Close
New

Medscape is available in 5 Language Editions – Choose your Edition here.

 

Nasal and Septal Fractures Workup

  • Author: Daniel G Becker, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
 
Updated: Mar 11, 2016
 

Imaging Studies

See the list below:

  • The use of radiography is controversial. Old fractures, vascular markings, and suture lines can lead to false-positive results. A Water's view can be used to evaluate the bony septum, dorsal pyramid, and lateral nasal walls. However, studies have shown that radiographs are not helpful in the diagnosis or management of nasal fractures.[7]
  • CT is more useful to assess for other associated injuries, as well as extent of nasal injury. Septal fractures may be more obviously depicted on these films. Because the nose occupies such a prominent and accessible position, careful examination is possible and may obviate any need for radiographic study.
  • Photographs are useful and necessary for documentation and for comparison with preinjury photos. Photographs should include the standard angles used in facial analysis: frontal, left and right lateral, left and right oblique, base view, and often a bird's eye or partial base view. A smiling lateral view can also be helpful to evaluate depressor septae nasalis function. While 35-mm film and cameras still allow a superior resolution, digital photography is quickly becoming more prevalent.
 
 
Contributor Information and Disclosures
Author

Daniel G Becker, MD Assistant Professor, Department of Otorhinolaryngology-Head and Neck Surgery, Division of Facial Plastic and Reconstructive Surgery, University of Pennsylvania School of Medicine

Daniel G Becker, MD is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Stephen G Batuello, MD Consulting Staff, Colorado ENT Specialists

Stephen G Batuello, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American Association for Physician Leadership, American Medical Association, Colorado Medical Society

Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA Professor of Otolaryngology, Dentistry, and Engineering, University of Colorado School of Medicine

Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American Head and Neck Society

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Cerescan;RxRevu;SymbiaAllergySolutions<br/>Received income in an amount equal to or greater than $250 from: Symbia<br/>Received from Allergy Solutions, Inc for board membership; Received honoraria from RxRevu for chief medical editor; Received salary from Medvoy for founder and president; Received consulting fee from Corvectra for senior medical advisor; Received ownership interest from Cerescan for consulting; Received consulting fee from Essiahealth for advisor; Received consulting fee from Carespan for advisor; Received consulting fee from Covidien for consulting.

Additional Contributors

Hassan H Ramadan, MD, MSc Professor and Vice-Chair, Department of Otolaryngology-Head and Neck Surgery, Professor, Department of Pediatrics, West Virginia University School of Medicine

Hassan H Ramadan, MD, MSc is a member of the following medical societies: American Academy of Otolaryngic Allergy, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Rhinologic Society

Disclosure: Nothing to disclose.

Acknowledgements

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous author Adam T Ross, MD, to the development and writing of this article.

References
  1. Kuhnel TS, Reichert TE. Trauma of the midface. GMS Curr Top Otorhinolaryngol Head Neck Surg. 2015. 14:Doc06. [Medline]. [Full Text].

  2. Hwang K, You SH, Lee HS. Outcome analysis of sports-related multiple facial fractures. J Craniofac Surg. 2009 May. 20(3):825-9. [Medline].

  3. Atisha DM, Burr Tv, Allori AC, Puscas L, Erdmann D, Marcus JR. Facial Fractures in the Aging Population. Plast Reconstr Surg. 2016 Feb. 137 (2):587-93. [Medline].

  4. Liu C, Legocki AT, Mader NS, Scott AR. Nasal fractures in children and adolescents: Mechanisms of injury and efficacy of closed reduction. Int J Pediatr Otorhinolaryngol. 2015 Dec. 79 (12):2238-42. [Medline].

  5. Pérez-Guisado J, Maclennan P. Clinical evaluation of the nose: a cheap and effective tool for the nasal fracture diagnosis. Eplasty. 2012. 12:e3. [Medline]. [Full Text].

  6. Han DS, Han YS, Park JH. A new approach to the treatment of nasal bone fracture: the clinical usefulness of closed reduction using a C-arm. J Plast Reconstr Aesthet Surg. 2011 Jul. 64(7):937-43. [Medline].

  7. Han DS, Han YS, Park JH. A new approach to the treatment of nasal bone fracture: radiologic classification of nasal bone fractures and its clinical application. J Oral Maxillofac Surg. 2011 Nov. 69(11):2841-7. [Medline].

  8. Hung T, Chang W, Vlantis AC, Tong MC, van Hasselt CA. Patient satisfaction after closed reduction of nasal fractures. Arch Facial Plast Surg. 2007 Jan-Feb. 9(1):40-3. [Medline].

  9. Yi CR, Kim YJ, Kim H, et al. Comparison study of the use of absorbable and nonabsorbable materials as internal splints after closed reduction for nasal bone fracture. Arch Plast Surg. 2014 Jul. 41(4):350-4. [Medline]. [Full Text].

  10. Fernandes SV. Nasal fractures: the taming of the shrewd. Laryngoscope. 2004 Mar. 114(3):587-92. [Medline].

  11. Mondin V, Rinaldo A, Ferlito A. Management of nasal bone fractures. Am J Otolaryngol. 2005 May-Jun. 26(3):181-5. [Medline].

  12. Reilly MJ, Davison SP. Open vs closed approach to the nasal pyramid for fracture reduction. Arch Facial Plast Surg. 2007 Mar-Apr. 9(2):82-6. [Medline].

Previous
Next
 
Oblique view.
Lateral view.
Nasal septum.
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.