21320 Closed treatment of nasal bone fracture; with stabilization

Name of the Procedure:

Closed treatment of nasal bone fracture; with stabilization
Common Name: Nasal fracture reduction with stabilization

Summary

This procedure involves realigning the broken bones in the nose without making any incisions (closed treatment) and using stabilizing elements like splints or packing to ensure the bones remain in the correct position while they heal.

Purpose

The procedure addresses nasal bone fractures, typically caused by trauma to the face.
Goals: Realign the broken nasal bones, ensure proper healing, restore function, and improve appearance.

Indications

• Visible deformity of the nose
• Difficulty breathing through the nose
• Persistent nosebleed (epistaxis)
• Swelling and bruising around the nose and eyes
• History of recent facial trauma

Preparation

• Fasting may be required if general anesthesia is used.
• Medications that thin blood (e.g., aspirin, anticoagulants) may need to be paused.
• Pre-procedure imaging (X-ray or CT scan) to assess the fracture.

Procedure Description

1. The patient is positioned, and anesthesia is administered (local or general).
2. The nose is carefully examined and the fracture is manually realigned using specific instruments.
3. Stabilization is achieved using internal splints, external splints, or nasal packing.
4. Post-alignment, the nose is re-checked to ensure proper positioning.

Tools: Nasal speculum, external splints, internal splints, nasal packing.

Duration

Typically takes about 30 minutes to 1 hour.

Setting

Performed in a hospital, outpatient clinic, or surgical center.

Personnel

• Surgeon (often an ENT specialist or plastic surgeon)
• Nurses
• Anesthesiologist (if general anesthesia is used)

Risks and Complications

• Infection
• Bleeding
• Septal hematoma
• Persistent deformity or asymmetry
• Decreased sense of smell
• Breathing difficulties
• Rarely, cerebrospinal fluid leak

Benefits

• Improved nasal function and aesthetics
• Relief from nasal obstruction
• Symmetry and alignment of nasal structure Expected benefits are generally realized within a few weeks as swelling subsides.

Recovery

• Avoid strenuous activities and nose-blowing for at least a week
• Keep the head elevated to reduce swelling
• Follow-up appointments for monitoring healing and removing splints or packing
• Full recovery typically within 1-2 weeks

Alternatives

• Open reduction surgery: More invasive but necessary for complex fractures.
• Watchful waiting: Minor fractures may heal on their own without intervention. Pros and cons vary based on fracture severity, patient health, and potential complications.

Patient Experience

During:

• Minimal discomfort if local anesthesia is used; general anesthesia ensures no pain.

After:

• Some pain and discomfort managed with pain relief medications.
• Swelling and bruising are common but subside within a few days to weeks.