Optimizing Recovery: Closed Technique Displaced Nasal Fracture Reduction
Information about the case
A 26-year-old male basketball player applied to the hospital due to his nose being crooked and breathing problems after he received an elbow blow to his nose during the match. The trauma occurred approximately 4 days ago, and as the nasal edema decreased, the changes in nose shape due to the nasal fracture were easily understood when compared to the previous photographs.
Physical examination
A crepitation sound was noticed in the patient during palpation. A c-nasal deformity and nasal septum deviation were detected in the nose. It was stated that this negative change in the patient's nose shape occurred immediately after the elbow blow he received in the basketball game, and a diagnosis of fragmented, displaced nasal fracture was made. The patient's paranasal sinus tomography images showed nasal fracture and displacement of the nasal bone lamellae.
Planned treatment
The patient was planned to have a closed technique nasal fracture reduction under general anesthesia.
Nasal fractures are a common occurrence, often resulting from trauma to the face. While some fractures may be minor and heal on their own, others require intervention to ensure proper alignment and function. Closed reduction, performed under general anesthesia, is a widely used technique to realign displaced nasal bones without the need for surgical incisions. In this article, we delve into the intricacies of closed technique nasal fracture reduction under general anesthesia, its benefits, procedure, and post-operative care. It can be seen in the photographs below that most of the asymmetrical light reflections on the dorsum of the nose have been corrected before and after the reduction of the patient. Since the patient shared here is a professional basketball player, it was recommended that he play with a face shield for a few months. With repeated nasal traumas, fracture fragments may shift again and serious nasal deformities may occur. Patients should avoid nasal trauma after closed fracture reduction.
Understanding Closed Technique Nasal Fracture Reduction
Closed reduction of nasal fractures involves manipulating the displaced nasal bones back into their proper position without making any external incisions. This technique is favored for its minimal invasiveness and ability to restore nasal anatomy with reduced risk of scarring or complications.
Benefits of Closed Technique Nasal Fracture Reduction
Preservation of Nasal Structure: Unlike open reduction techniques that involve surgical incisions, closed reduction minimizes the risk of altering the natural contours of the nose, leading to a more aesthetically pleasing outcome.
Reduced Risk of Infection: By avoiding external incisions, the risk of post-operative infections is significantly lowered, promoting faster healing and recovery.
Quicker Recovery Time: Patients undergoing closed reduction often experience shorter recovery times compared to those undergoing open surgical procedures, allowing them to return to their daily activities sooner.
Procedure Overview
Closed technique nasal fracture reduction under general anesthesia typically involves the following steps:
Pre-operative Assessment: Prior to the procedure, the patient undergoes a thorough evaluation, including imaging studies such as X-rays or CT scans, to determine the extent and location of the nasal fracture.
Anesthesia Administration: General anesthesia is administered to ensure the patient is unconscious and pain-free throughout the procedure.
Nasal Manipulation: With the patient under anesthesia, the surgeon carefully manipulates the displaced nasal bones back into their correct alignment using specialized instruments and techniques.
Confirmation of Alignment: Once the bones are repositioned, the surgeon verifies the alignment using intraoperative imaging studies to ensure proper placement.
Post-procedural Care: Following the procedure, the patient is monitored closely in a recovery area until they are fully awake. Pain management and post-operative instructions are provided to promote healing and minimize discomfort.
Post-operative Care and Recovery
After closed reduction of a nasal fracture, patients are advised to follow specific post-operative instructions to optimize healing and recovery. These may include:
Pain Management: Over-the-counter or prescription pain medications may be prescribed to manage any discomfort following the procedure.
Nasal Care: Patients may be instructed to use saline nasal sprays or irrigations to keep the nasal passages clean and moist.
Activity Restrictions: Patients are typically advised to avoid strenuous activities and contact sports for a specified period to prevent further injury to the nose.
Follow-up Appointments: Scheduled follow-up appointments allow the surgeon to monitor healing progress and address any concerns or complications that may arise.
Closed technique nasal fracture reduction under general anesthesia is a safe and effective procedure for realigning displaced nasal bones without the need for surgical incisions. With its minimal invasiveness, reduced risk of complications, and quicker recovery times, it offers patients a viable option for restoring nasal function and aesthetics following trauma. As with any medical procedure, it is essential to consult with a qualified healthcare provider to determine the most appropriate treatment plan based on individual needs and circumstances.
Link group where you can read the articles I have previously written and published about nasal fracture >> https://www.ent-istanbul.com/search?q=nasal+fracture
Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon
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