Is It Normal to Realign Nose Without a Splint?

I just left an ENT's office and he said I had a broken nose. He shot some numbing agent into my nose and then used a tool to realign the bones.

The break has indented the line of my nose. He then packed. He did not put any sort of cast or splint on my nose, is this okay?

Doctor Answers 6

Cast or Splint Is Usually Placed to Stabilize Nasal Bones After a Fracture

Most rhinoplasty surgeons will put an external splint made of aluminum, plaster, plastic, etc on the exterior of the nose after a nasal fracture or after the nose has been surgically broken. The purpose of this splint is to protect the nose and hold the nasal bones in position as they heal.

It is possible that the internal packing repositioned the nasal bones into proper alignment and that an external splint was not needed in your case. Visit with your surgeon about your concerns.

Dallas Facial Plastic Surgeon
4.7 out of 5 stars 145 reviews

Important to have splint

Anytime the nose is broken it must be reset. It sounds as though the patient has had a closed nasal reduction, which does not work as well as an open reduction of a nasal fracture. Full medial and lateral osteotomies need to be performed to straighten and realign the nasal bones after a fracture. No packing is necessary inside the nose. Packing is painful and has caused toxic shock syndrome in the past. Antibiotics and very strong pain relievers have to be used if the nose is packed. Nasal packing went out of favor over 20 years ago. It is important to have a splint placed across the bridge of the nose after the nasal bones have been reset. This is done under a general anesthesia and not done in the office.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

Nasal splint is required

Nasal fractures could be aligned easily if there is minimal comminution of the nasal bones.

I would like to keep a nasal splint in place to prevent movement of the pieces and to maintain the reduction. Think about it as having an arm splint or cast following a fracture.

Hisham Seify, MD, PhD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 19 reviews

Usually a splint is applied.

If he realigned the bones after a fracture, then we usually put a splint on the nose. If the bones are quite stable after this, some surgeons may not. I always do to protect "my work".

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews

Not standard Rhinoplasty practice

Normally, I always place a nasal splint after closed reduction of a nasal fracture. There are cases where the bone has infractured (become depressed) and I will pack inside the nose to help support the nasal bone outward back into its native position. The splint is mainly to serve as protection to the mobilized nasal bones, not to hold hem in position.

The splint rarely serves any purpose to help keep bones in position, so in some cases it may not be absolutely necessary, but I always put one on to help protect the area. In your case it might not be necessary, but you should talk to your surgeon again.

Samson Lee, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 7 reviews

Something Smells Fishy Despite Decreased Sense of Smell After Nasal Trauma

Dear nose?,

It is standard practice to place a splint on nasal bones after the repair of a nasal fracture. Unless the fracture just occurred, and there is little or no swelling, repair of a nasal fracture is usually performed 5 to 7 days after the trauma when all of the swelling has resolved. If there is bleeding into the nasal septum (a septal hematoma) then immediate drainage of the hematoma is indicated because the septal cartilage blood supply may be compromised resulting in a nasal septal perforation internally, and a "saddle nose" deformity of the external nasal dorsum.

If your nasal bones were actually broken, and the surgeon said that the bones were being reduced with the "tool", then a splint is indicated. This is to prevent external pressure from displacing the bones. If a hematoma was drained then no splint is needed. Your sense of smell may be decreased from your recent fracture, but something smells a little "fishy" to me.

Discuss your concerns with your surgeon.

I hope that all goes well with your healing process. Be well.

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.