyword(s):  
English Language ◽  
Motor Vehicle ◽  
Concomitant Administration ◽  
Qt Prolongation ◽  
Azole Antifungals ◽  
Vehicle Accidents ◽  
Cardiac Dysrhythmias ◽  
Case Summary ◽  
First Case ◽  
Patients At Risk

OBJECTIVE: To report a case of QT prolongation and syncopal episodes resulting from concomitant use of cisapride and agents known to inhibit its metabolism. CASE SUMMARY: A 53-year-old white woman was involved in two motor vehicle accidents on the same day after experiencing syncopal episodes. Cardiac and neurologic evaluations were negative; the syncopal episodes were attributed to QT prolongation associated with the concomitant use of cisapride and agents known to inhibit its metabolism. DISCUSSION: This is the first case published in the English-language literature describing QT prolongation resulting from the concomitant use of cisapride and agents known to inhibit its metabolism. Clarithromycin inhibits CYP3A4, the isoenzyme responsible for the metabolism of cisapride. Concomitant administration of cisapride with agents known to inhibit CYP3A4 (i.e., azole antifungals, erythromycin, clarithromycin) may result in elevated cisapride concentrations. Elevated cisapride concentrations have been associated with QT prolongation, syncopal episodes, and cardiac dysrhythmias. CONCLUSIONS: Acquired QT prolongation is a well-recognized adverse effect of several drugs. Recognition of newer drugs and drug combinations that place patients at risk for this potentially fatal adverse event is imperative for appropriate monitoring and prevention.

scholarly journals External Fixation of Unstable, “Flail” Nasal Fractures

2012 ◽  
Vol 5 (2) ◽  
pp. 99-105 ◽  
Author(s):  
George E. Anastassov ◽  
Ali Payami ◽  
Zain Manji
Keyword(s):  
External Fixation ◽  
Closed Reduction ◽  
Nasal Septum ◽  
Bone Fractures ◽  
Nasal Bone ◽  
Facial Fractures ◽  
Kirschner Wires ◽  
Nasal Bones ◽  
External Stabilization ◽  
Nasal Fractures

Nasal bone fractures are the most common among facial fractures. Usually these are adequately treated with closed reduction and internal and/or external stabilization with splints. However, there are clinical situations where the nasal bones are severely displaced, the nasal septum fractured and displaced, or there are external drape lacerations which preclude the use of nasal splints. If the nasal bones are reducible but unstable we consider them “flail” and in this case transmucosal, endonasal Kirschner wires are used for dorsal support until sufficient healing occurs. The technique is simple, quick, and predictable and causes minimal discomfort to the patients.

Changes in nasal aesthetics following nasal bone manipulation

2007 ◽  
Vol 122 (1) ◽  
pp. 38-41
Author(s):  
S C L Leong ◽  
M Abdelkader ◽  
P S White
Keyword(s):  
Bone Fractures ◽  
Nasal Bone ◽  
Post Treatment ◽  
Facial Injury ◽  
Nasal Fracture ◽  
Initial Injury ◽  
Nasal Trauma ◽  
The Aesthetic

AbstractNasal bone fractures are the commonest type of bony facial injury causing aesthetic deformity. The aim of this study was to identify the effect of nasal trauma and fracture manipulation on the aesthetic proportions of the nose, by comparing pre- and post-treatment nasal aesthetics. Thirty-two patients (26 men and 6 women) underwent aesthetic assessment prior to treatment of the injury by closed nasal manipulation, 7 to 10 days after the initial injury. Standard facial aesthetic photographic assessments were performed prior to and following manipulation. Assessment involved measurement of standard nasal aesthetic parameters. In the nasal trauma cohort, the main anomalies in nasal aesthetics were nasal deviation and differences in the nasal aesthetic profile. Nasal fracture manipulation successfully reduced deviation from an average of 35° pre-manipulation to an average of 9° post-manipulation.

scholarly journals Tratamento de fratura nasal pediátrica: relato de caso clínico

