Is a septal fracture without pain of serious concern?

Question

Hi doctor,

My sister-in-law fell from the bike and got injured. After consulting a small clinic, they asked us to take a CT scan, and it was mentioned as a nasal bone fracture and a nasal septal fracture in the CT scan report. Can you please advise if medical attention is required or if it will cure itself, as there is no pain?

Answer 1

Hi,

Welcome to icliniq.com.

Thanks for the query.

I want to ask a few questions to get more details about your query. Is there is any obvious external nasal deformity post-trauma? If the answer is yes, and if there is a gross nasal deformity, it will require proper surgical correction only for cosmetic purposes. Is there any nasal obstruction associated? If there is a very mild nasal obstruction that is reasonably expected, it is fine. But if there is a significant nasal obstruction, it could be due to a nasal septal fracture causing bony deviation. It might require surgical correction later and is not an emergency. Is the patient completely conscious? The CT (computed tomography) scan shows some subarachnoid bleed (attachments removed to protect the patient's identity), which usually resolves. Still, I would want you to take an opinion from a neurosurgeon as well to be sure. Make sure you send the films of the CT scan as well, so that we know the extent of the nasal bleed. If there is altered consciousness or loss of sensorium, please visit the emergency and consult with a neurosurgeon. She can use saline nasal drops, 3 drops, five to six times a day, for the next three weeks. There will be some minor nasal bleeding or blood clots coming out with mucus. She should start an antibiotic. I would suggest tablet Augmentin 625 mg (Amoxicillin and Clavulanic acid) one tablet in the morning, afternoon, and evening after food for one week.

I hope this answers your query.

If there is anything else you need to know, please ask us, and we will get back to you soon.

Thank you.

Answer 2

Hi,

Welcome back to icliniq.com.

I do not see any obvious nasal deformity externally (attachments removed to protect the patient's identity), and hence I will not suggest any requirement for cosmetic correction. Please consult a neurosurgeon for the subarachnoid hemorrhage and see if any intervention is required. CT scans look fine to me, nothing severe as far as the ENT (ear, nose, and throat) side is concerned. Swelling around the face will take at least four to six weeks to subside. Minor abrasions will heal in a week.

Do let me know if there are any further queries.

Thank you.