US Gymnast Maroney Suffers Nasal Fracture

World vault champion McKayla Maroney on the US gymnastics team suffered a nasal fracture during pre-meet training when she over-rotated at the end of a tumbling run and fell hard earlier this month. She also suffered a concussion. A visit to the ER revealed her injuries. Apparently no surgical intervention was pursued.

This case illustrates that most nasal and even facial fractures do NOT require surgical repair.

The key elements that lead towards a decision for facial and/or nasal fracture surgery are the following (not all-inclusive, but general pointers):

- Any functional deficit including inability to open and close the jaw.
- Change in your occlusion (the way your teeth come together).
- Double vision (blurry vision does not count).
- Cosmetic deformity due to nasal/facial fracture (bruising and swelling does not count).
- Nasal obstruction not due to swelling.

The two main specialties able to assess whether surgery is required or not is ENT and Plastic Surgery as well as some oral surgeons.

Source:
Maroney suffers concussion, nasal fracture. ESPN 6/10/12

Welding a Cut Nerve Together Using a Laser

Although preliminary, researchers have successfully "welded" a cut nerve together using a laser rather than traditional suture repair.

When a nerve is cut, the only way to allow potential for the nerve to regain function is to bring the cut edges together and hope nerve regeneration crosses over. Traditionally, this was pain-stakingly accomplished under the microscope using sutures as thin as a human hair.

Using the rabbit facial nerve, researchers used a laser to weld the cut nerve edges together rather than using sutures and demonstrated a trend towards superior outcomes. Not only was the outcome better, it was way easier and faster to perform.

This new technique has tremendous application in ENT surgery, but can also apply to any surgery where nerves can get damaged or cut... vocal cord paralysis from thyroid surgery (recurrent laryngeal nerve), unable to lift shoulder from neck dissection (accessory nerve), facial paralysis from parotid gland tumor resection (facial nerve), etc, etc.

Reference:
Laser Facial Nerve Welding in a Rabbit Model. Arch Facial Plast Surg. Published online August 15, 2011. doi: 10.1001/archfacial.2011.61