Quality of Life of Patients with Nasal Bone Fracture After Closed Reduction in a Tertiary Centre in Nepal

Abstract

Background
Nasal bone fracture is the most common facial fracture, and closed reduction is the standard treatment. However, patient-reported quality of life (QoL) outcomes after surgery remain underexplored. The Sinonasal Outcome Test-22 (SNOT-22) is a validated tool for assessing sinonasal symptoms and postoperative recovery. This study evaluated changes in QoL following closed reduction of nasal bone fractures and identified factors associated with postoperative improvement.
Methods
A prospective observational study was conducted among 138 patients with nasal bone fractures who underwent closed reduction at the ENT outpatient department of College of Medical Sciences and Teaching Hospital from February 2025 to February 2026. QoL was assessed using the SNOT-22 questionnaire preoperatively, at 2 weeks postoperatively, and at 3 months follow-up. Demographic data, fracture characteristics, and postoperative complications were recorded. Paired statistical tests and multivariable analyses were performed.
Results
Among 138 patients, the mean age was 34.8 ± 12.6 years, and 66.7% were male. Road traffic accidents were the leading cause of injury (44.9%). The mean SNOT-22 score significantly improved from 41.6 ± 9.8 preoperatively to 18.9 ± 7.4 at 2 weeks postoperatively (p < 0.001), with sustained improvement at 3 months. Improvement was noted across all symptom domains, especially nasal obstruction and facial pain. Patients with septal deviation had relatively higher postoperative scores, although overall improvement remained significant. No sex-based differences were observed.
Conclusions
Closed reduction significantly improves patient-reported QoL after nasal bone fracture. Routine use of validated tools such as SNOT-22 supports comprehensive assessment of functional outcomes and patient-centered care.