What are the common causes of nose fractures. How can you identify a broken nose. What are the immediate first aid steps for a nose injury. When should you seek medical attention for a nasal fracture. What are the long-term complications of untreated nose fractures.

Understanding Nose Fractures: Types and Causes

A nose fracture, also known as a broken nose, is a break in the bone or cartilage of the nasal structure. These fractures can occur in various parts of the nose, including the bridge, sidewall, or septum (the structure dividing the nostrils). Nose fractures are the most common type of facial fracture, often resulting from blunt force trauma.

There are several types of nasal fractures:

• Nasal bone fracture: A break in the bony structure over the bridge of the nose
• Septal fracture: Damage to the cartilage separating the nostrils
• Nasal-orbital-ethmoid (NOE) fracture: A more complex injury involving the nose and surrounding facial bones

Common causes of nose fractures include:

1. Sports injuries
2. Motor vehicle accidents
3. Falls
4. Physical altercations
5. Workplace accidents

Are certain individuals more prone to nose fractures? Athletes participating in contact sports, such as boxing, rugby, or basketball, are at a higher risk of sustaining nasal fractures. Additionally, individuals with weakened bone structure due to conditions like osteoporosis may be more susceptible to nasal fractures from relatively minor impacts.

Recognizing the Symptoms of a Broken Nose

Identifying a nose fracture promptly is crucial for proper treatment and recovery. The symptoms of a broken nose can vary depending on the severity of the injury, but common signs include:

• Pain and tenderness in the nasal area
• Swelling of the nose and surrounding tissues
• Bleeding from the nostrils
• Bruising around the eyes (often referred to as “raccoon eyes”)
• Difficulty breathing through the nose
• A visibly misshapen or crooked nose
• Crunching or crackling sounds when touching the nose

Can the symptoms of a nose fracture be mistaken for other conditions? In some cases, the symptoms of a nose fracture may be similar to those of a severe nasal contusion or a deviated septum. However, the presence of multiple symptoms, particularly visible deformity and difficulty breathing, strongly suggests a fracture.

Immediate First Aid for Nasal Injuries

When a nose injury occurs, taking prompt and appropriate action can help minimize complications and promote faster healing. Here are the essential first aid steps to follow:

1. Remain calm and assess the situation
2. Breathe through the mouth to avoid swallowing blood
3. Sit upright and lean slightly forward to prevent blood from flowing down the throat
4. Apply gentle pressure to the nostrils to stop bleeding
5. Use cold compresses or ice packs to reduce swelling (avoid applying direct pressure to the nose)
6. Take over-the-counter pain relievers like acetaminophen to manage pain

Is it safe to attempt realigning a visibly crooked nose? No, it is crucial to avoid trying to straighten a broken nose yourself. This action can potentially worsen the injury and should only be performed by a medical professional.

When to Seek Medical Attention for a Nose Fracture

While minor nasal injuries may be managed at home, certain symptoms warrant immediate medical attention. Seek professional help if you experience:

• Persistent bleeding that doesn’t stop after 15-20 minutes of applying pressure
• Clear fluid draining from the nose, which may indicate cerebrospinal fluid leakage
• Severe pain or difficulty breathing through the nose
• Visible deformity of the nose
• Signs of infection, such as fever or increasing redness and swelling
• Loss of consciousness or other symptoms of head injury

How soon after an injury should you consult a doctor for a potential nose fracture? It’s best to seek medical evaluation within 1-2 weeks of the injury, even if symptoms seem minor. This timeframe allows for initial swelling to subside, making it easier for doctors to assess the extent of the damage and determine appropriate treatment.

Diagnostic Procedures for Nasal Fractures

Accurate diagnosis of a nose fracture is essential for determining the most effective treatment plan. Healthcare providers may use various diagnostic methods, including:

1. Physical examination: Assessing the appearance, tenderness, and stability of the nose
2. Nasal endoscopy: Using a thin, flexible tube with a camera to examine the internal nasal structures
3. X-rays: Capturing images of the nasal bones to identify fractures
4. CT scans: Providing detailed 3D images of the nasal bones and surrounding facial structures
5. MRI: Used in cases where soft tissue damage is suspected

Why might a doctor prefer to wait before conducting a thorough examination? In some cases, doctors may delay a detailed examination for 3-5 days to allow initial swelling to subside. This approach can provide a clearer picture of the injury and help determine the most appropriate treatment course.

