Nasal Fractures - Causes, Symptoms, Diagnosis, Treatment
Nasal fracture can occur due to trauma to the face, nasal bone can be broken or cracked due to traumatic forces.
It is the most common type of facial fractures and nasal fractures account for approximately 40% of all bone injuries (source: Nasal Fracture Imaging - eMedicine - Medscape)
Nasal Fracture Definition
|Nasal Fracture Definition|
Nasal Fracture Symptoms
|Nasal Fracture Symptoms|
- Nose hyperemia and bruises
- Swelling in the nose
- Nasal Deformity
- Nasal congestion
- Hearing of crepitation sounds when touching the nose
If other facial bones broken in well together, additional findings may occur
The above, patients are seen photographs which have nasal deformities after nasal fracture.
In patients with nasal fracture depending on the severity of the trauma, nasal septum fracture, epistaxis or septal hematoma may occur.
Detailed examination of ENT can reveal these findings . X-ray of nasal bone and paranasal sinuses tomography can help for detecting the severity of the trauma.
Nasal Fracture Diagnosis
|Nasal Fracture Diagnosis|
During the examination:
- Crepitation sounds on palpation of nose
- Changes in the form of nose (patient photo which taken before the trauma) be evaluated.
Nasal Fracture Treatment
Non-displaced fractures usually require no treatment. To follow of the patient is satisfactory and fracture heal spontaneously.
Displaced fractures require reduction to prevent permanent nasal deformity.
Nasal fracture reduction (for displaced fractures) in adults can usually be carried out in the office using local anesthesia. It can require general anesthesia in an outpatient setting especially in young children.
Nasal Fracture Reduction Technique (Closed Reduction of Nasal Fracture):
Boies or Salinger elevator inserted into the nose under the depressed fragment. Steady outward pressure can be applied on the posterior aspect of the nasal bone. Control outward pressure with counterpressure exteriorly with the other thumb. Fragments may need to be molded into the proper position.
Walsham forceps can be use also to directly grasp the nasal bone. Manipulation of the nasal bone into position can require for all efforts.
Septal reduction can be checked also. If not adequately reduced, Asch forceps can be used to elevate the nasal pyramid while applying direct pressure to the displaced portion of the septum until it is moved back into the proper position.
Septal hematoma can be checked and drained if present.
Internal packing (eg, Vaseline gauze or 8-cm Merocel) and an external splint (eg, Thermaplast, Aquaplast) can be use to stabilize reduction. Nasal dorsal skin should be protected with Steri-Strip bandage application prior to placement of the splint. While the nasal packing is in place, the patient should be on an oral antibiotic with adequate.
This reduction technique can be made with open approach. Usually, closed reduction technique can used in almost all patients.
Post-operative Instructions for Reduction Nasal Fracture
|Post-operative Instructions for Reduction Nasal Fracture|
During that period of nasal fracture healing time, activity that may cause further nasal trauma should be avoided. nasal protection used. Internal nasal packing can remove in 2-5 days and external nasal splint can remove in 7 days.
Antibiotics and pain medication are usually given for a period of first one week.
Q-tip dipped in hydrogen peroxide or warm soapy water can be used to clean the front of the nose and nostrils.
Head elevation can help to reduce blood pressure on the facial area (sleeping with an extra pillow or two can elevate head slightly).
There are no diet restrictions, but alcohol consumption is not recommended and tobacco use is prohibitedas Nicotine decreases blood flow to the healing nasal tissues and can actually compromise wound healing.
In the first two months after broken nose glasses are inconvenient to use.
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