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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”).