nasal bone fracture
Introduction
Introduction to nasal bone fracture A fracture of the nose (fracture of nasalbone) can occur alone or in combination with other jaw fractures. The outer nose protrudes from the face and is subject to damage from impacts, falls, bullets and explosive shrapnel. External nasal trauma accounts for 50% of nasal trauma, of which laceration and nasal bone fractures are more common. The type of fracture is related to the direction and size of the violence. basic knowledge The proportion of illness: 0.003% Susceptible people: no specific people Mode of infection: non-infectious Complications: shock
Cause
Cause of nasal bone fracture
Nasal bone fractures are often caused by direct violence, such as intentional or unintentional trauma, fighting, traffic or work-related accidents during exercise. Nasal fractures can also be caused by the nose or forehead landing when the child falls.
Prevention
Nasal bone fracture prevention
The preventive measures for this disease mainly include the following measures:
1, pay attention to rest, avoid direct head hair dryer.
2, wear glasses, temporarily removed.
3, such as suffering from cough, allergic rhinitis, try to control cough and sneezing.
4, diet, early fractures, due to severe swelling and pain, fever and loss of appetite, so the diet should not be excessive, the dishes should not be greasy, late, swelling and pain has gradually eased, the appetite is gradually returning to normal, can strengthen nutrition to promote healing.
Complication
Nasal bone fracture complications Complications
Any substantial nasal bone displacement has a bone nasal septum fracture; cartilage bridge impact can also affect the nasal septal cartilage fracture; so the nasal bone fracture often has a septal fracture, because the nasal cone is close to the ankle, maxilla, tear bone, frontal bone, After the ethmoid bone and the skull are on it, the nasal bone fracture can often cause a combined injury; because of motorcycles, car-wounded people, it is prone to serious compound injuries, especially head injury, in addition to this, it can also occur in the face. And severe upper and lower jaw fractures, laryngeal and tracheal injury, cervical and thoracic injury and traumatic shock and other complications, and external sequelae and nasal dysfunction and other sequelae are mostly due to treatment is not timely or incomplete.
Symptom
Symptoms of nasal bone fracture Common symptoms Nasal septum or nasal cavity... Nodules above the nose, nose, exposed nose, poor shape, nasal end, nasal septum, cerebrospinal fluid, nasal leakage, nasal column defect, nosebleed
Nosebleed
Nasal bone fractures were almost always had tears of the nasal mucosa and nosebleeds.
2. Local malformation
When the violence comes from one side, the ipsilateral nasal bone subsides, the contralateral bulge, and the nose is deformed. The positive violence often causes the nasal bones to fracture on both sides, and the nasal bridge collapses, forming a saddle deformity. After 2 to 4 hours of injury, the nasal soft tissue and the eyelids are swollen. In the case of congestion, the deformity is temporarily covered, accompanied by dislocation or fracture of the nasal septum, and the cartilage is exposed in the nasal septum or nasal cavity.
3. Touch pain and bone rubbing
After the nasal bone fracture, the pain is not obvious, but the fracture of the fracture site is obvious, and the bone rubbing can often be touched. The lower edge of the nasal bone is palpated simultaneously with two fingers, and the fracture side loses the normal hard resistance. If the patient has a wound after the injury Nasal movement, airflow may spread through the mucosal tearing mouth in the nasal back and ipsilateral eyelids, which may cause subcutaneous snoring.
Open nasal bone fractures generally suffer from severe trauma, often comminuted fractures, and often have other craniofacial fractures. There may be foreign bodies in the wound. If there is a sieving plate fracture, there may be cerebrospinal fluid rhinorrhea. Should be brought to the attention.
When the diagnosis of nasal bone fracture is not clear, the lateral X-ray film helps to determine the location of the fracture line and the displacement of the flap.
Examine
Nasal bone fracture examination
According to the patient's clinical manifestations and signs, the disease can generally be diagnosed. If the diagnosis is not clear, some supplementary examination methods are needed, and the main imaging examination is performed:
1, X-ray inspection:
X-ray of the lateral side of the nose can be seen in the fracture line and bone subsidence, and the nasal root collapse is obvious. X-ray (sinus position, head position, etc.) should be taken to exclude the ethmoid sinus, frontal sinus and upper jaw. Sinus fractures, should also pay attention to the presence or absence of skull base fractures can occur cerebrospinal fluid rhinorrhea, showing a stream of red nosebleeds, nose blood for sugar test, sugar positive is cerebrospinal fluid rhinorrhea.
2, CT examination:
The current CT scan can accurately distinguish the damage of the maxillary frontal process, nasal bone, tear bone, nasal frontal joint, nasal and maxillofacial joint and nasal joint, which provides a reliable basis for clinical treatment.
Coronal CT scan in the diagnosis of nasal bone, bilateral fractures, maxillary frontal fractures, composite fractures and nasal and maxillary suture separation is significantly better than transverse CT scan, and transverse CT scan in the nasolacrimal duct fracture, nasal Separation of the suture, the diagnosis of the internasal suture is significantly better than the simple coronal CT scan. The reason for the above results is obvious and the coronal CT scan reduces the error caused by the layer thickness and interval in the CT scan of the transposition and can clearly understand The nasal septum, nasal and nasal bones are adjacent to the maxillary frontal projections and provide more information than transverse transposition scans.
Diagnosis
Diagnosis and identification of nasal bone fracture
Diagnosis can be based on medical history, clinical symptoms, and laboratory tests. The disease generally has a history of obvious trauma, but it should be differentiated from normal nasal bone mutations during diagnosis to avoid misdiagnosis.
