Fracture of the anterior nasal spine: A systematic review

Publication date: Available online 14 October 2017
Source:Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology
Author(s): Blake S. Raggio, H.D. Graham
ObjectiveFracture of the anterior nasal spine is uncommon and poorly described in the literature. Herein we report a rare case of anterior nasal spine fracture (ANSF) and conduct the first systematic review on the management of ANSFs.MethodsA systematic review of PubMed, Ovid-MEDLINE, and EMBASE was conducted per PRISMA guidelines. Articles in English of all study designs were eligible for review.ResultsFrom an initial 53 articles reviewed, 6 met criteria for qualitative analysis (all Case Reports) comprising a total of 7 ANSF cases including our own. Patients with ANSF were more often young (mean age, 24.3 years), male (86%), and Caucasian (83%) with a history of facial trauma (100%). Common clinical features included columellar tenderness (71%), mucogingival ecchymosis (57%), and mucosal edema (57%). Lateral plain films definitively diagnosed an ANSF in 3/4 patients (75%). A computed tomography scan definitively diagnosed an ANSF in 4/4 patients (100%). Six of 7 patients (86%) experienced an ANSF with either no, mild, or unspecified displacement and were treated conservatively. One of 7 patients (14%) exhibited an ANSF with severe displacement and underwent open repair. Satisfactory outcomes were reported in 3/3 patients who underwent conservative treatment and 1/1 patient who underwent open repair.ConclusionANSF remains a poorly elucidated mid-face fracture. There is insufficient evidence to make definitive recommendations regarding the management of ANSFs. Further prospective research is warranted.



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