BROKEN NOSE AND NASAL FRACTURES
A nasal fracture can occur with blunt force trauma to the nose such as in a sporting accident. A fracture can occur from a blow to the side or top of the nose causing both of the nasal bones to be twisted and crooked. When the upper lateral cartilage of the nasal bones is fractured, it creates a twist in the lower portion of the nose between the tip and nasal bones. Damage to the upper lateral cartilages can cause valve collapse and vestibular stenosis, impeding a patient’s ability to breath properly. To restore proper breathing, cartilaginous spreader grafts are placed to bolster the upper lateral cartilages outward.
Often times when a nose is broken severely the internal septum is also fractured. When the septum is fractured, it is also known as a deviated septum. The shaded area in red shows where the deviated septum (bone and cartilage) is removed from to improve airfow. To correct this, the fracture must be reduced through a procedure referred to as an Open Reduction Nasal and Septal Fracture. All of the multiple fragments of bone are put back into realignment along the nasal bridge to repair the nose back to its pre-injury state. Realignment of the nasal bones is done with osteotomies and resetting of the nasal bones with a cast placed over the bridge of the nose for one week. No packing is placed inside the nose after the surgery.
BREATHING SURGERY – DEVIATED SEPTUM
Deviated septum arises from a congenital outgrowth of both bone and cartilage in which it impacts the airway of the nose. Fracturing the septum and nose can displace the septal cartilage and/or bone over into the airway creating a deviated septum and a bone spur or a shelf, which impedes breathing. A septoplasty is performed to improve airflow through the nose and straighten out the airway passages. Sometimes submucous resection of the inferior turbinates is also performed simultaneously to improve the airflow dynamics through the nose as well.