21338 Open treatment of nasoethmoid fracture; without external fixation

Name of the Procedure:

Open Treatment of Nasoethmoid Fracture (No External Fixation)

Summary

Open treatment of a nasoethmoid fracture involves surgically repairing a broken bone in the nasal bridge area without using external devices to hold the bones in place. This procedure aims to realign bones and stabilize the fracture internally, usually through incisions made on the face.

Purpose

Condition Addressed: Nasoethmoid fractures, which are breaks in the bones located near the bridge of the nose and between the eyes. Goals: Restore proper alignment and stability to the nasal and ethmoid bones, improve appearance, and ensure normal function and breathing.

Indications

• Visible deformity in the nasal region.
• Difficulty breathing through the nose.
• Persistent pain and swelling.
• Double vision or other vision problems caused by the fracture.
• Suitable for patients who do not require external fixation to stabilize the bones.

Preparation

• Pre-Procedure Instructions: Patients may need to fast for 6-8 hours before surgery and avoid certain medications as advised by the healthcare provider.
• Tests/Assessments: Imaging tests like X-rays or CT scans to confirm the extent of the fracture and plan the surgery.

Procedure Description

1. Anesthesia: General anesthesia is administered to ensure the patient is asleep and pain-free.
2. Incision and Exposure: A surgical incision is made near the fracture site to access the bones.
3. Bone Realignment: The surgeon carefully realigns the nasal and ethmoid bones to their correct positions.
4. Internal Fixation: Small plates, screws, or sutures may be used to stabilize the bones internally, but no external devices are used.
5. Closure: The incision is closed with sutures, and the area is bandaged.

Duration

The procedure typically takes about 1-3 hours, depending on the severity and complexity of the fracture.

Setting

Performed in a hospital or surgical center, usually in an operating room equipped for facial surgeries.

Personnel

• Surgeon specialized in facial or craniofacial surgery.
• Anesthesiologist to administer anesthesia.
• Surgical nurses and assistants.

Risks and Complications

• Infection at the incision site.
• Bleeding or hematoma formation.
• Nerve damage leading to numbness or tingling.
• Unintended bone movement or misalignment.
• Scarring or visible changes in appearance.
• Rare risk of complications from anesthesia.

Benefits

• Improved cosmetic appearance of the nose.
• Enhanced breathing functionality.
• Relief from pain and discomfort.
• Restored vision if affected by the fracture.
• Benefits can be realized immediately post-surgery, with continued improvement over weeks.

Recovery

• Post-Procedure Care: Keep the head elevated, use ice packs to reduce swelling, and follow wound care instructions.
• Recovery Time: Full recovery can take several weeks. Patients should avoid strenuous activities and follow up with their surgeon for evaluation.

Alternatives

• Closed Reduction: Non-surgical realignment of the bones; less invasive but may be less precise.
• External Fixation: Using an external device to stabilize bones; suitable for more severe fractures.
• Conservative Management: Observation and pain management without surgical intervention, which may be viable for minor, non-displaced fractures.

Patient Experience

• During Procedure: Patients are under general anesthesia and do not experience pain or awareness during the surgery.
• After Procedure: Some pain, swelling, and bruising can be expected. Pain is managed with prescribed medications. Patients may feel discomfort in the nasal area but will gradually improve with proper care and time.