Nasal bone fracture
As a protruding part of the body, the nose is exposed to violent impacts, blows or falls, and the nasal bone fracture is a relatively common injury. In the case of a push from the front, the nasal bones usually kink across the lower third. Often the cartilaginous nasal septum is also broken. A septal hematoma is not uncommon . In the event of greater violence, the neighboring bone structures can also be included ( frontal process of the upper jawbone , tear bone , ethmoid bone ).
A nasal bone fracture is usually with epistaxis connected, followed by swelling and bruising discoloration of the nasal bridge. A displacement of the bone fragments is usually clearly visible in the form of a sunken nasal bridge or a lateral deviation of the nose ( boxer's nose ). A swelling can occasionally hide a slight change in shape at the beginning.
A change in shape leaves no doubt about a broken nose. An inspection of the inside of the nose ( rhinoscopy ) is necessary to assess the nasal septum . By palpating the nose, broken edges can be felt or mobility of the fragments can be determined. X-rays of the nose reveal the fracture gap and any displacements of the fragments.
If the fractures are not displaced, the nasal bones grow back together without treatment. Displaced bone fragments must be reduced to avoid permanent obstruction of nasal breathing.
If the frequent nosebleed does not stop by itself, a nasal packing is required.
Displaced bone fragments are lifted under local or general anesthesia with an elevator from the inside of the nose and brought back into proper position. The repositioning must take place no later than eight to ten days after the break, otherwise the nose (in the shifted position) is already fixed again. A septal hematoma or a septal fracture with displacement must be treated surgically. The procedure is similar to that of a septoplasty . Extensive debris fractures must u. U. are supplied by exposure from the outside. After the operation, the nose is fixed with a splint or a plaster cast .
- J. Theissing: ENT surgery theory. 3. Edition. Thieme-Verlag, Stuttgart 1996, ISBN 3-13-463703-0 .
- Surgery portal over a nasal fracture