What are the common causes of a broken nose. How can you identify the symptoms of a nasal fracture. What treatment options are available for a broken nose. When should you seek medical care for a suspected nasal fracture. How is a broken nose diagnosed and treated by medical professionals.

Understanding Nasal Fractures: Types and Anatomy

A broken nose, medically known as a nasal fracture, occurs when there is damage to the bony or cartilaginous structures of the nose. To understand nasal fractures better, it’s important to first examine the anatomy of the nose:

• The upper part of the nose, between the eyes, consists of bone
• The lower part is made of cartilage, which is more flexible and resistant to fracture
• The external shape of the nose is formed by both bone and cartilage

Nasal fractures can be classified into several types:

1. Hairline fracture: A small crack in the nasal bone without displacement
2. Nondisplaced fracture: The bone is broken but remains in proper alignment
3. Displaced fracture: The broken bone fragments are out of alignment, potentially altering the nose’s appearance

Are all nasal fractures equally severe? No, the severity of a nasal fracture can vary greatly. While hairline and nondisplaced fractures may not require extensive treatment, displaced fractures often need medical intervention to restore proper alignment and function.

Common Causes of Nasal Fractures

Nasal fractures typically result from trauma to the nose or face. The most frequent causes include:

• Sports injuries: Contact sports like boxing, football, or basketball
• Physical altercations: Personal fights or assaults
• Domestic violence incidents
• Motor vehicle accidents
• Falls, especially in children and the elderly

Can everyday accidents lead to a broken nose? Yes, even seemingly minor incidents like walking into a door or tripping on uneven ground can potentially cause a nasal fracture, especially if the impact is direct and forceful.

Recognizing the Symptoms of a Broken Nose

Identifying a nasal fracture can be challenging, especially in the immediate aftermath of an injury when swelling is prominent. However, several symptoms may indicate a broken nose:

• Pain and tenderness, especially when touching the nose
• Swelling of the nose and surrounding areas
• Bruising around the nose and under the eyes (often called “raccoon eyes”)
• Nosebleeds
• Difficulty breathing through the nose
• Crooked or misshapen appearance of the nose
• Crunching or crackling sound when touching the nose

Can a broken nose heal on its own? In some cases, minor fractures may heal without intervention. However, it’s crucial to have any suspected nasal fracture evaluated by a medical professional to prevent potential complications.

Diagnosis and Medical Evaluation of Nasal Fractures

When a nasal fracture is suspected, prompt medical evaluation is essential. The diagnostic process typically involves:

1. Physical examination: A doctor will visually inspect and gently palpate the nose to assess damage
2. Medical history: Information about the injury and any previous nasal surgeries or fractures
3. Imaging studies: X-rays or CT scans may be ordered to confirm the fracture and assess its extent

How soon after injury should a nasal fracture be evaluated? Ideally, a suspected nasal fracture should be examined within the first few hours following injury. However, if immediate evaluation isn’t possible, it’s still important to see a doctor within 3-7 days, as this timeframe allows for optimal treatment planning.

Role of Specialists in Nasal Fracture Diagnosis

While initial evaluation may occur in an emergency room setting, consultation with an ear, nose, and throat (ENT) specialist, also known as an otolaryngologist, can provide more comprehensive assessment and treatment options. These specialists have advanced training in nasal anatomy and can offer tailored recommendations based on the specific nature of the fracture.

Treatment Options for Nasal Fractures

The treatment approach for a nasal fracture depends on several factors, including the type and severity of the fracture, the time elapsed since injury, and the patient’s preferences. Treatment options include:

1. Conservative Management

For hairline or nondisplaced fractures, conservative management may be sufficient. This typically involves:

• Rest and limiting physical activities
• Applying ice packs to reduce swelling
• Taking over-the-counter pain medications
• Avoiding manipulation of the nose

2. Closed Reduction

Closed reduction is a procedure used for displaced fractures where the bones are manually realigned without making incisions. This procedure is typically performed:

• Within the first few hours after injury, before significant swelling occurs
• Or 5-20 days after injury, once swelling has subsided

How is closed reduction performed? The procedure is usually done under local or general anesthesia. The doctor uses specialized instruments to manipulate the nasal bones back into proper alignment through the nostrils.

