Nose injury in a child

Int J Otolaryngol. 2010;2010:752974. Epub 2010 Dec 19.

Nasal birth trauma: a review of appropriate treatment.

Department of Otolaryngology, Waterford Regional Hospital, Waterford, Ireland.

Abstract

The aetiology of nasal deformity has frequently included birth trauma. There is no consensus in the literature as to whether nasal surgery, in the form of closed reduction, is indicated in neonates. The majority of studies in the literature that advocate intervention have inadequate followup periods and there is a paucity of evidence for the adverse effects of conservative management. This case highlights the therapeutic dilemma posed by such nasal injuries in the neonate and, to the best of the authors’ knowledge, at the time of writing, represents the earliest reported case in the literature of nasal deformity in the neonate. The term nasal deformity is used to denote deformity of the nasal pyramid, soft tissue, and septum. Three main aspects of neonatal nasal deformity are addressed including, firstly, if nasal deformity at birth needs to be addressed, secondly, if left unaltered, what the long-term effects are and, finally, if intervention alters the normal course of midfacial development.

Rhinoplasty information from the American Academy of Facial Plastic & Reconstructive Surgery

www.aafprs.org/patient/procedures/rhinoplasty.html

A very well thought out information source. AAFPRS is a body that standardized provision of Facial Plastic Surgery in the USA.

Facial Plastic Surgery is very well organized in the US with strict criteria for certification of surgeons and health providers.dscn8880_3

Munish Shandilya with the President of AAFPRS Robert L. Simons, Toronto 2006,
10 years after attending the Goldman’s tip Seminar at the Mount Sinai Hospital in Manhattan with him and getting hooked to the art of rhinoplasty.

His passion and enthusiasm were infectious …

NOSE FRACTURE IN SPORTS : WHEN CAN I GO BACK TO TRAINING ?

sport

There are approximately 190 youngsters in my large prospective series of nasal fractures (472 and growing … ) who suffered nose injuries while playing sports.


All invariably ask “how soon can I return to active sports” ?


In my opinion the nose will take nearly 8 weeks to return to its pre-injury strength … maybe even longer …
I have on occasion successfully manipulated nasal fractures as late as 5 weeks after injury. This has led me to recommend a 8-12 week period of protection.


This however is an advice based on observation rather than concrete evidence and the sportsperson is allowed to make their own decision  in my clinics. I believe that ironclad recommendations against training … sometimes dissuade keen sportspersons from seeking timely and appropriate intervention …


Educating and informing patients with clear computer graphics is invaluable.


BTW 6 sportspersons broke their nose despite wearing helmets during a hurling match ! … those sliotars are slippery  customers …


There are several protective face devices that may be used during sports other than hurling …
for 8-12 weeks after nose surgery.

Advanced Septoplasty: Augmentation of cartilage deficient nose after multiple sports injuries.

Augmentation Rhinoplasty after complete destruction  or dissolution of Septal cartilage necessitates surgeries with a high potential for morbidity. The most popular choice of material has been costal cartilage, irradiated cadaver cartilage or alloplastic material. This is the first use of PDS foil scaffolding for conchal cartilage graft in Ireland where two cases of septal cartilage replacement were successfully acheived. PDS foil has been used in the nose before and the pioneering work by Miriam Boenisch and Gilbert Nolst Trenite is remarkable …

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