Nose Treatment

NASAL BONE FRACTURE

Fracture of the nose is the commonest fracture in humans.

Epidemiology: More common in Caucasians than Asians or Africans.

    Aetiology:
      Usually low velocity trauma to the nose is the common cause.
      This may result from:
      • Personal assault.
      • Sports injuries.
      • Road traffic accidents.
      • Personal accidents.

    Types of fracture:
    • Class I: Blow of severity due to frontal or fronto-lateral trauma. There is a breach in the quadrilateral cartilage with depression or displacement of distal part of nasal bone.
    • Class II: Medium velocity lateral trauma. There is a breach in root of nasal bone and maxillary process of frontal bone. The ethmoid labyrinth is intact.
  • 3.Class III: High velocity trauma. Fracture extends to the ethmoid labyrinth. The patient has pig-like appearance. Injury to lacrimal sac and nasolacrimal duct may be present.
Clinical features:
  • Swelling of nose.
  • Periorbital ecchymosis.
  • Tenderness.
  • Nasal deformity: Depressed from the front or side, or the whole nasal pyramid deviated to one side.
  • Crepitus and mobility of fractured fragments.
  • Epistaxis.
  • Nasal obstruction due to septal injury or hematoma.
  • Lacerations of the nasal skin with exposure of nasal bones and cartilage may be seen in compound fractures.


Diagnosis:
  • Diagnosis is best made on physical examination.
  • X-rays may or may not show fracture.

Complications:
  • Deviated nasal septum.
  • Saddling of the nose.
  • Bleeding.
  • Cerebrospinal fluid leak.
  • Orbital complications.
Image

X ray nasal bone lateral view show fracture of nasal bone.

Image

Nasal bone reduction.

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