1. Nasal Surgery
Armie Jade S. Gante, RN

2. FACIAL TRAUMA AND
NASAL FRACTURES

3. • Reduction of nasal fractures may
be done by a closed manipulation
with external casting in the office
or by open surgical technique in
the operating room
• Repair and stabilization of other
maxillofacial fractures usually
require an operating room
procedure for wiring or plating

4. NASAL SEPTAL
SURGERY

5. • Nasal septal reconstruction
involves resection or removal of
cartilaginous (or bony) septum
followed by reconstruction of all
parts of the septum that may
produce nasal airway obstruction

6. • Submucous resection of the
septum is an operation in which
cartilaginous and/or osseous
portions of the septum that lie
between the flaps of the mucous
membrane and perichondrium
are removed or straightened to
establish a midline partition
between the right and left nasal
cavities to provide a clear nasal
airway

7. RHINOPLASTY

8. • Involves changing the nose's
external appearance
• Grafted cartilage or bone
harvested from other parts of the
body may be used
• A septorhinoplasty may be done
when there are external and
internal nasal deformities

9. SINUS SURGERY

10. • Functional endoscopic sinus
surgery (FESS)
– done with rigid endoscopes and
long-handled forceps working
through the nose to widen the natural
sinus ostia and to facilitate the natural
sinus drainage patterns.
• Polyps and other small intranasal
growths can be removed
endoscopically

11. • The packing used after FESS is very
small, filling only the area adjacent
to the sinus ostia, so is not visible
except for a retrieval string
extending outside the nasal ala

12. • Other traditional approaches to
the sinuses:
– Caldwell-Luc procedure opening
under lip to enter maxillary sinus and
strip out diseased mucosa)
– nasoantral window (creating an
opening between the maxillary sinus
and the anterior inferior nose)

13. – external or internal ethmoidectomies,
with their historically extensive
postoperative nasal and sinus
packing, are now used only in
selected complicated cases

14. PREOPERATIVE
MANAGEMENT

15. • If a fracture or trauma has
occurred, head of bed should be
raised to promote drainage, lessen
edema, and make patient more
comfortable.
• Intermittent cold compresses and
pain medications should be
utilized as ordered.

16. • Antibiotics may be used to reduce
bacterial colonization of nose and
sinuses.
• The patient should be advised that
a sensation of pressure may be felt
in the nasal area during surgery if
done under local anesthetic.

17. • The patient should be told about
the use of nasal packing to effect
hemostasis and the appearance
of facial or periorbital ecchymosis
(bruising) that may be present and
will subside over a course of
weeks.

18. • The patient should avoid use of
aspirin, nonsteroidal anti-
inflammatories, and drugs that
may affect platelet function
before surgery.