The nose is an organ that is very open to traumas due to its location. In ENT practice, fracture of the nose due to a fall, traffic accident or attack is a very common condition.
Nose Fracture
What Kind of Bone Is the Nasal Bone: The nasal bone that can be palpated when we feel it on the back of the nose, two on the right and left, is the flat and flat bones that attach to the forehead bone at the top and the upper jawbone on the sides. In nasal traumas, fractures are usually seen in the bone because the cartilage parts are more flexible.
How Nasal Fracture Occurs : The most damaged bone in trauma to the face is the nasal bone. A blow to the nasal bone may occur from the front or the side. Fracture mostly occurs as a result of blows coming from the side. Although nasal fracture sometimes manifests itself with a slight crack without causing displacement of the bone, in severe traumas, fractures with multiple fragments and collapses may develop in the bone. Fractures may occur in other facial bones along with nasal fractures.
What Kind of Symptoms Occur: Symptoms of nasal fracture are related to trauma. Findings such as bleeding, cuts, bruising and edema on the nose and other parts of the face are encountered. Bleeding, edema and nasal congestion can also be seen in the nose.
What to See on Examination: In the examination of patients with nasal fracture, bruising, cuts, bleeding, and bruises on the skin are seen in the foreground again. The nose can be seen shifting to one side. On palpation of the nose, increased sensitivity and movement in the bones are detected. Intranasal examination reveals closure of the nose by broken bone or cartilage on one or both sides, tears in the mucosa and bleeding.
How to Diagnose: Detection of bone movement in the patient’s examination is sufficient for diagnosis. In this case, there is no need to take x-rays except for forensic cases. However, in cases where the fracture is suspected, x-rays should be taken. However, nasal bone x-rays may not always show the fracture. In this case, the inspection is more important.
How to Treat : In patients with nasal fracture, if there is no displacement, it may be sufficient to just put a tampon in the nose and provide support. However, this should be corrected in patients with displacement and deformity. The ideal time to correct the nasal bones is the first few hours. During this period, the procedure is easier as edema does not develop yet. If the edema is excessive, the intervention is delayed for 3-5 days, since the shape of the nose cannot be evaluated well. However, in patients who have passed more than 2 weeks, the intervention is performed with rhinoplasty techniques after 6 months, as the bone will begin to fuse. The first intervention is usually done under local anesthesia. However, sometimes general anesthesia may be required, especially in children. After the nose is anesthetized with local anesthesia, with an elevator inserted into the nose, On the other hand, it is tried to restore the nasal bones to their original shape by hand from the outside. This can be difficult sometimes. After the nasal bones are set in place, they should be supported with tampons from the inside of the nose. An antibiotic-impregnated gauze pad is usually placed as a tampon. It is necessary to support the nasal bones from the outside as well. For this, plaster or plasters can be used from the outside. At the end of the intervention, the patient should be given antibiotics, antihistamines and painkillers.
What should I pay attention to : The most important issue to be considered after the nose fracture is corrected is not to get a new blow to the nose. Apart from this, intranasal tampons are usually removed after 3 days. Plaster or plasters outside the nose are also removed after 1 week.