A fracture of the nasal bone is a very common injury, which can occur during sports or physical work, for example. In most cases, the nasal septum is broken. In the case of greater force and impact, neighboring bone structures such as the ethmoid bone, the forehead or the upper jaw bone can also be involved.
A fracture of the nasal bone can also heal without surgery. If the bone parts are not displaced, the nasal bones grow together again by themselves. Displaced fractures, where the nose is crooked, require a reduction.
This involves repositioning the nose to its original shape. This is done under local or intubation anesthesia. The displaced bone parts are then moved from the inside out into their anatomically correct position and then fixed in place with a metal or plaster splint.
This means that no incisions from the outside are necessary. The reduction should be carried out no later than eight days after the fracture, otherwise shape defects such as a saddle nose or a crooked nose may remain. The operation is similar to septoplasty. In comminuted fractures, exposure from the outside is necessary. Here, incisions are made from the outside.
Septoplasty
A septoplasty is a procedure that is performed when the nasal septum is bent beyond the natural extent. Naturally, the nasal septum is never completely straight, this does not hinder breathing or the quality of life in everyday life. However, if the nasal septum is bent beyond its natural extent, it can lead to breathing difficulties, sleep disorders, snoring, sinusitis and pharyngitis.
The development of middle ear inflammation, olfactory disorders, nosebleeds and headaches can also be the consequences of impaired nasal ventilation. A fracture of the nasal bone is a possible cause of a displacement of the nasal septum and may thus require a semptum plasty. Whether a septoplasty is necessary is determined by the attending physicians by inspecting the nose.
Endoscopy and x-rays can be used for a more precise diagnosis. The latter is particularly important if surrounding bone structures, such as the paranasal sinuses, are also to be examined. The procedure as such is performed with preservation of the septal cartilage, which distinguishes it from septal resection.
The cartilage pieces are gently straightened, rejoined and then left in the nose. For stabilization, plastic platelets, so-called splints, or foils are used, which are sutured to both sides of the corrected nasal septum. These are removed after about 5-7 days.
After an operation on the nasal septum, a nasal tamponade is often inserted into the nose. It stops the bleeding. After a few days this is also removed.
