by Garrett H. Bennett, MD
What is a nasal fracture?
The nasal bones are a pair of bones that extend about a third of the way from the forehead to the tip of the nose. Because they are very thin and in the center of the face, they are highly susceptible to injury. Nasal fractures account for 40 percent of all bone fractures. The most common causes of breaks among younger people they are fights and sports injuries, whereas falls are the most common cause in the older population. Trauma to the nose can change the shape and functionality of the bone and cartilage that make up the nose.
How do I know if I have a broken nose?
Breaking the nose is usually very painful. The nose will swell, and breathing can become difficult. The outside of the nose may be depressed, twisted, or C-shaped. The nasal bones may be mobile, and you may be able to feel or hear them moving. The eyes may be black and blue and the nose will frequently bleed profusely.
Do I need to see a doctor?
Yes. It is important to see a doctor as soon as possible after the injury occurs. The doctor will look for signs of a septal hematoma, or blood collected against the cartilage of the middle nose that can cause infection and destruction of the cartilage. It is best to see an Ear, Nose and Throat doctor, as they will be able to diagnose and treat the problem at the same time. Diagnosis is usually made by physical examination and an X-ray is rarely necessary.
How long do I have to fix my nose?
The broken bones will be mobile for up to two weeks and can sometimes be moved back into a natural position during that time. This can be done in the office or in an ambulatory surgery center. If the injury remains untreated for more than two weeks, the patient must wait at least two months – allowing the bones to completely heal – before seeking reparative treatment. The patient must then undergo a more extensive treatment to repair the nose.
What are the complications of a broken nose?
The main complications of a broken nose include permanent difficulty breathing and physical deformity of the nose. A fractured or deviated septum may be the cause of this breathing difficulty. The shape of the nose tip may change if the tip of the septum is bent. A hole in the septum (septal perforation) can cause the nose to collapse (saddle nose deformity). The cerebrospinal fluid (CSF) that cushions the brain may leak. The patient may lose their sense of smell. Infections of the nose or sinuses may occur. Other bones of the face may also be fractured, so you should check carefully for any addition head or neck injuries. Seek emergency medical attention if you suspect you may have a septal hematoma, CSF leakage, or an uncontrollable nosebleed (epistaxis).
What can I do at home?
Applying ice across the nose and keeping your head elevated will reduce swelling. Consistent pressure to the nose for 10-15 minutes without letting go will control most nosebleeds. Afrin drops inside the nose may also help the bleeding stop. Tylenol (acetaminophen) is the only over the counter pain medication that should be used. Other pain medicines like Motrin/Advil (ibuprofen), aspirin, and Aleve (naproxen) can promote or worsen bleeding.
Will insurance pay to fix my broken nose?
Insurance will almost always cover the cost of broken nose and deviated septum repair, as these are considered functional issues. Insurance will never cover cosmetic surgery, although your nose may look better after it is repaired with functional surgery. We will check your benefits for you and let you know what they are.