ENT Specialists Provide Advanced Care for Nasal Fractures

A nasal fracture, more commonly known as a broken nose, is when the bone in your nose is broken or cracked. Most often, the break will occur over the bridge of the nose. If you have a fracture of your septum - the structure that separates your nostrils, this is a separate area but may also need to be addressed.

Nasal fractures are always trauma related. The most common causes are car accidents, falls, assaults/fights and sporting accidents, contact sports in particular. Initial symptoms of a broken nose are typically swelling, tenderness, black eyes and in some cases, difficulty breathing through the nose. If left untreated, nasal fractures can not only lead to long-term cosmetic problems (crooked nose), it can lead to breathing problems caused by nasal obstruction and/or collapse.

If you suspect you have a broken nose, it is important to consult with an ear, nose and throat specialist if you have any of the following issues:

• You have not been evaluated by a medical professional for your broken nose condition.
• You have nasal blockage or congestion that is bothersome to you.
• You have a change in the appearance of your nose that is bothersome to you.
• You have constant clear drainage from your nose or constant bleeding from your nose that is not stopping.
• You have a salty or metallic taste in your mouth that is new.

Diagnosing a Nasal Fracture

Your doctor can usually diagnose a broken nose by performing a visual and physical examination, which will require touching your nose and face.

Confirming a diagnosis of nasal fracture, will usually require an X-ray or CT scan of the nose. These imaging studies can help determine the extent of the damage to your nose and face and what "type" of fracture you have. There are two basic types of nasal fractures - displaced and nondisplaced. The treatment approach is different for the two types.

Treating Displaced Nasal Fractures

This type of nasal fracture occurs when the bone is broken into two or more parts, allowing the bones to shift and no longer be properly aligned. This type of nasal fracture can be treated with a surgical procedure called a closed nasal reduction.

A closed nasal reduction is typically done in an operating room or procedure room with the patient being briefly anesthetized. The surgeon re-breaks the bone and manipulates the bone segments back into the proper position without making any incisions in the skin. After the procedure, most patients will go home with a small case or splint taped to their nose to hold the cartilage and bone in position while they heal. For the best results, closed reduction surgery should take place within 14 days of the injury.

In some cases, displaced nasal fractures will not be managed surgically, particularly with patients who may be at risk with anesthesia and those who aren’t concerned about the appearance of their nose or have no nasal breathing issues. You may be recommended to avoid any pressure on your nasal bridge for a month so that the bones will heal over time.

Treating Nondisplaced Nasal Fractures

In a non-displaced fracture, the bone cracks either part or all of the way through, but doesn’t move and maintains its proper alignment. Nondisplaced fractures are not treated surgically but rather with conservative management techniques that may include pain medication and avoidance of contact or pressure on the nose. Patients are advised not to wear glasses during the healing process and avoid any activities that might put the nose at risk of further injury for one month or more.