2019 ◽  
Vol 7 (12) ◽  
Author(s):  
Júlio Leite de Araújo-Júnior ◽  
Elma Mariana Verçosa de Melo-Silva ◽  
Anderson Maikon de Souza-Santos ◽  
Tiburtino José de Lima-Neto ◽  
Murilo Quintão dos Santos ◽  
...  
Keyword(s):  
Bone Fracture ◽  
Closed Reduction ◽  
Motor Vehicle ◽  
Nasal Bone ◽  
Facial Trauma ◽  
Motor Vehicle Collisions ◽  
Bone Deformity ◽  
Vehicle Collisions ◽  
Nasal Fractures ◽  
Zygomatic Fractures

Introdução: Os ossos nasais são os mais proeminentes do esqueleto facial, tornando esses os mais frequentes nas fraturas faciais, sendo o terceiro osso mais comumente fraturado do esqueleto humano. Objetivo: Apresentar um relato de caso de fratura nasal em um paciente pediatrico tratado com redução incruenta. Método: Estudo descritivo com um paciente que apresentou diagnóstico clínico/imaginológico de fratura nasal. Conclusão: O tratamento através de redução incluenta mostrou-se adequado em pacientes pediatricos. A ocorrência de traumatismos e lesões associadas a fraturas nasais reforça a importância de uma abordagem multidisciplinar.Descritores: Fraturas Ósseas; Osso Nasal; Traumatismos Faciais.ReferênciasMa L, Shen SH, Hu P, Wu ZQ. The observation of curative effect on closed reduction of nasal bone fracture under ultrasound guidance: report of 38 cases. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2017;52(12):933-35.Schoinohoriti O, Igoumenakis D, Rallis G. Fractures of the nasal bones: is external splinting really warranted? J Craniofac Surg. 2017;28(8):e760-e63.Kang CM, Han DG. Correlation between Operation Result and Patient Satisfaction of Nasal Bone Fracture. Arch Craniofac Surg. 2017;18(1):25-9.Kyung H, Choi JI, Song SH, Oh SH, Kang N. Comparison of postoperative outcomes between monitored anesthesia care and general anesthesia in closed reduction of nasal fracture. J Craniofac Surg. 2018;29(2):286-88.Nishioka H, Kondoh S, Yuzuriha S. Convex bone deformity after closed reduction of nasal bone fracture. J Plast Reconstr Aesthet Surg. 2018;71(1):85-9.Lu GN, Humphrey CD, Kriet JD. Correction of Nasal Fractures. Facial Plast Surg Clin North Am. 2017;25(4):537-546.Kim SW, Park B, Lee TG, Kim JY. Olfactory Dysfunction in Nasal Bone Fracture. Arch Craniofac Surg. 2017;18(2):92-6.Davidson J, Nickerson D, Nickerson B. Zygomatic fractures: comparison of methods of internal fixation. Plast Reconstr Surg. 1990;86(1):25-32.Yabe T, Tsuda T, Hirose S, Ozawa T. Comparison of pediatric and adult nasal fractures. J Craniofac Surg. 2012;23(5):1364-6.Murphy RX Jr, Birmingham KL, Okunski WJ, Wasser TE. Influence of restraining devices on patterns of pediatric facial trauma in motor vehicle collisions. Plast Reconstr Surg. 2001;107(1):34-7.

Subdural Hemorrhage in Utero

PEDIATRICS ◽  
1985 ◽  
Vol 76 (4) ◽  
pp. 605-610
Author(s):  
TANIA R. GUNN ◽  
PUI M. MOK ◽  
DAVID M. O. BECROFT
Keyword(s):  
Case Report ◽  
Head Circumference ◽  
Motor Vehicle ◽  
Motor Vehicle Accidents ◽  
Subdural Hemorrhage ◽  
Maternal Trauma ◽  
Vehicle Accidents ◽  
First Case ◽  
Subdural Hemorrhages ◽  
History Of

Acute subdural hemorrhage following the trauma of a difficult birth is a recognized cause of an increase in head circumference and anemia soon after birth.1 Although major subdural hemorrhages occurring in the fetus before the onset of labor are relatively rare, in most reported cases these also have been traumatic, the result of motor vehicle accidents or assaults.2-7 With few exceptions, there have been associated uteroplacental or other fetal injuries. In 1977, MacDonald et al8 believed they were making the first case report of an infant born with hydrocephalus and anemia due to bilateral subdural hematomas in which there was no history of maternal trauma.

