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Video

Facial Plastic and Reconstructive Surgery

(A423) Rates of OSR After CNR in the Adult and Pediatric Populations

Monday, October 13, 2025
12:00 PM - 1:00 PM EDT
Location: OTO EXPO, Posters

    Presenting Author(s)

  • NW

    Nicole L. Wershoven, MD

    Resident
    University of Colorado Department of Otolaryngology
    Aurora, Colorado, United States

    • Co-Author(s)

  • MH

    Matthew Hill, MD

    Resident Physician
    University of Colorado Department of Otolaryngology
    Denver, Colorado, United States

  • GF

    Geoffrey Ferril, MD

    Associate Professor
    University of Colorado Department of Otolaryngology
    Broomfield, Colorado, United States

  • Christian R. Francom, MD

    Assistant Professor
    Children's Colorado ENT
    Aurora, CO, United States

  • SM

    Scott E. Mann, MD

    Associate Professor of Otolaryngology
    University of Colorado
    Denver, CO, United States

  • Adam Terella, MD

    Associate Professor
    University of Colorado Department of Otolaryngology
    Aurora, Colorado, United States

    • Senior Author(s)

  • Andrew Winkler, MD

    Section Chief-Facial Plastic & Reconstructive Surgery
    University of Colorado Department of Otolaryngology
    Aurora, Colorado, United States

Disclosure(s):
Nicole L. Wershoven, MD: No relevant relationships to disclose.
Matthew Hill, MD: No relevant relationships to disclose.
Geoffrey Ferril, MD: No relevant relationships to disclose.
Adam Terella, MD: No relevant relationships to disclose.
Andrew Winkler, MD: No relevant relationships to disclose.


Introduction: Management strategies for nasal fractures typically aim to restore both function and aesthetic form, with closed nasal reduction (CNR) often serving as the initial treatment modality. Despite its effectiveness in many cases, a subset of patients may require subsequent surgical interventions, such as open septorhinoplasty (OSR), to address residual functional or cosmetic concerns.

Methods: This project is a retrospective cohort analysis using the PearlDiver database (PearlDiver, Inc., Colorado Springs, CO) which encompasses information on 170 million patients across the United States from 2010 to 2024, covering all insurance payer types. Adult and pediatric cohorts were queried.

Results: In the pediatric population, a total of 193,226 pediatric patients with nasal fractures were identified. Of these, 46,602 (24.1%) underwent closed nasal reduction (CNR). Among those who underwent CNR, 568 (1.2%) subsequently required open septorhinoplasty (OSR). In the adult population, there were 1,023,216 cases of nasal fractures, with 173,495 (17.0%) undergoing CNR. Of the adults who received CNR, 1,659 (1.0%) went on to have OSR. The average time between CNR and OSR in the pediatric population was 1095 days while in adults was 751 days.

Conclusions: A higher proportion of pediatric patients with nasal fractures underwent CNR compared to adults. The percentage of patients requiring OSR after CNR was similar between pediatric and adult populations, however there was a longer time between CNR and OSR in the pediatric population. This analysis highlights differences in the management and outcomes of nasal fractures between pediatric and adult patients.