Treatment Options for Nose Fractures

The treatment for a nose fracture depends on the severity and location of the injury. Options may include:

• Conservative management: For minor fractures, treatment may involve pain management, ice application, and nasal decongestants
• Closed reduction: A procedure to realign the nasal bones without surgery, typically performed within 14 days of the injury
• Open reduction: Surgical intervention for more complex fractures or those involving the nasal septum
• Septoplasty: A surgical procedure to correct a deviated septum resulting from the fracture
• Rhinoplasty: Cosmetic surgery to address both functional and aesthetic concerns following a nasal fracture

How long does it typically take for a nose fracture to heal? The healing process for a nasal fracture usually takes about 3-6 weeks. However, complete resolution of symptoms and restoration of normal appearance may take several months, depending on the severity of the injury and the chosen treatment approach.

Potential Complications of Untreated Nose Fractures

Failing to seek proper treatment for a nose fracture can lead to various complications, including:

1. Chronic nasal obstruction
2. Persistent pain and discomfort
3. Septal hematoma formation
4. Nasal deformity
5. Chronic sinusitis
6. Sleep apnea
7. Psychological distress due to altered facial appearance

Can untreated nose fractures lead to long-term breathing difficulties? Yes, untreated nasal fractures can result in chronic nasal obstruction, affecting breathing and potentially leading to sleep disorders or reduced quality of life. Prompt treatment is essential to minimize these risks and maintain proper nasal function.

Prevention Strategies for Nose Fractures

While it’s impossible to prevent all nasal injuries, several measures can help reduce the risk of nose fractures:

• Wear appropriate protective gear during sports and high-risk activities
• Use seatbelts and airbags while driving
• Implement safety measures in the workplace to prevent falls and accidents
• Practice proper techniques in contact sports to minimize the risk of facial injuries
• Maintain a safe home environment to prevent falls, especially for elderly individuals

Are there specific types of protective gear that are most effective in preventing nose fractures? Face shields, helmets with face guards, and nose guards are particularly effective in protecting against nasal fractures during sports and other high-risk activities. These devices help distribute impact forces and reduce the likelihood of direct trauma to the nose.

The Role of Nutrition in Bone Health and Fracture Prevention

Maintaining strong bones can help reduce the risk of fractures, including those of the nose. Key nutrients for bone health include:

• Calcium: Essential for bone strength and density
• Vitamin D: Aids in calcium absorption and bone metabolism
• Vitamin K: Supports bone mineralization
• Magnesium: Contributes to bone structure and strength
• Protein: Necessary for bone matrix formation

How can individuals ensure they’re getting enough of these nutrients? A balanced diet rich in dairy products, leafy greens, nuts, and fish can provide many of these essential nutrients. For those with dietary restrictions or increased needs, supplements may be recommended under the guidance of a healthcare provider.

Psychological Impact of Nose Fractures

The effects of a nose fracture can extend beyond physical symptoms, potentially impacting an individual’s mental health and self-esteem. Some psychological consequences may include:

1. Anxiety about facial appearance
2. Depression related to physical discomfort or altered self-image
3. Social withdrawal due to visible nasal deformity
4. Reduced self-confidence in personal and professional settings
5. Post-traumatic stress, especially if the fracture resulted from a violent incident

What support options are available for individuals struggling with the psychological impact of a nose fracture? Mental health professionals, support groups, and counseling services can provide valuable assistance in coping with the emotional aspects of nasal injuries. Additionally, cosmetic procedures may help address appearance-related concerns and boost self-esteem in some cases.

Advances in Nasal Fracture Treatment

Medical advancements continue to improve the diagnosis and treatment of nose fractures. Some recent developments include:

• 3D printing technology for creating custom nasal splints
• Minimally invasive endoscopic techniques for septoplasty
• Advanced imaging methods for more precise fracture detection
• Bioabsorbable materials for internal nasal support during healing
• Computer-assisted surgical planning for complex nasal reconstructions

How might these advancements impact patient outcomes? These innovations can lead to more accurate diagnoses, less invasive treatments, and improved aesthetic and functional results. As technology continues to evolve, patients may experience shorter recovery times and better long-term outcomes following nasal fracture treatment.

