CR Nasal Bones

Open Dropdown

Preoperative Considerations


  • bleeding
  • infection
  • nasal septal hematoma
  • septal perforation
  • nasal deformity
  • failure to achieve desired results


  • Sedation or GA (preferred due to nasal bleeding risk)


  • None


  • Local anesthesia
  • Nasal Speculum
  • Bayonet Forcep
  • Goldman elevator
  • Ribbon packing & Afrin PRN
  • Mastisol
  • Steri Strips
  • Thermoplastic Nasal Splint or Denver Nasal Splint
  • Hot water bath PRN


3D Recon demonstrating depressed nasal bone fracture

Depressed left nasal dorsum
Infraorbital block
Local infiltration
Infratrochlear nerves anesthetized
Measure externally with elevator prior to maniupulation

Segment is reduced
Demonstration of symmetrical appearance after reduction
Mastisol application
Steri Strip Application
Thermoplastic nasal splint is measured
Splint trimmed
Placed in hot water bath
Splint is gently adapted to reduced nose
Translucency indicates plasticity
Final appearance of rigid splint after cooling

Postoperative Considerations


  • Restrain hands to avoid nasal manipulation PRN

Follow Up:

  • Splint stays on 1 week

Operative Note

Surgeon(s): ***

Assistant Surgeon(s):  ***

Preoperative Diagnosis: ***

Postoperative Diagnosis: Same

Procedure(s): ***

Anesthesia: General

Implants: None


Drains: None

Fluids: See anesthesia record

EBL: Minimal

Complications: None

Counts:  Correct x2

Indications: ​***

Findings: As expected

Procedure in Detail:

The patient was seen in the preoperative holding area with a H&P was updated, consents were verified, surgical site marked, and all questions and concerns related to the proposed procedure were discussed in detail.  The patient was transferred to the operating room by the anesthesia team.  The patient underwent general anesthesia with endotracheal intubation. Tegaderms were placed over the eyes. The patient was prepped and draped in the standard fashion for maxillofacial procedures.  A time-out was performed and the procedure began.

Local anesthesia was injected intra and extranasally. Nasal bone elevator was used for manipulation and the segments were reduced. Exam revealed improved symmetry and speculum exam confirmed patency of both internal and external nasal valves. Masitisol and steri strips were applied and the nasal bones were stabilized using thermoplastic nasal splints.

The patient's face was then cleaned and the posterior pharynx was suctioned. An OG tube was used to suction out the contents of the stomach. Tegaderms were removed from the eyes. Dressings were placed. The patient was then transferred back to the care of the anesthesia team for extubation and recovery.


  • 21310 - Closed treatment of nasal bone fracture; without manipulation
    • This code is used when the nasal bone fracture is reduced without manipulation, often in cases where the fracture fragments are minimally displaced and can be realigned without the need for significant force.
  • 21315 - Closed treatment of nasal bone fracture; with manipulation
    • This code is used when the nasal bone fracture requires manual manipulation or force to realign the fractured bones into their proper position.