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What is the Best Imaging Study to Evaluate a Broken Nose?

About Dr. Hootan Zandifar

Dr. Hootan Zandifar is board-certified in Otolaryngology and fellowship-trained in Facial Plastics and Reconstructive Surgery. Dr. Zandifar is the director of the Skin Center at the Osborne Head and Neck Institute based at Cedars-Sinai Medical Towers.

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About Dr. Jason Hamilton

Jason S. Hamilton, M.D. is the Director of Plastic and Reconstructive Surgery for the Osborne Head and Neck Institute based at Cedar-Sinai Medical Towers. Dr. Hamilton has advanced training in plastic and reconstructive surgical techniques involving the face, head, and neck, and limits his practice to the treatment of these areas exclusively.

Case Study

The patient is a 29-year-old female who sustained a fall and injury to her face. She was seen in the emergency room and was noted to have a swollen face and nose with nose bleed. She was diagnosed with a suspected nasal bone fracture and referred for evaluation. She was seen in office and a CT scan was obtained. The CT scan clearly showed nasal bone fracture with displacement of the nose. She underwent closed nasal reduction within one week of her trauma. Follow up CT showed great alignment of her nasal bones.

Figure 1: Sagittal CT of the face before closed nasal reduction showing the fractured nasal bones.
Figure 1: Sagittal CT of the face before closed nasal reduction showing the fractured nasal bones.
Figure 2: Axial CT of the face before closed nasal reduction showing the fractured nasal bones.
Figure 2: Axial CT of the face before closed nasal reduction showing the fractured nasal bones.
Figure 3: Sagittal CT of the face after closed nasal reduction showing well-aligned nasal bones.
Figure 3: Sagittal CT of the face after closed nasal reduction showing well-aligned nasal bones.
Figure 4: Axial CT of the face after closed nasal fracture showing well-aligned nasal bones.
Figure 4: Axial CT of the face after closed nasal fracture showing well-aligned nasal bones.

Discussion

A nasal bone fracture (broken nose) is a very common injury. In addition to the obvious cosmetic deformity of the nose, untreated nasal fractures can also lead to functional issues. These issues may include difficulty breathing, recurrent nosebleeds, and mouth breathing. However, if diagnosed early and treated within the first 2 weeks of injury, it is highly possible to avoid extensive surgery, functional changes, and disfigurement. One of the best methods to diagnose a broken nose is to obtain radiographic imaging. A CT scan will give the optimal visualization of the bones that are under the skin. A CT scan can also aid in surgical planning of both early treatment and, if necessary, more extensive surgery.

Early treatment is usually performed without any cutting or need for packing of the nose. This is done via a procedure called closed nasal reduction. The recovery time from a closed nasal reduction is only a few days and most patient’s can go back to full activity within a week. After this procedure it is important to not put any pressure on the nose for 2 months while the bones heal in place. Normal sport activity can be resumed within a week with the aid of a specialized mask that protects the nose and keeps the bones in place.

To learn more about Dr. Hootan Zandifar and nasal fracture repair, please visit www.FacialTraumaMD.com.

Contact a Physician at Osborne Head & Neck Institute

If you would like to speak with one of our physicians regarding this issue or another ear, nose, throat problem; or have other questions or concerns, please complete the contact form below or call us at 310-657-0123.

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