The advantages of local anesthesia include reduced cost, greater flexibility in timing of the procedure, and elimination of risks associated with general anesthesia. However, treatment of children, young adults, or anxious patients may require a general anesthetic. The authors advocate the use of local anesthetic when possible. Technique Reduction of nasal fractures can be accomplished with either an open or closed technique. The majority of nasal fractures can be managed adequately with closed reduction.
Many surgeons also use intravenous sedation or analgesia as an adjunct to the local anesthetic.
Instrumentation is often required as an aid in reduction. The depressed nasal bone is stabilized between a Boies elevator intranasally and a finger externally. The Walsh and Asch forceps can also be used to reduce septal fractures and dislocations. External splints and nasal packing are commonly used postoperatively. Splints can be contoured to the external nose and should be kept in place for 7 to 14 days.