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NASAL FRACTURES

In contact sports & fights Depressed or deviated NB Nonaccidental injury Simple or Compound. NASAL FRACTURES. Deformity, Obstruction& bleeding The deformity is obvious Careful palpation Nasal cavity examination Radiography. NASAL FRACTURES Clinical Presentaion. Reduction of NF

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NASAL FRACTURES

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  1. In contact sports & fights • Depressed or deviated NB • Nonaccidental injury • Simple or Compound NASAL FRACTURES

  2. Deformity, Obstruction& bleeding • The deformity is obvious • Careful palpation • Nasal cavity examination • Radiography NASAL FRACTURESClinical Presentaion

  3. Reduction of NF • Disimpacted bony fragments • Swinging, reduces the fracture • Depressed NB is lifted • External cast NASAL FRACTUREStreatment

  4. Fracture of Nasal Bone

  5. Complicationsof Nasal Trauma –Septal deviation– Septal hematoma– Septal abscess– Causes of cosmetic defects: • poor initial management• secondary infection

  6. NASAL FRACTURE Prof.BAFAQEEH Prof.BAFAQEEH

  7. FRACURE NASAL BONE

  8. * Prof.BAFAQEEH

  9. NASAL Fracture

  10. Perichondrium injury • Hematoma • necrosis abscess • int. sepsis • [”saddle nose”] Complications of NF(Septal Hematoma)

  11. Examination: • Thin, firm& swollen septum • Fluctuant swelling • Nasal obstruction • Urgent drainage • Firm N packing (Septal Hematoma)

  12. Complication of NFDS & Nasal deformity • DS : “Springiness” • Elective or acutely septoplasty • Difficult 2ndprocedures

  13. Key Points in NF

  14. Common • Blunt violent injury • Tripod fracture Fractures of the Zygoma&the Bony Orbit tripod fracture 3

  15. Inspection: Globe level • Palpation: Orbital rim • Depressed maxilla • Parasthesia OR Numbness • Jaw& Eye movements Fractures of the Zygoma&the Bony Orbit

  16. No Treatment • Reduction: OE,DF,ION damage • Elevation OR Open reduction &wiring Fractures of the Zygoma&the Bony Orbit

  17. Isolated Blowout Fracture –Localized violence --> Orbital contents – A blow (a fist, a tennis ball, a sq. ball, a champagn bottle cork, etc ) – Fractures of the orbital bony floor – Trapping of the orbital contents

  18. Blowout FractureSymptoms – Enophthalmos – Double vision – Limitation of eye movement – Infraorbital nerve sensation disorders

  19. Blowout FractureDiagnosis •Radiographs “tear drop” • Tomograms • Ophthalmologic examination Prof.BAFAQEEH

  20. Blowout FractureTreatment • The antral cavity must be explored: - The bony fragments are exposed - The prolapsed part is replaced - Bridging or stabilization (Lyophilized dura, cartilage or plastic prop) • Alternative or supplementary measures: - Orbital access - Lyophilized dura, silicone sheet, or teflon - Autologous implant to correct enophthalmos

  21. Ear Foreign Bodies – Careful otoscopy– Careful history (nature)– GA in small children– Syringing if TM is intact– Using a hook under otoscopic control– Complication: TM perforation Injury to ossicles or facial canal

  22. Syringing is contraindicated following recent injury or ear surgery and in patients with a history of perforation of the eardrum. Key Point

  23. Usually found in children • Beads, coins, peas, pieces of rubber, paper,metal fragments… Symptoms: -unilateral nasal obstruction -unilateral purulent discharge .RHINOLITH[ca] Foreign Bodies in the Nose

  24. Nose Foreign Bodies Cardboard Carton Marble Metal screw

  25. RHINOLITH Plastic tiddlywink

  26. Diagnosis: -anterior rhinoscopy -radiology -speculum of a fiberoptic auriscope .Treatment: -removal inst.. By probe and tipping - under GA Foreign Bodiesin the Nose

  27. Removalof NasalBody

  28. Key Point : Unilateral, Offensive, Purulent nasal discharge in a child is usually due to Foreign Body.

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