Nose fracture Information | Mount Sinai

Fracture of the nose; Broken nose; Nasal fracture; Nasal bone fracture; Nasal septal fracture 

A nose fracture is a break in the bone or cartilage over the bridge, or in the sidewall or septum (structure that divides the nostrils) of the nose.

A nasal fracture is a break in the bone over the ridge of the nose. It usually results from a blunt injury and is one of the most common facial fracture. Symptoms of a broken nose include pain, blood coming from the nose, bruising around the eyes, misshapen appearance, swelling, and difficulty breathing through the nose. Serious nose injuries can cause problems that require immediate attention. However, for minor nose injuries, the doctor may prefer to see the victim after the swelling subsides to evaluate the extent of injury.

Considerations

A fractured nose is the most common fracture of the face. It most often occurs after an injury and often occurs with other fractures of the face.

Nose injuries and neck injuries are often seen together. A blow that is forceful enough to injure the nose may be hard enough to injure the neck.

Serious nose injuries cause problems that need a health care provider’s attention right away. For example, damage to the cartilage can cause a collection of blood to form inside the nose. If this blood is not drained right away, it can cause an abscess or a permanent deformity that blocks the nose. It may lead to tissue death and cause the nose to collapse.

For minor nose injuries, the provider may want to see the person within the first week after the injury to see if the nose has moved out of its normal shape.

Sometimes, surgery may be needed to correct a nose or septum that has been bent out of shape by an injury. A doctor may be able to return nasal bones that have moved out of place back to their normal position within the first 2 weeks after the break.

Symptoms

Symptoms may include:

• Blood coming from the nose
• Bruising around the eyes
• Difficulty breathing through the nose
• Misshapen appearance (may not be apparent until the swelling goes down)
• Pain
• Swelling

The bruised appearance most often disappears after 2 weeks.

First Aid

If a nose injury happens:

• Try to stay calm.
• Breathe through your mouth and lean forward in a sitting position to keep blood from going down the back of your throat.
• Squeeze the nostrils closed and hold pressure to stop the bleeding.
• Apply cold compresses to your nose to reduce swelling. If possible, hold the compress so that there isn’t too much pressure on the nose.
• To help relieve pain, try acetaminophen (Tylenol).

Do Not

If a nose injury happens or if someone may have a broken nose:

• DO NOT try to straighten a broken nose.
• DO NOT move the person if there is reason to suspect a head or neck injury.

When to Contact a Medical Professional

Get medical help right away if:

• Bleeding does not stop
• Clear fluid keeps draining from the nose
• You suspect a blood clot in the septum
• You suspect a neck or head injury
• The nose looks deformed or out of its usual shape
• The person is having difficulty breathing

Prevention

Wear protective headgear while playing contact sports, or riding bicycles, skateboards, roller skates, or rollerblades.

Use seat belts and appropriate car seats when driving.

Chegar BE, Tatum SA. Nasal fractures. In: Flint PW, Francis HW, Haughey BH, et al, eds. Cummings Otolaryngology: Head and Neck Surgery. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 30.

Kim L, Huddle MG, Smith RM, Byrne P. Nasal fractures. In: Dorafshar AH, Rodriguez ED, Manson PN, eds. Facial Trauma Surgery. Philadelphia, PA: Elsevier; 2020:chap 1.10.

Mayersak RJ. Facial trauma. In: Walls RM, ed. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 34.

Rodriguez ED, Dorafshar AH, Manson PN. Facial injuries. In: Rodriguez ED, Losee JE, Neligan PC, eds. Plastic Surgery: Volume 3: Craniofacial, Head and Neck Surgery and Pediatric Plastic Surgery. 4th ed. Philadelphia, PA: Elsevier; 2018:chap 3.

Last reviewed on: 11/29/2022

Reviewed by: Josef Shargorodsky, MD, MPH, Johns Hopkins University School of Medicine, Baltimore, MD. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

How do you fix a nasal fracture?

