LOR pulciņa dalībnieku Daigas Marnauzas, Marka Roņa, Lanas Mičko un Lindas Veideres ZPD "A RETROSPECTIVE ANALYSIS OF NASAL BONE FRACTURES IN ADULTS IN PAULS STRADINS CLINICAL UNIVERSITY HOSPITAL". Prezentēts RSU ISC 2016. Darba vadītāja Dr.Jānis Sokolovs.

1. Authors: Daiga Marnauza1
, Marks Ronis1
, Lana Mičko1
, Linda Veidere1
Scientific research supervisor: Jānis Sokolovs M.D., otorhinolaryngologist 1,2
1
Rīga Stradiņš University, Latvia
2
Children’s Clinical University Hospital, Latvia
A Retrospective Analysis Of Nasal Bone
Fractures in Adults in Pauls Stradins
Clinical University Hospital
INTRODUCTION
Nasal trauma plays an important role in the field of craniofacial injury. Nasal bone fractures account for greater than
50% of all facial fractures in adults [1]. As the bones and cartilage of the nose provide aesthetic and structural
support for the midface and airway, it is necessary to emphasize the role of different factors and causes leading to
trauma to possibly decrease the frequency of nasal bone fractures and its rate of complications such as nasal airway
compromise and nasal deformity.
AIM OF THE WORK
To obtain descriptive statistics regarding the adult population with the diagnosis “Fracture of Nasal Bones”, to
determine the most common traumatic causes, as well as to establish a typical patient profile and nasal trauma risk
groups to prevent further injuries and optimize patient care.
MATERIALS AND METHODS
Retrospectively collect and analyze medical records of patients admitted to the ENT department and Emergency
Care center of Pauls Stradiņš Clinical University Hospital with the diagnosis“Fracture of Nasal Bones”S02.2 (ICD-10)
in the time period 01.01.12 - 31.12.14. Statistical analysis of data performed using IBM SPSS software (descriptive
statistics, crosstabs with χ2 test). p<0,05 was considered statistically significant.
RESULTS
A total of 297 patients in the age group of 15 to 91 years old were selected for this study. The overall ratio of males
to females was 3.6 : 1. Young adults belonging to age group of 21-27 were significantly more likely to sustain nose
fractures – 84% of all cases (Figure 1). The most common cause of injury was violence (n=171, 57.6%), followed by
falls (n=63, 21.2%), sports trauma (n=32, 10.8%) and other – road traffic accidents, occupational trauma, epilepsy
(n=20, 6.6%). Nasal bone fractures related to criminal violence most commonly tend to occur in summer – 65.9%,
most frequently in July and August (Figure 2). 133 (48.2%) of all patients sough for medical help during weekends
(Figure 3). The most frequent emergency care visiting day was Saturday – 70 (23.6%) between 0 AM and 4 AM – 81
(27%) patients; 52 (40.3%) of them had alcohol intoxication (Figure 5). Moreover, among those patients who were
involved in violence – 98 (78.4%) were under the influence of alcohol when receiving emergency care (Figure 7).
There is no evidence that dislocation to the left side in criminal trauma is more frequent than dislocation to the right
(Figure 6). No correlation between the etiology of trauma and full moon phase period was found (p>0.05)
(Figure 4).
0
20
40
60
80
100
Fig.1 Age Distribution
0%
50%
100%
Criminal
Trauma
Routine
Trauma
Sports
Trauma
Other
Fig.2 Trauma Frequency by
Season
Winter Spring Summer Autumn
32 28
37
20
47
70
63
0
10
20
30
40
50
60
70
80
Fig.3 Fracture Frequency by Days of Week
M
onday
Tuesday
W
ednesday
Thursday
Friday
Saturday
Sunday
18%
21%
82%
79%
FULL MOON
OTHER MOON PHASES
Fig.4 Impact of Moon Phases on
Frequency of Criminal Trauma
Days With Trauma Days Without Trauma
10
15
20
25
30
35
8-12 12-16 16-20 20-24 0-4 4-8
Fig.5 Alcohol Presence at Time of
Trauma
No Presence of Alcohol Alcohol Intoxication
14%
44%
42%
Fig.6 Side of Nasal Bone Dislocation
in Criminal Trauma
No Dislocation Dislocation to Right Dislocation to Left
32%
66%
97%
68%
68%
34%
3%
32%
0%
20%
40%
60%
80%
100%
Criminal Trauma Routine Trauma Sports Trauma Other
Fig.7 Alcohol Presence in Types of Trauma
No Presence of Alcohol Alcohol Intoxication
REFERENCES
1. Renner G J. Management of nasal fractures. Otolaryngol Clin
North Am //1991;24:195–213. [PubMed]
2. d Injuries in Alexandria During the Egyptian Revolution 2011,
Neurosurgery Quarterly // February 2015 Vol. 25 - Issue 1: p 1–5
3. Murray J A, Maran A G. The treatment of nasal injuries by
manipulation. J Laryngol Otol. // 1980;94:1405–1410. [PubMed]
CONCLUSIONS
This study provides an overview of nasal bone fractures in adult
population, illustrates trends and characteristics of this type of
trauma. It is useful to predict the most frequent time of the day, day
of the week and month of the year when patients visit
otorhinolaryngologist due to nasal bone fractures. The study has
shown a typical profile of the patient with a nasal trauma presenting
to ENT specialist – a 24 years old man after alcohol intake with
tendency of aggressive behaviour.
DISCUSSION
Management of maxillofacial trauma is often challenging in
emergency room. Alcohol intoxicated patients are usually difficult
to examine [2], they lack compliance, very often refuse admission to
hospital and further investigations. Young adults in the age group
of 21 – 27 were significantly more likely to sustain nasal bone
fractures, the explanation – the third decade of life represents the
main period of activeness for individuals that are more involved in
outdoor activities responsible for maxillofacial trauma [3]. Seasonal
incidence of nasal bone fractures was slightly higher in the autumn.
This finding may be explained with the increase of student
migration to the capital city at the beginning of the study semester,
commonly associated with an increase in social activities often
involving alcohol consumption.