Sport and Recreational Causes of Nasal Bone Fractures

2021 ◽  
pp. 000348942110424
Author(s):  
Christopher C. Xiao ◽  
Rijul S. Kshirsagar ◽  
Jacob E. Hoerter ◽  
Alexander Rivero
Keyword(s):  
Emergency Department ◽  
Bone Fractures ◽  
Nasal Bone ◽  
Emergency Department Visits ◽  
Injury Surveillance System ◽  
The Past ◽  
Total Incidence ◽  
Common Causes ◽  
The Mean ◽  
Nasal Fractures

Objective: Nasal bone fractures are the most common facial bone fractures. However, there is limited literature on the etiology of these fractures, particularly distribution across sports and other recreational activities. Methods: The Nationwide Electronic Injury Surveillance System (NEISS) national injury database was queried for emergency department visits involving the diagnosis of nasal or nose fractures associated with sports and recreation activities over the most recent 10 year span available. Demographic, disposition, and weighted incidence were analyzed. Results: Total incidence of nasal fractures across 10 years was 158 979. The mean age of nasal bone fractures was 20.4 years old. Nasal fractures were more common in males (74.6%) and white patients (54.1%). National estimated incidence of nasal fractures decreased from 21 028 in 2009 to 11 108 in 2018, a reduction of 47.2%. The most common causes among all patients were basketball (23.2%), baseball (17.1%), softball (9.8%), soccer (7.4%), and football (7%). In pediatric patients, the most common cause was baseball (25.1%). The majority (98.1%) of patients were discharged from the emergency department, while 0.9% of patients were admitted. Conclusion: The most common recreational causes of nasal fractures are sports, with the most common being non-contact sports like basketball and baseball. However, the incidence of nasal bone fractures due to recreational causes nationwide has decreased significantly over the past 10 years. This may reflect improved safety protocols among athletes.

The Craniovertebral Junction Area and the Role of the Ligaments and Membranes

Neurosurgery ◽  
2015 ◽  
Vol 76 (suppl_1) ◽  
pp. S22-S32 ◽  
Author(s):  
Alberto Debernardi ◽  
Giuseppe D'Aliberti ◽  
Giuseppe Talamonti ◽  
Fabio Villa ◽  
Maurizio Piparo ◽  
...  
Keyword(s):  
Surgical Planning ◽  
Motor Vehicle ◽  
Bone Fractures ◽  
Craniovertebral Junction ◽  
Traumatic Injuries ◽  
Junction Area ◽  
Vehicle Accidents ◽  
Diving Accidents ◽  
Secondary Function

Abstract Traumatic injuries of the craniovertebral junction (CVJ) area are common and frequently the outcome of motor vehicle accidents, falls, and diving accidents. To define and characterize CVJ traumatic injuries, some international classifications are currently in use, and they are thought and focused on junction bone fracture. However, recent data point out a major important role of the CVJ ligaments and membranes in traumatic injuries with a secondary function of the osseous structures. Emphasizing the correct role of the ligaments and membranes is extremely important for determining appropriate medical or surgical planning for patients and also to design new CVJ injury classifications. We reviewed every recent major publication on the ligaments and membranes of the CVJ area. We divided the information into sections concerning anatomy, embryology, biomechanics, trauma, and CVJ bone fractures. A role of the ligaments and membranes in the traumatic injuries of the CVJ area has often been recognized; but only recently, with the increase in the knowledge of the anatomic and biomechanical junction area, supported by neuroradiological tools (magnetic resonance imaging) and a more detailed traumatic injuries assessment, has the role of the ligaments and membranes been highlighted. Ligaments and membranes have a pivotal role in each junctional ability and are the key to orienting any medical or surgical indications in this unique area of the spine.

