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March 1952


AMA Arch Otolaryngol. 1952;55(3):321-342. doi:10.1001/archotol.1952.00710010331004

ONE CANNOT do a number of rhinoplasties without being forced to question the soundness of the management of recent nasal fractures. We believe that many difficult nasal reconstructions, tedious submucous resections, and extensive scar excisions could have been avoided had the proper treatment been instituted at the time of injury. Since the main respiratory current passes just beneath the dorsal arch,1 and the nasal skeleton is practically subcutaneous,2 even slight malalinements resulting from inaccuracies in reduction, such as unlocked fragments of bone, displaced spicules, or overriding bone edges—considered negligible in most fractures —may here cause serious impairment of function and conspicuous deformity.3

Through sad experience we have learned that to attempt a correction by blind reduction, using force in reverse of that which caused the fracture, often serves merely to aggravate the damage.4 For instance, in fractures with lateral deviations, force applied to the side of

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