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.

Sycosis of the nose

To the guide

Nasal sycosis refers to the development of inflammation localized in the hair follicles of the vestibule of the nose. Local treatment.

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Nasal sycosis (folliculitis) is a purulent inflammatory process localized in the vestibule of the nose and affecting the hair follicles.

Causes of nasal sycosis

The main causative agents of pathology are staphylococci and streptococci. In most cases, the infection enters the skin from the fingers, when combing or removing crusts from the nasal passages with the hands. The resulting microtraumas and cracks open direct access to pathogens inside.

As provoking factors, purulent rhinitis and sinusitis are considered, occurring with the formation of a viscous purulent secret, which, when separated, irritates the skin of the nasal vestibule.

Clinical picture

With sycosis, the entrance to the nose is covered with individual pustules, which, when spontaneous or directed opening, are replaced by crusts. The skin in the affected area is edematous and hyperemic. Some clinical cases suggest a limited nature of inflammation, which makes it difficult to diagnose the localization of the process. This is especially true of the upper corner of the tip of the nose, which is difficult to see. For better visualization, a nasopharyngeal mirror and an endoscope are used.

Patients complain of severe itching, burning in the affected area, aggravated by scratching and cracking. Pinpoint abscesses are clearly visible at the locations of the hair follicles. They break open, forming crusts that prevent breathing through the nose.

A characteristic sign of nasal sycosis is a long course of the disease, accompanied by frequent relapses, the average duration of which can reach several months. A typical complication of such inflammation can be eczema, which worsens the general condition of the patient.

Sycosis treatment

Sycosis of the nose is treated on an outpatient basis. The skin is treated with boric alcohol (sometimes salicylic). To soften the crusts on the eve of the nose, synthomycin ointment is laid, which, if necessary, can be replaced with salicylic or mercury.

Hair in the affected area to be removed. To do this, you can use ordinary tweezers. If mechanical hair removal seems too painful, X-ray irradiation is indicated, which gives the effect of epilation and additionally conducts anti-inflammatory treatment of the area.

In case of a protracted course of the disease with frequent relapses, general antibiotic therapy is added to the local treatment.