• Posted on: Jun 21 2012
• By: brandon.shaw

The outside of the nasal passages has bone and a cartilage that gives shape to the external nose. The lower part is made from cartilage that is mostly pliable and can withstand forces without breaking, and the upper part, between the eyes, is made from bone. Trauma to the outside of the nose can sometimes lead to fracture of the nasal bones. This could be in the form of a hairline fracture, and nondisplaced fracture where the bone fragments are still in the proper location, or a displaced nasal fracture which then distorts the external appearance of the nose. Often, nasal fractures are accompanied by severe nasal swelling as well as ecchymosis (black and blue formation). Frequently, nasal fractures can also be accompanied by nose bleeds.

The diagnosis of a nasal fracture can be confirmed in an emergency room setting, usually with the help of a nasal x-ray. If you are able to see your ear, nose, and throat specialist in a timely manner this can also be accomplished more professionally. A patient with a documented nasal fracture has a few options. In cases of hairline fracture or a nondisplaced nasal fracture, technically nothing needs to be done. Letting time for the bones to heal will ultimately restore the strength of the nasal bones.

A displaced nasal fracture usually needs more attention. This kind of a fracture does not necessarily mean obstruction of the nasal breathing passages, and is more of an external concern rather than an outstanding medical problem. The patient might choose to let the fracture be left alone, or have a closed reduction, or have a more open reduction. Closed reduction means that no incisions are made, and the bone fragments are popped back into proper alignment using devices that can accomplish this through the nostril. An open reduction means that incisions are made usually on the inside of the nose to visualize the broken bones in order to achieve better rate of success with realignment of the nasal fragments.

A closed nasal reduction could be accomplished immediately after the injury, before any significant swelling has evolved. This is usually within the first few hours after the injury. Unfortunately, most patients are not able to see an ENT specialist in that short amount of time, and by the time they are seen in the office there is quite a bit of swelling. This swelling prevents an accurate assessment of the location of the bones in order to achieve a better alignment. Alternatively, a closed reduction can be once again accomplished once the swelling has resolved after few days of waiting and application of ice packs to the nose. Most cases of closed reduction are achieved anywhere between 5 to 20 days after the initial injury.

If reduction of the nasal fracture has not been accomplished in the time frame as mentioned above, the bones then fuse in whatever locations they have been left. A patient who is seen quite a few weeks or few months after the injury has already bones that have healed and fused. The next option is to have an open nasal reduction. This is usually done in an operating room setting under anesthesia for most patients. Typically, the bones that have healed in a nonaligned location need to be refractured and reset into proper alignment.

The general recommendation is to have the nasal bones examined as soon as possible in order to assess if a fracture is present. A consultation with your ENT specialist, supplemented with appropriate X-Rays, will let you have a thorough evaluation and recommendations tapered to your specific needs.

Tagged with: closed reduction, displaced nasal fracture, ear nose throat, ENT, Isaac Namdar, Isaac Namdar MD, nasal fracture, New York, new york city, Nose, open reduction, Otolaryngology, Otorhinolaryngology

Posted in: Nose

Nasal furuncle: symptoms, diagnosis, treatment of nasal furuncle

Furuncle is an inflammatory process of the skin, which is caused by the penetration of infection (bacteria) into the structures of the hair follicle. The vestibule of the nose is lined with skin that has a large number of hair follicles. Therefore, if an infection enters them, a boil may occur.

Furuncle of the vestibule of the nose is a rather serious disease, which should be treated with great care and in no case be self-medicated. If you suspect that you have a boil in your nose, be sure to consult a doctor, you need qualified help.

Causes of nasal furuncle

Causes of a boil in the nose include:

• instability of the skin to infectious agents,
• vitamin deficiency,
• diabetes,
• metabolic failure in the body,
• hypothermia.

Please note that a boil in the nose may indicate diabetes.

Symptoms

Symptoms of a boil in the nose include:

• slight itching and (or) feeling of a foreign body in the vestibule of the nose,
• pain (pain may be moderate to severe), pain may occur when touching the affected area, may be constant,
• swelling and redness of soft tissues in the nasal area of ​​varying prevalence,
• temperature (up to 38 – 38. 5 degrees C).

