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Open treatment of nasal fracture; uncomplicated

CPT4 code

Name of the Procedure:

Open Treatment of Nasal Fracture; Uncomplicated

Common names: Open nasal fracture reduction, Surgical repair of nasal fracture

Summary

The open treatment of a nasal fracture involves surgically correcting a broken nose, realigning the nasal bones and cartilage to restore their normal shape and function. This procedure is typically performed when a nasal fracture is severe or cannot be corrected using a closed reduction method.

Purpose

Addressed Condition:
  • Nasal fracture (broken nose)
  • Misalignment of nasal bones and cartilage
Goals/Outcomes:
  • Correct the alignment of nasal bones and cartilage
  • Restore normal nasal function and appearance
  • Improve breathing function if obstructed by the fracture

Indications

  • Visible deformity of the nose following trauma
  • Difficulty breathing through the nose due to misalignment
  • Persistent bleeding or swelling after an injury
  • Failure of closed reduction to set the bones properly

Preparation

  • Fasting from midnight before the day of surgery
  • Discontinuation of certain medications as advised by the physician
  • Pre-operative blood tests and imaging studies (X-ray or CT scan) to assess the extent of the fracture

Procedure Description

  1. Anesthesia: Administered either general anesthesia or local anesthesia with sedation, depending on the case.
  2. Incisions: Small incisions are made inside the nostrils or occasionally on the skin.
  3. Reconstructing: The surgeon carefully repositions the fractured bones and cartilage.
  4. Fixation: Internal splints, sutures, or other devices may be used to hold the bones in place.
  5. Closure: Incisions are closed with sutures, and external splints may be applied.

Duration

The procedure typically takes between 1 to 2 hours.

Setting

Performed in a hospital operating room or an outpatient surgical center.

Personnel

  • ENT (Ear, Nose, and Throat) surgeon or plastic surgeon
  • Surgical nurses
  • Anesthesiologist

Risks and Complications

  • Bleeding or infection
  • Scarring
  • Persistent nasal deformity or asymmetry
  • Difficulty breathing through the nose
  • Anesthesia-related risks
  • Septal hematoma

Benefits

  • Restored nasal appearance and symmetry
  • Improved nasal airway and breathing
  • Reduced risk of long-term complications such as chronic breathing difficulties or sinus issues

Recovery

  • Initial swelling and bruising expected to subside within 1-2 weeks
  • Pain managed with prescribed medications
  • Nasal splints typically removed within a week
  • Avoidance of strenuous activities for a few weeks
  • Follow-up appointments to monitor healing

Alternatives

  • Closed reduction: Non-surgical realignment of nasal bones (applicable for minor fractures)
  • Non-intervention: In some cases, minor fractures may heal on their own without surgical intervention (risk of improper healing)
  • Minimally invasive procedures: As determined by the surgeon based on fracture complexity

Patient Experience

  • During: Little to no discomfort due to anesthesia
  • Post-procedure: Swelling, bruising, congestion, and mild to moderate pain managed by medications
  • Pain management includes prescribed pain relievers and cold compresses for swelling
  • Patients are given comprehensive care instructions for optimal recovery

This description provides a detailed and comprehensive understanding of the open treatment of nasal fracture, addressing essential aspects from preparation through recovery.

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