Fractures of the nose are the most common facial fractures and reported to be the third most common fracture of the human skeleton. Nasal trauma can lead to obvious or more subtle loss of function or form and cosmetic compromise. Untreated it can lead to immediate or longer term issues. The overall goal of treatment is to restore the nose to its original state and minimise need for further surgery or intervention. The management of nasal trauma has remained controversial and challenging through the ages, with even Hippocrates mentioning it 2000 years ago. This article written by an ENT surgeon from the USA details the assessment of nasal trauma and provides a simple algorithm based on the clinical picture and other published guidelines. It is easily followed and the paper itself is easy to follow. Well illustrated and step wise, it provides an excellent discourse on the examination. There is also an important section on paediatric nasal trauma. A review of the instrumentation and treatment techniques is described, this is brief, but does provide some insight to the surgical techniques. It is an excellent paper for anyone revising or merely brushing up on a common problem that is easily sub optimally assessed.

An algorithm for the initial management of nasal trauma.
Hoffman JF.
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Sunil K Bhatia

Royal Shrewsbury Hospital, Shrewsbury, UK.

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