Trauma (nasal)

Question 1

Whats the most commonly fractured facial bone?

Whats the most common MOI?

Answer 1

Nasal bone (Adult and peds)

MVC (Adult)

Question 2

Important 2 questions to ask a pt before you begin treatment planning of nasal fx?

Answer 2

1. Does your nose look different from before the injury?

2. Did you have a deviated septum before the injury?

Question 3

Anatomy
From the frontal view, what 2 cartilages make up the nose?

From the sagittal view, what cartilages makes up inferior lateral parts of nose?

Answer 3

Insert pic from bugherri’s (fig. 36-1)

• Upper lateral cartilage
• Lower lateral cartilage

-Lower lateral cartilage is made up of
lateral crus
medial crus

Question 4

Anatomy

From the sagittal view, what makes up the midline structures of the nose? (3)

Answer 4

Insert pic from bugherri’s (fig 36-2)
Quadrangular septal cartilage

Perpendicular plate of ethmoid bone

Vomer

Question 5

Standard of care imaging for nasal fx’s?

Answer 5

CT scan w/o contrast

Question 6

What are the 2 indications for surgical management?

Answer 6

1. Esthetics

2. Function

Question 7

What is the term for loss of smell?

Answer 7

Anosmia

This may occur after high-impact nasal and naso-orbital-ethmoidal injuries

Question 8

What is the surgical intervention time window for a nasal fracture? (why)

Answer 8

10-14 days

after that, a callus begins to form that will not allow for easy manipulation/reduction
This requires open reduction and bony osteotomy

Question 9

are post op Abx indicated?

Answer 9

yes, to prevent TSS from nasal packing

Question 10

How long should nasal packing be left in after surgery if needed?

Answer 10

take them out within 1 week to prevent TSS. Can replace with new packing if still needed

Question 11

what does the cottle/modified cottle test for (anatomically)?

What 3 structures make up that structure?

Answer 11

internal nasal valve

Internal nasal valve:

1. Lower lateral cartilage
2. head of inferior turbinate
3. nasal septum