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Nasal Traumas: From Simple Nosebleeds to Complex Fractures

In the bustling corridors of Tufts Medical Center, in Boston, MA, Dr. Ramya Bharathi, a Resident Physician in Otolaryngology, navigates the complex world of nasal traumas on a daily basis.

Here, she treats conditions ranging from commonplace nosebleeds to intricate nasal fractures. Her expertise in this nuanced field offers insights into the challenges and innovations in treating these prevalent yet often underestimated injuries.

“Nasal traumas are incredibly diverse in their nature and severity,” explains Dr. Bharathi. “While nosebleeds might seem trivial, they can sometimes be indicative of underlying health issues. On the other end of the spectrum, nasal fractures, the most common type of facial fracture, require precise intervention to prevent long-term complications.”

Born in India she emigrated to Canada when I was eight. After finishing high school, her family moved to the United States.

She attended undergrad at New York University and medical school in St. Louis, Missouri, and did her training in Boston.

She says: “I love the wide range of pathologies we treat, from simple issues like nosebleeds to complex cancers. Collaborating with other specialities is also rewarding, and the head and neck region’s role in human expression and communication makes our work impactful on patients’ lives.”

Dr. Bharathi adds simple nosebleeds, or epistaxis, are among the most common ENT emergencies they have to handle. However, despite their frequency, Dr. Bharathi emphasizes that they should not be taken lightly: “Recurrent nosebleeds can be a sign of hypertension, blood clotting disorders, or even tumors in the nasal cavity,” she says.

“It’s important to understand the root cause to treat them effectively.”

Dr. Bharathi’s approach to treating nosebleeds reflects her broader philosophy of patient care: thorough, empathetic, and holistic. “I always strive to understand the full picture — what’s happening medically and how it’s affecting the patient’s life,” she shares.

When it comes to nasal fractures, the stakes are higher: “Timely and accurate assessment is critical,” Dr. Bharathi stresses.

“Untreated or improperly treated nasal fractures can lead to chronic breathing difficulties, persistent pain, and cosmetic issues.”

With over five years of experience in otolaryngology, Dr. Bharathi has seen various nasal trauma cases.

“Each case is unique,” she says. “What works for one patient might not be suitable for another. This is where personalized care really comes into play.”

Her extensive research, including multiple peer-reviewed publications and oral presentations, has focused on various aspects of nasal and sinus disorders, enriching her clinical practice with evidence-based insights:  “Research is vital in refining our surgical techniques and improving patient outcomes,” she notes.

Dr. Bharathi also highlights the technological advancements that have revolutionized the treatment of nasal traumas: “Innovations like 3D imaging and endoscopic surgery allow us to operate with greater precision and less invasiveness,” she explains.

“This not only improves the surgical outcomes but also minimizes recovery time.”

Dr. Bharathi is particularly passionate about the psychological impact of nasal traumas: “A person’s nose is central to their facial identity,” she says.

“Injuries can have profound emotional and psychological effects, which is why restoring both function and appearance is crucial.”

As an esteemed member of professional societies such as the Massachusetts Society of Otolaryngology and the American Academy of Otolaryngology – Head and Neck Surgery, Dr. Bharathi is a respected voice in her field.

Her commitment to advancing medical knowledge is evident in her involvement in groundbreaking research. Dr. Bharathi’s work on comparative studies, such as those examining different tracheotomy techniques, showcases her dedication to exploring various facets of otolaryngology: “Such studies are crucial for understanding the nuances of our field and for developing better treatment protocols,” she explains.

For Dr. Bharathi, the journey doesn’t end with the surgery or treatment. “Follow-up care is just as important,” she says. “Ensuring that patients heal properly and regain full functionality is a vital part of the recovery process.”

Her advice to anyone experiencing nasal trauma is straightforward: “Seek medical attention promptly. Early intervention can make a significant difference in outcomes.”

Dr. Kathryn Noonan, is a fellowship-trained surgeon specializing in pediatric and adult ear and skull base surgery at Tufts Medical Center. She is also an Otolaryngologist and (Ear, Nose & Throat) Specialist.

She has worked with Dr. Bharathi since she started as an intern and throughout her residency, and as well as grading her work, they have also worked together on ear surgery cases and placing cochlear implants to help deaf people hear again.

Speaking highly of Dr.Bharathi’s commitment and ability, she says: “Ramya has strong leadership qualities, coupled with a nurturing approach towards junior residents, which exemplify her outstanding character. As a person responsible for grading residents, I find discussions about Ramya at faculty meetings particularly enjoyable. Everyone acknowledges her brightness, welcoming nature, and the infectious kindness she brings to the team.”

Dr. Noonan adds that patients frequently expressed their appreciation for Dr. Bharathi’s’ care, noting how she made them feel at ease: “Her mature and responsible approach extends to self-improvement, where Ramya uniquely focuses on turning her weaknesses into strengths. This attitude is rare and commendable.”

She concludes that in clinical settings, especially in resident-run clinics, Dr. Bharathi’s dedication shines: “She advocates for patients, ensuring insurance coverage, timely surgery scheduling, and comprehensive care. Her focus isn’t limited to singular tasks; she aims for patients’ overall well-being, going above and beyond to ensure their needs are met. Her multifaceted skills, from patient care to team coordination, contribute significantly to our program’s success.”

Dr. Bharathi stands out as a beacon of expertise and empathy in a field where precision meets compassion. Her work not only alleviates the physical symptoms of her patients but also addresses the broader impact of nasal traumas on their lives.