21336 Open treatment of nasal septal fracture, with or without stabilization

Name of the Procedure:

Open Treatment of Nasal Septal Fracture

• Common Name(s): Septoplasty for Nasal Fracture, Septal Fracture Repair
• Technical/Medical Term: Open Reduction of Nasal Septal Fracture

Summary

The open treatment of a nasal septal fracture involves surgically realigning and repairing a broken nasal septum, the cartilage and bone structure dividing the nostrils. This procedure may include stabilization using internal supports to ensure proper healing.

Purpose

This procedure addresses nasal septal fractures, which can cause nasal obstruction, difficulty breathing, and cosmetic deformity. The goal is to restore normal nasal function and appearance, and to prevent long-term complications such as persistent difficulty in breathing or recurring infections.

Indications

• Symptoms such as nasal obstruction, difficulty in breathing, or nasal deformity after trauma.
• Visible deformity or displacement of the nasal septum.
• Recurrent nosebleeds or chronic nasal discharge.
• Sleep disturbances due to nasal airway obstruction.

Preparation

• Patients may need to fast for several hours before the procedure.
• Discontinuation of certain medications such as blood thinners, as advised by the physician.
• Pre-procedure diagnostic tests might include nasal endoscopy or CT scans to assess the extent of the fracture.

Procedure Description

1. Anesthesia: Administered general anesthesia or local anesthesia with sedation.
2. Incision: A small incision is made inside the nasal cavity to access the septum.
3. Realignment: The fractured segments of the septum are carefully repositioned.
4. Stabilization: Splints or packs may be placed inside the nose to stabilize the septum.
5. Closure: The incisions are closed with sutures.

Duration

The procedure typically takes 1 to 2 hours.

Setting

Performed in a hospital or an outpatient surgical center.

Personnel

• Surgeon: An ENT (Ear, Nose, and Throat) specialist or plastic surgeon.
• Nurses: Surgical and post-operative nursing staff.
• Anesthesiologist: Administers and monitors anesthesia.

Risks and Complications

• Common: Bleeding, infection, swelling, bruising.
• Rare: Septal perforation, adverse reactions to anesthesia, unsatisfactory cosmetic results, numbness, or scar tissue formation.

Benefits

• Improved nasal breathing.
• Restoration of normal nasal appearance.
• Reduction in recurrent nosebleeds and infections.

Recovery

• Post-procedure care includes keeping the head elevated, avoiding strenuous activities, and using prescribed medications to control pain and prevent infection.
• Nasal packs or splints may be removed after a few days.
• Full recovery can take several weeks, with follow-up appointments to monitor healing.

Alternatives

• Closed Reduction: A less invasive procedure without incisions. Not suitable for all types of fractures.
• Non-Surgical Management: Medications and nasal splints may be used for minor fractures, though less effective for severe cases.

Patient Experience

• During the procedure, the patient is under anesthesia and should not feel pain.
• Post-procedure, the patient may experience some discomfort, swelling, and nasal congestion.
• Pain is generally manageable with prescribed medications.
• Most patients can resume normal activities within a few weeks, but should avoid strenuous activities until fully healed.