3. Open Reduction

In cases where closed reduction is not possible or unsuccessful, open reduction may be necessary. This surgical procedure involves:

• Making incisions inside the nose to directly access the fractured bones
• Realigning the bones under direct visualization
• Potentially using small plates or screws to stabilize the bones

When is open reduction typically performed? Open reduction is often reserved for complex fractures or cases where significant time has elapsed since the injury, allowing the bones to heal in a misaligned position.

Complications and Long-Term Effects of Nasal Fractures

While many nasal fractures heal without significant issues, potential complications can occur, including:

• Deviated septum: Misalignment of the cartilage dividing the nasal passages
• Nasal obstruction: Difficulty breathing through the nose
• Cosmetic deformities: Changes in the nose’s appearance
• Septal hematoma: Blood collection in the nasal septum, which can lead to cartilage damage if untreated
• Chronic sinusitis: Recurring sinus infections

Can untreated nasal fractures lead to long-term problems? Yes, if left untreated or improperly managed, nasal fractures can result in both functional and aesthetic issues that may require more extensive corrective procedures in the future.

Prevention and Safety Measures

While not all nasal fractures can be prevented, several measures can reduce the risk of injury:

• Wearing appropriate protective gear during sports activities
• Using seatbelts and ensuring proper airbag function in vehicles
• Implementing fall prevention strategies for the elderly and young children
• Addressing domestic violence and promoting conflict resolution skills

How effective are sports-related protective measures in preventing nasal fractures? Studies have shown that the use of properly fitted face masks and helmets in contact sports can significantly reduce the incidence of nasal and facial fractures.

Recovery and Follow-up Care

The recovery process following a nasal fracture treatment varies depending on the severity of the injury and the type of intervention. General guidelines for recovery include:

• Avoiding strenuous activities for several weeks
• Protecting the nose from further injury
• Following prescribed medication regimens, including antibiotics if indicated
• Attending follow-up appointments to monitor healing progress

How long does it typically take for a nasal fracture to heal completely? While initial healing occurs within a few weeks, complete healing and resolution of symptoms may take several months. During this time, it’s crucial to follow medical advice and avoid activities that could risk re-injury.

Long-Term Monitoring and Potential Revisions

In some cases, the full extent of nasal deformities may not be apparent until swelling completely subsides, which can take several months. For this reason, some patients may require follow-up evaluations to assess:

• Nasal airway function
• Cosmetic appearance
• Need for additional corrective procedures

Is it common to need revision surgery after initial treatment of a nasal fracture? While many patients achieve satisfactory results with initial treatment, a small percentage may require revision procedures to address persistent functional or aesthetic concerns.

Psychological Impact and Coping Strategies

The psychological impact of a nasal fracture should not be overlooked. Patients may experience:

• Anxiety about appearance changes
• Stress related to breathing difficulties
• Trauma associated with the injury event, especially in cases of assault

Coping strategies and support mechanisms may include:

1. Counseling or therapy to address emotional concerns
2. Patient support groups for individuals with facial injuries
3. Education about the healing process and expected outcomes
4. Open communication with healthcare providers about concerns and expectations

How can healthcare providers best support patients’ emotional well-being during nasal fracture treatment? A comprehensive approach that addresses both physical and emotional aspects of recovery is crucial. This may involve collaboration between medical specialists, mental health professionals, and patient advocates to ensure holistic care.

Advances in Nasal Fracture Treatment and Research

The field of nasal fracture treatment continues to evolve, with ongoing research and technological advancements aimed at improving outcomes. Some areas of development include:

• 3D imaging and printing technologies for preoperative planning and custom implant design
• Minimally invasive techniques for fracture reduction
• Biocompatible materials for nasal reconstruction
• Enhanced post-treatment imaging to assess outcomes

What promising innovations are on the horizon for nasal fracture treatment? Researchers are exploring the use of tissue engineering and regenerative medicine techniques to potentially grow custom nasal cartilage for reconstruction. While still in early stages, these approaches hold promise for more personalized and effective treatments in the future.

