Name of the Procedure:

Open Treatment of Nasal Fracture with Concomitant Open Treatment of Fractured Septum

Summary

This surgical procedure involves the open repair of a broken nose (nasal fracture) and the simultaneous repair of a fractured nasal septum, which is the thin wall of bone and cartilage that separates the two nostrils.

Purpose

The purpose of this dual procedure is to correct deformities and ensure proper alignment of both the nasal bones and the septum, which can improve breathing, restore the appearance of the nose, and prevent complications such as nasal congestion and chronic sinus infections.

Indications

• Visible deformity of the nose
• Difficulty breathing through the nose
• Nasal blockage or congestion
• Persistent nosebleeds
• Pain or tenderness of the nose
• History of trauma to the nasal area

Preparation

• Fasting for at least 6 hours before the procedure
• Avoiding certain medications such as blood thinners
• Pre-procedure imaging tests such as X-rays or CT scans to assess the extent of the fractures
• Discussion with the anesthesiologist about medical history and allergies

Procedure Description

1. The patient is placed under general anesthesia.
2. An incision is made on the nasal area to access the bones and cartilage.
3. The fractured nasal bones are carefully aligned and fixed.
4. The fractured septum is accessed and repaired to ensure proper alignment and stability.
5. The incision is closed with sutures.
6. Nasal packing or a splint may be applied to support the nose during healing.

Duration

The procedure typically takes about 1-2 hours, depending on the extent of the fractures.

Setting

The procedure is usually performed in a hospital or outpatient surgical center under sterile conditions.

Personnel

• Otolaryngologist (ENT surgeon) or plastic surgeon
• Anesthesiologist
• Surgical nurses
• Operating room technicians

Risks and Complications

• Bleeding and infection
• Swelling and bruising
• Scarring or changes in nasal shape
• Difficulty breathing
• Septal hematoma (blood clot in the septum)
• Rarely, cerebrospinal fluid leak

Benefits

• Improved nasal function and breathing
• Restoration of nasal appearance
• Reduced nasal congestion and improved airflow
• Decreased risk of long-term complications such as chronic sinusitis

Recovery

• Nasal packing or splints may be in place for a few days to a week
• Pain management with prescribed medications
• Avoiding strenuous activities and nose blowing for at least a week
• Follow-up appointments to monitor healing and remove packing or splints
• Most patients can return to normal activities within 1-2 weeks, with complete healing taking 4-6 weeks

Alternatives

• Closed reduction of nasal fracture (without surgical incision)
  • Pros: Less invasive, faster recovery
  • Cons: May not be as precise for complex fractures
• Non-surgical management (e.g., watchful waiting, pain management)
  • Pros: No surgical risks
  • Cons: May not correct deformities or improve function

Patient Experience

Patients can expect to feel discomfort or pain after the procedure, which can be managed with pain medications. The nose may be swollen and bruised, and breathing through the nose may be difficult initially due to packing or splints. Over the next few weeks, swelling will decrease, and breathing will improve. Regular follow-up appointments ensure proper healing and address any concerns.