Resident Manual of Trauma to the Face, Head and Neck

C. Evaluation and Diagnosis 1. History of Trauma y y Usually blunt. y y Motor vehicle accident. y y Altercation. y y Sports (especially, but not always, contact). y y Falls (especially in elderly, debilitated). y y Injuring blow, usually delivered from one side or from front, occasionally from below, rarely from above. 2. Nasal Deformity, Causally Related to Occasion of Trauma y y Establish presence of deformity. y y Comparison with preinjury photos (e.g., driver’s license). y y Delay definitive examination for 10–12 days, allowing swelling/ bruising to decrease. 3. Simple Lateral Deviation (Figure 4.11) y y Of bony vault. y y Of cartilaginous vault. y y Of both. 4. Complex Deviation (“Twisted Nose”) (Figure 4.12)

Figure 4.11 Simple lateral deviation.

Figure 4.12 Complex deviation (“twisted nose”).

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