In conclusion, nasal fractures represent a common yet potentially complex injury that requires prompt evaluation and appropriate management. By understanding the causes, symptoms, and treatment options for broken noses, individuals can seek timely care and achieve optimal outcomes. As research continues to advance, we can expect even more refined and effective approaches to nasal fracture treatment in the years to come.

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

Broken Nose (Nasal Fracture) Symptoms and Home Treatment Before Your Doctor Visit

Written by WebMD Editorial Contributors

Medically Reviewed by Jennifer Robinson, MD on August 22, 2021

• Broken Nose Overview
• Broken Nose Causes
• Broken Nose Symptoms
• When to Seek Medical Care
• Exams and Tests
• Broken Nose Treatment Self-Care at Home
• Medical Treatment
• Medications
• Surgery
• Other Therapy
• Next Steps Follow-up
• Prevention
• Outlook
• For More Information
• Synonyms and Keywords
• More

A broken nose is any crack or fracture in the bony portion of the nose.

Causes of a broken nose are related to trauma to the nose or face. Common sources of trauma include the following:

• Sports injury
• Personal fights
• Domestic violence
• Assaults
• Motor vehicle accidents
• Falls

Signs that suggest a person has a broken nose may include the following:

• Tenderness when touching the nose
• Swelling of the nose or face
• Bruising of the nose or under the eyes (black eye)
• Deformity of the nose (crooked nose)
• Nosebleed
• When touching the nose, a crunching or crackling sound or sensation like that of rubbing hair between 2 fingers
• Pain and difficulty breathing out of the nostrils

Call the doctor for any of the following:

• You think you might have a broken nose.
• The pain or swelling does not go away in 3 days.
• The nose looks crooked.
• You feel dizzy or light-headed.
• Breathing through the nose is not possible after the swelling has gone down.
• Fever develops.
• Recurring nosebleeds develop.
• Significant injury that requires medical attention possibly exists.

Go to a hospital’s emergency department immediately if any of the following signs or symptoms are present:

• Bleeding for more than a few minutes from one or both of the nostrils
• Clear fluid draining from the nose
• Other injuries to the face or the body
• Loss of consciousness (fainting)
• Severe or unrelenting headaches
• Repeat vomiting
• Decrease or change in vision
• Neck pain
• Numbness, tingling, or weakness in the arms
• Significant injury that may require immediate medical attention

In the emergency department, a doctor will examine the head and neck.

• The doctor will inspect the outside and the inside of the nose, often using special instruments.
• Depending on the injuries, the doctor may perform a thorough exam.
• Doctors usually do not recommend X-ray films of the face or nose unless they suspect the results might alter the course of treatment.

Taking the following actions at home may help reduce the symptoms of a broken nose, once it has been diagnosed by a doctor.

• Place some ice wrapped in a cloth over the nose for about 15 minutes at a time and then remove the ice. This process can be repeated multiple times throughout the day. Use ice at the time of injury and for 1-2 days afterward to reduce pain and swelling. Be sure to take breaks between applications, and do not apply the ice directly to the skin.
• Take acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) to reduce pain. Only use these medications as directed.
• Take an over-the-counter nasal decongestant if recommended by your doctor to aid in breathing through the nostrils. Be sure to read warning labels associated with these medications.
• Elevate the head, especially when sleeping, to avoid increased swelling of the nose. Prop the head up with pillows or lift the head of the bed by placing large blocks or phone books under the mattress.

For simple breaks in which the nose has not been displaced (the bone is not crooked), the doctor may prescribe only pain medication, ice, and nasal decongestants.

• For markedly displaced fractures, the doctor may attempt to realign the bone pieces. The doctor may use pain medication, local anesthesia, and nasal instruments.
  • Not all displaced fractures can be relocated immediately.
  • Not all displaced fractures can be relocated in the emergency department.
  • The doctor will advise you of the best care.
• If the nose continues to bleed, the doctor may insert packing into the nostrils.
  • A soft gauze pad will be placed in the bleeding nostril and should stop the nosebleed completely. The doctor usually removes the packing in 2-3 days.
  • Do not attempt to remove this packing.
  • The doctor may prescribe antibiotics and pain medication while the packing is in place.
• If other injuries exist, additional diagnostic tests and treatment may be given.

