NASAL BONE FRACTURE

NUR HANISAH BINTI ZAINOREN

TRAUMA TO THE FACE

LOWER THIRDMandible and

lower teeth

MIDDLE THIRDBetween the supraorbital

ridge and the upper teeth

UPPER THIRDAbove the level of supraorbital ridge

TRAUMA TO THE FACE

LOWER THIRDMandible and

lower teeth

MIDDLE THIRDBetween the supraorbital

ridge and the upper teeth

UPPER THIRDAbove the level of supraorbital ridge

TRAUMA TO THE FACE

LOWER THIRDMandible and

lower teeth

MIDDLE THIRDBetween the supraorbital

ridge and the upper teeth

UPPER THIRDAbove the level of supraorbital ridge

# of NASAL BONES & SEPTUM

Fractures of nasal bones are the most common trauma to the face because of the projection of nose on the face

Traumatic force may act from the

front or side

Magnitude of force will determine the depth of injury

Types of Nasal Fractures

depressed angulated

Due to frontal blow

Lower part of nasal bones (thinner), easily gives way

Severe frontal blow will cause “open-book fracture” nasal septum is collapsed and nasal bones splayed out

Greater force comminution of nasal bones and even the frontal process of maxillae with flattening and widening of nasal dorsumDEPRE

SSED

ANGULATED Due to lateral blow

May cause: Unilateral depression of

nasal bone on the same side

Fracture both nasal bones & septum with deviation of nasal bridge

nasal fractures are often accompanied by injuries of nasal septum (buckled, dislocated, or comminuted)

CLINICAL FEATURES

DIAGNOSIS• Best made on physical

examination • Xray:

– may or may not show fracture– Patient should not be

dismissed as having no fracture because xrays did not reveal it

– Should include Water’s view, right & left lateral view and occlusal view

TREATMENT• Simple fracture with no displacement NO

TREATMENT

• Closed reduction– Interfered by presence of oedema– Best time is before the appearance of oedema, or after it

has subsided (usually 5-7 days)– Difficult after 2 weeks because it heals by that time

• Open reduction (rare)

REFERENCES• Diseases of Ear, Nose and Throat & Head and Neck

Surgery, 6th Edition, PL Dhingra, Elsevier• https://www2.aofoundation.org/wps/portal/!ut/p/

a0/04_Sj9CPykssy0xPLMnMz0vMAfGjzOKN_A0M3D2DDbz9_UMMDRyDXQ3dw9wMDAzMjfULsh0VAbWjLW0!/?bone=CMF&classification=92-Nasal%2FNOE%2C%20Nasal%20bone&segment=Midface&showPage=diagnosis&teaserTitle=&contentUrl=/srg/92/01-Diagnosis/nasal.jsp

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