Nasal SurgeryArmie Jade S. Gante, RN
FACIAL TRAUMA ANDNASAL FRACTURES
• Reduction of nasal fractures may  be done by a closed manipulation  with external casting in the office  or by open surg...
NASAL SEPTALSURGERY
• Nasal septal reconstruction  involves resection or removal of  cartilaginous (or bony) septum  followed by reconstructio...
• Submucous resection of the  septum is an operation in which  cartilaginous and/or osseous  portions of the septum that l...
RHINOPLASTY
• Involves changing the noses  external appearance• Grafted cartilage or bone  harvested from other parts of the  body may...
SINUS SURGERY
• Functional endoscopic sinus  surgery (FESS)  – done with rigid endoscopes and    long-handled forceps working    through...
• The packing used after FESS is very  small, filling only the area adjacent  to the sinus ostia, so is not visible  excep...
• Other traditional approaches to  the sinuses:  – Caldwell-Luc procedure opening    under lip to enter maxillary sinus an...
– external or internal ethmoidectomies,  with their historically extensive  postoperative nasal and sinus  packing, are no...
PREOPERATIVEMANAGEMENT
• If a fracture or trauma has  occurred, head of bed should be  raised to promote drainage, lessen  edema, and make patien...
• Antibiotics may be used to reduce  bacterial colonization of nose and  sinuses.• The patient should be advised that  a s...
• The patient should be told about  the use of nasal packing to effect  hemostasis and the appearance  of facial or perior...
• The patient should avoid use of  aspirin, nonsteroidal anti-  inflammatories, and drugs that  may affect platelet functi...
Nasal surgery
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Nasal surgery

  1. 1. Nasal SurgeryArmie Jade S. Gante, RN
  2. 2. FACIAL TRAUMA ANDNASAL FRACTURES
  3. 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. 4. NASAL SEPTALSURGERY
  5. 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. 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. 7. RHINOPLASTY
  8. 8. • Involves changing the noses 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. 9. SINUS SURGERY
  10. 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. 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. 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. 13. – external or internal ethmoidectomies, with their historically extensive postoperative nasal and sinus packing, are now used only in selected complicated cases
  14. 14. PREOPERATIVEMANAGEMENT
  15. 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. 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. 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. 18. • The patient should avoid use of aspirin, nonsteroidal anti- inflammatories, and drugs that may affect platelet function before surgery.

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