21337 Closed treatment of nasal septal fracture, with or without stabilization

Name of the Procedure:

Closed treatment of nasal septal fracture, with or without stabilization

Summary

The closed treatment of a nasal septal fracture involves manually realigning the displaced or broken parts of the nasal septum without making any incisions. Stabilization may be used to keep the septum in place during the healing process.

Purpose

This procedure addresses a broken or displaced nasal septum, which is the wall dividing the nostrils. The goals are to restore normal nasal function and appearance, as well as to alleviate breathing difficulties and potential complications such as nasal obstruction or chronic nosebleeds.

Indications

• Obvious nasal deformity or displacement following trauma
• Difficulty breathing through the nose
• Persistent nasal obstruction or blockage
• Frequent nosebleeds (epistaxis)
• Pain and swelling in the nose

Preparation

• Patients may be advised to fast if sedation or general anesthesia is planned.
• Medication adjustments might be required, especially for blood thinners.
• Diagnostic tests such as X-rays or CT scans to assess the extent of the fracture.

Procedure Description

1. The patient is positioned appropriately, and local or general anesthesia is administered.
2. Using specialized instruments, the doctor carefully manipulates and realigns the fractured septum from outside the nose without making incisions.
3. Once realigned, internal splints or external nasal packing might be used to stabilize the septum.
4. If stabilization is used, it remains for several days to weeks, depending on healing progress.

Duration

The procedure typically takes between 15 to 30 minutes.

Setting

This procedure is usually performed in an outpatient clinic or surgical center.

Personnel

• ENT (Ear, Nose, and Throat) specialist or surgeon
• Nurses
• Anesthesiologist (if sedation or general anesthesia is used)

Risks and Complications

• Bleeding
• Infection
• Nasal obstruction or scarring
• Septal hematoma (collection of blood within the septum)
• Recurrence of the deformity

Benefits

• Restoration of normal nasal anatomy and function
• Improved nasal breathing
• Relief from nasal obstruction and associated symptoms
• Enhanced nasal appearance

Recovery

• Post-procedure instructions may include avoiding nose blowing, strenuous activities, and contacts sports.
• Pain management with prescribed medications.
• Follow-up appointments to remove splints or packing and to monitor healing.
• Most patients can return to normal activities within 1 to 2 weeks.

Alternatives

• Observation: Minor fractures may heal without intervention.
• Surgical treatment (open reduction): Involves making an incision to reposition the septum, used for more severe fractures.
  • Pros: Potential for more precise alignment.
  • Cons: More invasive with longer recovery.

Patient Experience

During the procedure, if under local anesthesia, the patient may feel pressure but should not experience pain. Post-procedure, there might be mild to moderate discomfort, swelling, and bruising. Pain management and comfort measures include prescribed pain relievers and applying ice packs to reduce swelling.