DATE OF OPERATION: MM/DD/YYYY
PREOPERATIVE DIAGNOSIS: Nasal septal fracture with obstruction.
POSTOPERATIVE DIAGNOSIS: Nasal septal fracture with obstruction.
OPERATION PERFORMED: Open reduction and reconstruction and stabilization of nasal septal fracture.
SURGEON: John Doe, MD
ANESTHESIA: General endotracheal.
COMPLICATIONS: None.
BLOOD LOSS: Minimal.
INDICATIONS FOR OPERATION: The patient is a (XX)-year-old lady who presents three weeks following severe nasal injury with external nasal deformity as well as intranasal obstruction of airway due to fractured septum. Therefore, the above procedure was indicated. The patient was consented for the procedure.
OPERATIVE FINDINGS:
1. External nasal deviation to the left with bony pyramid to the left and significant nasal airway obstruction on the right.
2. Septal buckling and fracture of cartilages.
DESCRIPTION OF OPERATION: The patient was brought to the operating room and positioned supine on the operating table. After induction of anesthesia, the patient’s head and neck were prepped and draped in the usual sterile fashion. The nasal cavity was inspected under headlight illumination. The above findings were noted.
Bilateral nasal sidewall and the inferior turbinates were injected with 1% lidocaine with 1:100,000 epinephrine solution. Bilateral intercartilaginous incision was made, and bony pyramid was returned to midline through bilateral osteotomies. The nasal bony pyramid was manipulated using external pressure as well as intranasal manipulation with a Boies elevator. The septal deviation and buckling was repaired through a left septal hemitransfixion incision with resection of fractured buckled cartilages as well as vomer bone. The septal mucoperichondrial flaps were then repaired with running chromic suture in a mattress fashion. Intraluminal splints were placed and secured.
The intercartilaginous incision and hemitransfixion incision were closed with interrupted chromic sutures. External nasal deformity was finally inspected and midline position was stabilized with external Denver splints. This was taped in place. The patient tolerated the procedure very well. The patient was awakened, extubated, and taken to the recovery room in stable condition. There was minimal blood loss. The patient received perioperative antibiotics. There were no perioperative complications.
