Article ; Online: How COVID-19 Changed Our Management of Nasal Bone Fractures and Its Impact on Patient Outcomes-A Retrospective Study.
2020 Volume 101, Issue 10, Page(s) 671–676
Abstract: Objectives: Nasal bone fractures are a common presentation to the Ear, Nose and Throat (ENT) surgeon. Simple, closed fractures are assessed and considered for closed manipulation under anesthesia (MUA #nasal bones). Most departments perform this under ... ...
| Abstract | Objectives: Nasal bone fractures are a common presentation to the Ear, Nose and Throat (ENT) surgeon. Simple, closed fractures are assessed and considered for closed manipulation under anesthesia (MUA #nasal bones). Most departments perform this under general anesthesia (GA). Our protocol changed in the face of COVID-19, where procedures were alternatively performed under local anesthesia (LA) in the clinic, to cope with lack of elective theater capacity during the pandemic, while still allowing a nasal fracture service to take place. We present postoperative patient outcomes on breathing and shape, comparing GA versus LA. Methods: Patient records retrospectively analyzed (January 2020-August 2020), and patients undergoing MUA #nasal bones interviewed by telephone after one month. Exclusion criteria were open injuries or depressed nasal bones requiring elevation. Breathing and shape scores were evaluated subjectively using a Likert scale (1 = very unsatisfied, 5 = very satisfied). Results: Two hundred five nasal injury referrals were made (21 MUA #nasal bones under GA and 27 under LA). Manipulation under anesthesia #nasal bones significantly improved both breathing satisfaction scores (GA; 2.88 ± 0.24 to 4.06 ± 0.23, Conclusions: Local anesthesia could provide a safer, cheaper, and satisfactory alternative for performing MUA #nasal bones in the clinic for selected patients, particularly with reduction of elective theater capacity in the event of further COVID-19 surges. We recommend training junior ENT surgeons to perform this procedure under supervision with adequate protective measures. |
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| MeSH term(s) | Humans ; Retrospective Studies ; COVID-19 ; Nasal Bone/injuries ; Skull Fractures ; Anesthesia, Local/methods ; Anesthesia, General ; Treatment Outcome |
| Language | English |
| Publishing date | 2020-12-11 |
| Publishing country | United States |
| Document type | Journal Article |
| ZDB-ID | 750153-5 |
| ISSN | 1942-7522 ; 0145-5613 |
| ISSN (online) | 1942-7522 |
| ISSN | 0145-5613 |
| DOI | 10.1177/0145561320981439 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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