Trauma of nose and nasal cavity inflammatory diseases
Trauma of nose 1.Fracture of nasal bone ◼ Because of its prominent position and protruding, delicate skeleton, the nose is predisposed to soft-tissue injury and fracture. 50% trauma of nose is external nose trauma caused by impact, fall, bullet and blast. Most of them is lacerating wound and nasal bone fracture. Tape of fracture is relatived to direction and size of violence
Fracture of nasal bone Etiology Traffic accident Physical combat. Sports injury Nasal bone- Upper end: thick Lower end: thin
Clinical Features Most common symptom is nose bleed and nose pain. Serious patient can lead to shock. 1.Simple contusions show external nose swelling and ecchymoma. Appears within few hours and may obscure details of examination. 2.Periorbital ecchymosis 3.Tenderness 4.Fracture of nasal bone can cause displacement and deformity, show bridge of the nose collapse and deviation and saddle nose
Clinical Features 5.Nasal septum fracture can cause nasal obstruction, mucosa dilaceration, cartilage or bone reveal. If have hematoma of nasal septum，we can see bulging in one or two side of nasal septum. 6.If nasal root collapses obviously, X-ray or CT should be taken so fracture of sinuses and skull base can be found earlier. Nasal discharge flood just like water, we should think about cerebrospinal fluid rhinorrhea. Final diagnosis can be get by chemical examination. 7.Open fractures often are comminuted fractures. Besides have soft tissues injury ,always have foreign bodies
◼ Although these injuries do not often appear to be severe, the mistake of undertreating nasal trauma can lead to significant long-term problems. External deformity, nasal obstruction, septal perforation and other complications (e.g., chronic sinusitis) often persist and sometimes worsen months or years after the original insult. Thoughtful assessment and proper management of nasal injuries can reduce the risk of these sequelae, thereby reducing the need for delayed corrective septorhinoplasty. Clinical Features
Diagnosis Diagnosis is best made on physical examination. X-ray may or may not show fracture. Patient should not be dismissed as having no fracture because X-rays did not reveal it. X-rays should include Waters’ view, right and left lateral views and occlusal view. We can see fracture line and sclerotin sag
front wall fracture front & back wall fracture (sunken fracture凹陷型) (smashed fracture 粉碎型) Diagnosis：Frontal palpation, X-ray, CT scans
Fractured Nasal bone
Fractured nasal bone