Symposium on trauma in otolaryngology.

Abstract

AbstractThe prominent position of the nose makes it one of the most frequently injured structures of the body. Most physicians are not trained to recognize and treat these injuries.A review of the literature gives very few details as to the technique of handling these injuries or the long term functional problems. Attempts are made at closed reduction and usually the result is far from satisfactory. Many patients are told that nothing can be done at the time, but if they so desire, a corrective operation can be done later.Evaluation and extent of the injury is important for proper approach to the problem. Early prevention of swelling and ecchymosis with restoration of contour, is the key to successful long term results.Anatomically, the nose is made up of four major parts: the bony pyramid, the cartilaginous vault, the lobule and the septum, and are joined together with different kinds of soft tissues which make up a functioning organ. The understanding of this normal anatomy will help to visualize what happens when a severe blow changes these relationships.Fractures of the nose are caused by any type of object. The direction and intensity determines the type and extent of the deformity. This can be illustrated as seen in fist fights, where this is a direct blow, a right or left hook, or an upper cut. Nasal fractures vary greatly in their characteristics, and may be classified as simple, comminuted and compound or a combination of the latter two, and invariably involve the septum. The importance of the septum is that it divides the nose into two air chambers and any change in relationship to the other structures with affect the breathing pattern.