Types of Nasal Bone Reduction

1. Closed Reduction

A minimally invasive method performed through the nostrils using instruments to reposition bones without external incisions. Best within 7–14 days of injury when bones are not yet fully healed.

2. Open Reduction (Open Rhinoplasty Approach)

Required for complex fractures, severe deformities, or when associated septal injury needs correction. Involves small external incision (columellar) to directly visualise and fix bones.

3. Septorhinoplasty / Functional Reconstruction

Combines fracture reduction with septal correction and aesthetic reshaping for long-term functional and cosmetic results.

Signs & Symptoms

• Nasal pain and swelling
• Visible deformity or crooked nose
• Nosebleeds (epistaxis)
• Difficulty breathing through one or both nostrils
• Bruising around the nose and under the eyes (raccoon eyes)
• Nasoseptal hematoma (painful swelling inside the nose) — an emergency

Diagnosis & Evaluation

Assessment includes clinical examination, nasal endoscopy, and imaging when needed.

• Detailed history of trauma and timing
• Physical exam: inspection, gentle palpation for mobility or step-off
• Anterior rhinoscopy or nasal endoscopy to assess septum and detect hematoma
• X-ray or CT scan for complex fractures, multiple facial fractures, or surgical planning

Treatment Options

Treatment depends on fracture severity, timing, airway compromise, and cosmetic concerns. Early management often gives the best result.

Immediate Care

• Control bleeding and apply cold packs to reduce swelling
• Assess and drain nasoseptal hematoma urgently to prevent cartilage loss
• Analgesia and tetanus update as needed

Closed Reduction Procedure

Performed under local anaesthesia with sedation or general anaesthesia. Steps include:

• Reduction of displaced nasal bones using elevators or forceps
• Stabilization with internal splints and external nasal splint/cast for 1–2 weeks

Open Reduction & Septorhinoplasty

Used for complex deformities or when septal repair is required. Allows direct visualization, fixation, grafting, and long-term functional/cosmetic correction.

When to Operate

Optimal timing for closed reduction is generally within 7–14 days post-injury before bone heals in displaced position. Open procedures may be planned after swelling subsides for definitive reconstruction.

Recovery & Aftercare

• Keep head elevated and use cold compresses for 48–72 hours
• Avoid strenuous activity and nose blowing for 1–2 weeks
• External splint usually removed after 7–10 days; internal splints as per surgeon’s protocol
• Follow-up visits for endoscopic cleaning and monitoring of septal healing

Possible Complications

• Persistent nasal obstruction or residual deformity
• Recurrent epistaxis or septal perforation
• Infection, asymmetry, or need for revision surgery
• Cosmetic dissatisfaction — may require secondary septorhinoplasty

Prevention & Safety Tips

• Use appropriate protective gear in sports and high-risk activities
• Seek prompt medical attention after nasal trauma
• Avoid delaying treatment — early intervention often simplifies repair

Why Choose Dr. Shrekha Padmakshan?

Dr. Shrekha Padmakshan offers experienced, evidence-based care for nasal fractures, balancing functional restoration with cosmetic outcomes for the best long-term result.

• Expertise in acute fracture management and reconstructive septorhinoplasty
• Prompt assessment to detect emergencies like septal hematoma
• Use of modern imaging, endoscopy and gentle surgical techniques
• Personalized care, clear counselling about timing and expectations

If you have suffered nasal trauma or notice persistent deformity or breathing problems after an injury, book a consultation for timely evaluation and individualized treatment options.