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with early (≤7 days) versus late (>7 days) repair Patients suspected of having nasal fractures should be reevaluated within to days after the swelling subsides Plain radiographs may be helpful at this time to determine whether malalignment exists Patients with nasal deformity to days after injury require urgent consultation with a subspecialist to restore anatomic alignment Zygoma and Maxilla Fractures CLINICAL PEARLS AND PITFALLS Particular attention to the airway is of paramount importance in children with midface fractures as significant bleeding and disruption of normal anatomic structures may compromise airway patency Clinical Considerations The zygoma is composed of a body or malar eminence and the zygomatic arch A complete fracture of the zygoma often extends through the floor of the orbit This may result in an inferior displacement of the zygoma because of the strong inferior forces applied by the masseter muscle, which attaches to the malar eminence Zygoma fractures often produce a flattened appearance to the cheek, with inferior displacement of the globe, and conjunctival hemorrhage Decreased sensation along the distribution of the infraorbital nerve is also common, as zygomaticomaxillary fractures usually include the infraorbital foramen Unilateral zygomatic arch fractures can cause a decrease in temporal width, which is best visualized when viewing the face from the front as a result of buckling of the zygomatic arch If this buckling is severe, the mandibular condyle may be impinged, with resultant difficulty in mouth opening