The Craniovertebral Junction Area and the Role of the Ligaments and Membranes

Neurosurgery ◽  
2011 ◽  
Vol 68 (2) ◽  
pp. 291-301 ◽  
Author(s):  
Alberto Debernardi ◽  
Giuseppe D'Aliberti ◽  
Giuseppe Talamonti ◽  
Fabio Villa ◽  
Maurizio Piparo ◽  
...  
Keyword(s):  
Surgical Planning ◽  
Motor Vehicle ◽  
Bone Fractures ◽  
Craniovertebral Junction ◽  
Traumatic Injuries ◽  
Junction Area ◽  
Vehicle Accidents ◽  
Diving Accidents ◽  
Secondary Function

Abstract Traumatic injuries of the craniovertebral junction (CVJ) area are common and frequently the outcome of motor vehicle accidents, falls, and diving accidents. To define and characterize CVJ traumatic injuries, some international classifications are currently in use, and they are thought and focused on junction bone fracture. However, recent data point out a major important role of the CVJ ligaments and membranes in traumatic injuries with a secondary function of the osseous structures. Emphasizing the correct role of the ligaments and membranes is extremely important for determining appropriate medical or surgical planning for patients and also to design new CVJ injury classifications. We reviewed every recent major publication on the ligaments and membranes of the CVJ area. We divided the information into sections concerning anatomy, embryology, biomechanics, trauma, and CVJ bone fractures. A role of the ligaments and membranes in the traumatic injuries of the CVJ area has often been recognized; but only recently, with the increase in the knowledge of the anatomic and biomechanical junction area, supported by neuroradiological tools (magnetic resonance imaging) and a more detailed traumatic injuries assessment, has the role of the ligaments and membranes been highlighted. Ligaments and membranes have a pivotal role in each junctional ability and are the key to orienting any medical or surgical indications in this unique area of the spine.

Satisfaction with cosmesis following nasal manipulation: do previous fractures matter?

2006 ◽  
Vol 120 (9) ◽  
pp. 749-752 ◽  
Author(s):  
M Supriya ◽  
W A Clement ◽  
F Ahsan ◽  
A J Cain
Keyword(s):  
Patient Satisfaction ◽  
Bone Fractures ◽  
Nasal Bone ◽  
District General Hospital ◽  
General Anaesthetic ◽  
Nasal Airway ◽  
Acceptable Result ◽  
Injury Group ◽  
History Of ◽  
Nasal Fractures

Objective: To determine if patients who have had multiple previous nasal fractures and who undergo manipulation of fractured nasal bones under general anaesthetic (MUA) are as likely to be satisfied with their post-operative nasal cosmesis as patients who have only sustained a single injury.Design: Telephone survey.Setting: District general hospital.Participants: Adult patients who had undergone MUA over the preceding three years.Main outcome measures: Patient satisfaction with nasal cosmesis and nasal airway and willingness to consider corrective surgery.Results: One hundred and two patients were contacted. Overall patient satisfaction with cosmesis and nasal airway was 82 and 77 per cent, respectively, with 15 per cent willing to consider a procedure to improve their nasal cosmesis and 12 per cent willing to consider a procedure to improve nasal airway. Twenty-three (22.5 per cent) gave a history of one or more nasal bone fractures, either treated or untreated, prior to the most recently treated injury. Patient satisfaction with cosmesis in this group was 65 per cent, compared with 87 per cent satisfaction in the single injury group (p = 0.03). No statistically significant differences were demonstrated when comparing these groups for: satisfaction with nasal airway (70 vs 80 per cent, p = 0.46); willingness to consider a procedure to improve cosmesis (26 vs 11 per cent, p = 0.16); and willingness to consider a procedure to improve nasal airway (17 vs 10 per cent, p = 0.46).Conclusions: A history of multiple previous nasal fractures does appear to alter patient satisfaction with the cosmetic outcome of nasal manipulation. These patients should be informed that they have a decreased chance of attaining a cosmetically acceptable result.

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