Is It Normal to Realign Nose Without a Splint?

Question

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?

C. Spencer Cochran, MD · Answer

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.

Toby Mayer, MD · Answer

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".

Michael A. Persky, MD · Answer

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

William Portuese, MD · Answer

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.

Hisham Seify, MD, PhD, FACS · Answer

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.

Is It Normal to Realign Nose Without a Splint?

Answers (6)

Answer: Important to have splint

Answer: Important to have splint

Answer: Nasal splint is required

Answer: Nasal splint is required

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Is It Normal to Realign Nose Without a Splint?

Answers (6)

Answer: Important to have splint

Answer: Important to have splint

Answer: Nasal splint is required

Answer: Nasal splint is required

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Recommended reading

Everything you need to know about Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.