Do not try to treat the furuncle of the nose yourself! Seek immediate medical attention to decide whether surgical or conservative treatment is required.

Diagnosis

Diagnosis of a boil of the nose includes:

• examination of the patient by a doctor,
• examination of blood and daily urine for sugar to exclude diabetes (in patients with recurrent and prolonged course of the boil),
• blood test for sterility (with a strong rise in temperature),
• smear from purulent discharge to determine the microflora and its sensitivity to antibiotics,
• probing the tip of the boil.

Treatment

A mild form of the disease with a furuncle of the nose is on an outpatient basis (the doctor prescribes antibiotics, vitamins, as well as the treatment of the boil itself).

Conservative treatment of a nasal furuncle involves the use of: antibacterial, anti-inflammatory, antiallergic drugs, physiotherapy procedures.

Surgical treatment is the opening of the boil. The opening of the boil, as a rule, is performed under local anesthesia and is painless for the patient.

Treatment of complicated forms of the furuncle of the nose is carried out only in a hospital.

Injuries of the nose – symptoms and treatment

The nose is most susceptible to various injuries due to its structure and location. In case of injury, the bone and cartilage structures of the nose, as well as soft tissues, can be damaged. This often results in a concussion or contusion of the brain.

Symptoms

Types

Causes

Complications

When you get a nose injury, a person experiences severe pain, because the nose, like other parts of the face, has many nerve endings. Soft tissue injury causes swelling and hematoma formation. The following symptoms indicate the presence of serious damage to the structures of the nose:

• Bleeding from the nose. Severe and prolonged bleeding from the nose during an injury is not always due to the degree of damage. It can be provoked by hypertension or blood clotting disorders.
• Hematoma formation. If the blood vessels are damaged, blood can both flow out of the nasal passages and accumulate in the soft tissues. Most often, small hematomas go away on their own, but with extensive hemorrhages, inflammation can occur. In some cases, large hematomas cause problems with nasal breathing.
• Changing the shape of the nose. This symptom indicates serious damage to the bony structures of the nose and often requires immobilization or surgical treatment. These injuries often occur after severe bruises or falls, so they are often accompanied by a concussion, and therefore require careful diagnosis and subsequent treatment. When concussion patients are worried about headache, dizziness, nausea, weakness, loss of consciousness.

Injuries of the nose can be open, which violate the integrity of the skin, as well as closed, located inside and not causing visible damage to the skin.

According to the severity of the nose injury, they are classified:

• Injuries of soft tissues, which are caused by a bruise, abrasion, stab wound.
• Injuries affecting the cartilage of the nose with a fracture of the nasal septum.
• Fractures of the bones of the nose are the most severe damage to the structure of the nose, in which displacement of bone fragments, damage to the paranasal sinuses and other disorders can occur.

According to statistics, men are the undisputed leaders in nose injuries. In the “risk group” are hyperactive children, people involved in martial arts, as well as military personnel. Injuries can occur at home, at work, while playing sports; children often get injured during active games.

Fractures of the bones of the roof of the nose or nasal septum can lead to the following disorders – displacement of the nose from the midline, the formation of a hump, changes in the shape of the nose (expansion, flattening or flattening of the nose, retraction of the back down), and the bony support of the nose may become soft. Frostbite, inhalation of steam or chemical (toxic) substances can lead to injuries to the nose.

Diagnosis of nasal injuries

When a patient visits a doctor, an external examination and palpation of the organ is performed. To determine the degree of damage to bone structures, to identify pathological changes in soft tissues or blood vessels, X-ray diagnostics of the nose and skull, as well as CT or MRI, are performed.

Treatment of a nose injury at the Gaide Clinic

Therapeutic measures vary depending on the degree of damage to the nose due to the injury. In case of bruising of soft tissues, without visible damage to bone structures, cold application is recommended. Superficial wounds and abrasions are treated with antiseptics, and a sterile dressing is applied.

If the bones of the nose are broken or displaced and if there is severe bleeding, seek immediate medical attention. The doctor must stop the bleeding and determine the degree of damage to bone structures, treatment tactics, and also exclude concussion and other complications.