Closed reduction - May be performed under local anesthesia or local anesthesia with mild sedation. Nasal skin has an abundant blood supply and tends to be thinner over the rhinion and thicker over the nasion. Nasal skin thickness varies among individuals. The nasal pyramid is composed of 2 nasal bones and the frontal process of the maxilla. Sesamoid cartilages are less important and lie in the fat pad between lower lateral cartilages and the piriform aperture.
Radiographs are controversial.
Old fractures, vascular markings, and suture lines can lead to false-positive results. A Water s view can be used to evaluate the bony septum, dorsal pyramid, and lateral nasal walls. However, studies have shown that radiographs are not helpful in the diagnosis or management of nasal fractures. CT scan is more useful to assess for other associated injuries, as well as extent of nasal injury. Because the nose occupies such a prominent and accessible position, careful examination is possible and may obviate any need for radiographic study.