Try acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) for pain, taking care to follow the instructions on the bottle. Do not exceed the dose stated on the package instructions.

For more serious injuries, stronger pain medication may be prescribed.

Call a doctor or pharmacist if any questions or concerns arise regarding any medication.

Surgery may be needed for severe or multiple breaks in the nose, persistent deformity, or damage to the inner portions of the nose.

• Some simple surgeries can be performed in the doctor’s office.
  • The doctor pushes the broken bones back into place.
  • Special instruments and pain medicine (anesthesia) may be used.
  • Anesthesia may be injected into the nose or placed in the nostrils.
• Other surgeries are performed in the operating room.
  • These surgeries tend to be more complex and involve realigning the nasal bones and surrounding tissue.
  • Intravenous (IV) anesthesia is often used.
• Simple breaks that are not out of place do not usually require surgery.
• A doctor will advise the best treatment plan.

If a nose might be broken, avoid resting anything on the nose, including glasses and sunglasses.

Do not attempt to straighten the nose.

About 3-5 days after the swelling in the nose has gone away, a person may be referred to an ear, nose, and throat (ENT) doctor, an oral and maxillofacial surgeon (OMFS), or a plastic surgeon.

Follow-up care should not be delayed. A delay, especially longer than 7-10 days, may cause a broken bone to be set in a deformed state.

Avoid drug and alcohol use. Many nose breaks occur during or after abuse of these drugs.

• Follow safety rules when participating in sports and physical recreation.
• Wear a seatbelt at all times while riding in a motor vehicle.

If a nasal injury is minor, further care may not be needed. Many will need a follow-up visit in about 3 days after the swelling has resolved. If a severe break has occurred, corrective surgery may be required.

American Association of Oral and Maxillofacial Surgeons
9700 West Bryn Mawr Ave
Rosemont, IL 60018-5701
(800) 822-6637

American Academy of Otolaryngology—Head and Neck Surgery

650 Diagonal Rd

Alexandria, VA 22314

(703) 836-4444

nasal fracture, nose fracture, punch in the nose, deviated septum, nose bleed, nosebleed, nasal bleeding, nose injury, nasal injury, facial trauma, face injury, broken nose, facial trauma, swelling of the nose, black eye, crooked nose

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Deviated septum of the nose – causes, in which diseases it occurs, diagnosis and methods of treatment

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  Curvature of the nasal septum: causes of occurrence, in what diseases it occurs, diagnosis and methods of treatment.

  Definition

  The nasal septum is a plate that divides the nasal cavity in half, its main function is to adequately distribute the air flow between the right and left halves of the nasal cavity. A deviated septum can be either congenital or acquired. The consequence of this curvature is the narrowing of one of the nasal cavities. People with this defect may experience impaired nasal breathing and smell, mucous discharge, hearing loss, nosebleeds, frequent respiratory infections, and snoring.

  Varieties of deviated septum

  Deviated septum is determined by severity:
  
  I degree. There is a slight deviation of the septum from the midline, which usually does not lead to impaired respiratory function.

  II degree. The most protruding section of the septum is equidistant from the midline and from the wall of the nasal cavity, as a result of which the air flow is distributed unevenly.

  III degree. In this case, the septum is in contact with the wall of one side of the nasal cavity, so breathing is carried out mainly through one nostril.

  
  According to clinical manifestations:

  1. A small one-sided vertical ridge in the anterior parts of the nasal septum.
  2. Pronounced vertical ridge in the anterior part of the nasal septum with cartilage displacement to the opposite side.
  3. Single-sided vertical comb for deep nasal cavity.
  4. Two vertical, one behind the other ridges on opposite surfaces of the nasal septum.
  5. One-sided horizontal ascending ridge in the back sections of the partition, resembling a Turkish saber in shape.
  6. Two horizontal ridges in the anterior and middle sections of the nasal septum on opposite surfaces.
  7. “Crumpled” septum with multiple break lines.

  Possible causes of deviated septum

  Among the reasons for the change in the position and structure of the septum are both developmental disorders in the embryonic period, birth injuries, and nasal fractures, polyps or tumors.

