nasal bone fracture

1.One of the most common fracture bone in facial trauma. Majority of the causes due to trauma either motorvehicle accident, blunt trauma, sport injury, assaulted and etc.

2.Clinical symptoms are directed to the injury, usually pt may presented with nose bleeding prior to injury and usually subsided spontaneously.later on patient will experience nose pain,nasal blockage, swelling at nasal bridge. However, sometimes we need to ask patient is there any watery nasal discharge which indicate CSF rhinorhea which is dangerous to patient if not treat properly.

3.Clinical manifestation patient will have swollen nasal bridge, bruises at nose, blood clot in nostril. The important one is to rule out is there any septal hematoma which can cause septal cartilage necrosis due to compromised blood supply to the cartilage which later on cause septal perforation and late complication will cause saddle nose.

4.Radiological xray of nasal bone is benefit to see how the fracture of nasal bone whether is it deviated or displaced. Then usually patient also need for nasoendoscope if available.

5.Treatment is depend on the severity,time prior injury and how patient presented to us. For example, if patient presented with already resolved nose bleed few days prior injury, if nose still swollen, need to give nasal decongestant, analgesic first.Then to review patient within 1 week or not exceed for 2 weeks, to see alignment of nasal bridge. If there is deviation of nasal bridge, we need to do nasal bone reduction under local anaesthesia or general anesthesia.

6.Post reduction, to put patient on nasal splint at least for 1 week. we need to review again patient few weeks after reduction

7.A certain patient, nasal bone reduction is failed due to few factors. Then patient will undergo rhinoplasty which usually done by rhinologist and plastic surgeon.