Disease Information for Fracture, nasal bone

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Clinical Manifestations
Signs & Symptoms
Depressed nasal bridge
Face Pain
Facial bruise/ecchymosis
Facial edema/swelling
Facial pain/nostril area
Facial/nose deformity/acquired
Prominent Nose
Red nose
Noisy Breathing
Noisy Breathing Aged/Elderly
Epistaxis Children
Epistaxis, severe/persistent
Nasal congestion
Nasal pain
Nose blocked/bilateral (sign)
Nose blocked/stuffy
Nose blocked/unilateral
Nose tenderness/cartilage
Rhinorrhea/CSF fluid
Runny nose/rhinorrhea
Saddle Nose Deformity
Snoring
Blackeye
Conjunctival/scleral hemorrhage
Disease Progression
Course/Acute
Course/Acute only
Diagnostic Test Results
X-RAY
Xray/Skeletal findings
Xray/Nasal bone/cartilage destruction
Associated Diseases & Rule outs
Associated Disease & Complications
Deviated nasal septum
Epistaxis/nosebleed
Fracture nasal bones
Nasal obstruction
Nasolacrimal duct stenosis
Osteomeatal complex disorder/maxillary
Disease Mechanism & Classification
Class
CLASS/Otolaryngology/ENT Specialty Population
CLASS/Bone disorder (ex)
CLASS/Facial bones involvement/disorder (ex)
CLASS/Skeletal (category)
CLASS/Nasal septum disorder (ex)
CLASS/Nose disorder (ex)
CLASS/Otolaryngology/ENT disorders (ex)
CLASS/Tracheonasal/larynx/pharynx (category)
Process
PROCESS/Trauma (category)
PROCESS/Fractures (ex)
Treatment
Surgical Procedures or Treatments
TX/Restrict Activities
Definition

Nasal bone fracture: minor nasal trauma history; Epistaxis; observe for associated injuries with Cervical Spine Injury; Mandibular fracture; Facial fracture; Zygomatic arch fracture; Maxillary sinus fracture; Orbital fracture; External exam: Clinical diagnosis (not radiographic); Localized Edema and Ecchymosis of nose; Nasal deformity: Birds Eye View;Palpate nose for crepitation or step-offs; Compare to photo before injury (best available); Use driver"s license if others not available; Internal exam; Apply anesthesia and vasconstrictor to mucosa and nasal speculum exam Assess Nasal Airway patency; Assess for continuing Epistaxis ; Assess turbinates: Septal Hematoma ; clear Rhinorrhea (possible CSF) Complications: Evaluate for in all cases; Septal Hematoma: Observe for white or purple swelling on septum; Depress septal mucosa to check for fluctuant area; Failed diagnosis may result in saddle deformity; CSF Rhinorrhea: Presents as clear Rhinorrhea; Double Ring Sign (variable efficacy); Place bloody Nasal discharge on filter paper May form double ring on paper if CSF present; Immediate consultation indications: Cerebrospinal fluid leak suspected; Limited extraocular movement (orbital fracture); New malocclusion of teeth (jaw joint or mandibular fracture); Altered mental status (closed head trauma/concussion); Radiology: Nasal X-Ray is not recommended; Low Test Sensitivity and Test Specificity instead Coronal CT of facial bones Indications Suspected facial fracture or Clear Rhinorrhea with CSF leak suspect; Closed Reduction Administer Conscious Sedation and analgesia; (Versed and Morphine IV Titrate to adequate effect) ; Instruments used Asch forceps and Walsham forceps or Boies elevator (preferred)---------[adapted Family Practice Notebook 2004]-----------

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External Links Related to Fracture, nasal bone
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NGC (National Guideline Clearinghouse)
Medscape (eMedicine)
Harrison's Online (accessmedicine)
NEJM (The New England Journal of Medicine)
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