  1. Physiological curvatures are caused by defects during the growth and ossification of the septum of the child’s nose, starting from the age of three months. The curvature is formed due to a discrepancy between the growth rate of the child and the development of bone structures.
  2. Traumatic deformities caused by any mechanical impact.
  3. Compensatory curvature occurs due to the formation of tumors or polyps in the nose.

  Which doctor should I contact for a deviated septum
  
  The choice of doctor to whom you should seek advice depends on the cause of the deformity. If this is a recent injury, you should immediately contact a traumatologist. If the patient notes periodic nasal congestion, he is worried about snoring, hearing loss, frequent infectious diseases, then you can routinely contact an otorhinolaryngologist.

  If breathing is disturbed, which leads to panic attacks or severe headaches, the help of a neuropsychiatrist may be required.

  Diagnosis and examination of deviated septum
  

  • If a bacterial or viral infection is suspected, a clinical blood test is necessary.

  Clinical blood test: general analysis, leukoformula, ESR (with microscopy of a blood smear in the presence of pathological changes)

  Synonyms: Complete blood count, KLA. Full blood count, FBC, Complete blood count (CBC) with differential white blood cell count (CBC with diff), Hemogram.
  Brief description of the study CBC: general a…

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  • Pharyngeal and nasal swabs for flora are prescribed if there are complaints of frequent respiratory tract infections.

  Culture of the upper respiratory tract for microflora, determination of sensitivity to antimicrobial drugs and bacteriophages (Upper Respiratory Culture, Routine. Bacteria Identification. Antibiotic Susceptibility and Bacteriophage Efficiency testing)

  Synonyms: Upper Respiratory Culture, Routine. Bacteria Identification. Antibiotic Susceptibility and Bacteriophage Efficiency testing.

  Brief description of the study “Sowing the discharge of the upper respiratory tract on …

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• X-ray of the paranasal sinuses is recommended to rule out inflammatory diseases, determine the size of the tonsils and the dynamics of their changes, as well as when detecting pronounced deviations and before performing surgery to correct the septum. Computed tomography is more informative. Magnetic resonance imaging is of secondary importance in diagnosis, since it does not give a detailed idea of ​​the state of bone structures, but reveals changes in soft tissues.

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X-ray examination of the paranasal sinuses for the diagnosis of pathological changes.

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Examination that allows to detect various pathologies of the ENT organs.

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• An X-ray of the bones of the nose may be performed as an initial examination if a nose fracture is suspected.

X-ray of the bones of the nose

X-ray examination of the bones of the nose to assess the integrity of the nasal bones and the condition of the sinuses.

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• Rhinoscopy. With anterior rhinoscopy, the degree of obstruction of the nasal passages with tissue, the presence of discharge and the severity of edema are assessed, and with the posterior one, the nasopharynx is examined and the presence of polyps in it, as well as their prevalence, are examined.
• Endoscopy of the nasal cavity.

Deviated septum treatment

If the deformation was the result of an injury, you should immediately contact the nearest emergency room for diagnostic procedures and determine the tactics of treatment.

In the presence of nausea and dizziness, you should make sure that there is no concussion of the brain.

Deviated septal treatment

If the curvature of the nasal septum is associated with a fresh injury, then anesthesia is performed first. If the deformity exists for a long time and is accompanied by frequent infectious diseases of the upper respiratory tract, during the period of their exacerbation, antibacterial, antiviral, vasoconstrictive agents and preparations for washing the nasal cavity can be prescribed. The main method of treatment remains a surgical operation, during which both the curvature itself and the causes that caused it (polyposis or tumors of the nose) can be eliminated.

Sources:

1. Modern approaches to the treatment of deformities of the nasal septum in children. Clinical guidelines. National Medical Association of Otorhinolaryngologists / ed. ON THE. Daihes, A.S. Yunusov, S.V. Rybalkin, E.B. Molchanov. – Moscow – St. Petersburg, 2015. 15 p.
2. Lopatin A.S. Reconstructive surgery of deformities of the nasal septum // Russian Rhinology. – 1994. – T. 1. – S. 3.

IMPORTANT!

The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.
For a correct assessment of the results of your analyzes in dynamics, it is preferable to do studies in the same laboratory, since different laboratories may use different research methods and units of measurement to perform the same analyzes.

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