Nasal Fractures and Nose Surgery
Nose fractures are the third most common form of fracture to the body. Nose fractures may affect the nasal bone surface, nasal cavity wall, nose plate and tear ducts. Nose fractures may result in both aesthetic and functional deformity when left untreated. There are primarily the types of fractures, but fractures may be complex because of the nature of the force. In addition, complications may result from nose fractures, including, but not limited to: sense of smell loss, cartilidge loss, boney callous formation, septal hematoma, brain absess and risk of more severe medical conditions due to complications. In fact, complications may not be present at the onset of fracture, but may surface over time. For these reasons, it is crucial to seek out medical attention if you suspect a nose fracture immediately.
Following injury to the nose, physicians will perform a thorough examination and may perform a cat scan to rule out fractures in the surrounding nasal area. Initial treatment for nasal bone fractures may involve swelling reduction remedies, internal and/or external nose packing and splinting the nose to bring the nasal dorsum into a central line. Hematomas are drained as soon as possible following injury. There is one component of the nose that, when broken, may require hospitlalization called the cribriform plate. A cribriform plate fracture may lead to a Cerebrospinal fluid leak requires draining over the course of several days. In certain cases, the Cerebrospinal fluid leak does not stop leaking and skull surgery is required. Some fractures do not respond to splinting for proper nose positioning. In these cases, nose surgery is required. Nose surgery may be performed within ten days of injury or several months after injury, depending upon the nature of the injury and the nose surgeon’s philosophy about the appropriate time for surgery.
Nose Surgery Techniques
There are two types of techniques that may be used to repair nose fractures, including closed reduction and open reduction.
- Closed nose surgery may be the most appropriate technique for bilateral or unilateral nasal bone fractures. The closed technique is applicable for nasal septal deviation resulting from fracture of the basal septal complex in less extensive cases.
- Open nose surgery is often called upon for complex fractures such as extensive deviation of the nasal pyramid, open septal fracture, and caudal septum fracture. The open approach may also be used in a secondary procedure following closed nose surgery that did not provide fully satisfactory results.
Because nose fractures often occur from auto accidents, altercations, and falls, the type of fractures to the nose can be complex. In fact, the nose is 3-dimensional which adds intricacy in treatment. It is important for people who have nose fractures to see a nose surgeon that is experienced in treating nose fractures. Nose surgery for fractures may be complex, but the right surgeon reduces the risk for greater complexity in cosmetic deformity and functional impairment that may last a lifetime.
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