Broken Nose (Nasal Fracture)
The term broken nose is heard all of the time. The paired nasal bones, shown below, extend from the forehead to about one-third of the way down the nose. Nasal bones are thick near the eyes and very thin towards the center of the face. Because of their prominent location they are the most injured bone in the body accounting for two-fifths of all fractures. Young people tend to break their noses from playing sports and fighting while older people tend to have nasal fractures from falls. Any nasal injury can change the function and appearance of the nose.
What are the signs and symptoms of a broken nose?
Pain is generally the first and most noticeable thing about breaking your nose. Bleeding is the second thing and cuts inside the nose or a fractured nasal septum can bleed profusely. The nose will swell on the inside and outside and breathing can become difficult or completely obstructed. The outside appearance of the nose may be collapsed or crooked. The bones can be easily moveable and can click when the nose is touched. Swollen and black and blue eyes are common.
When should I see a doctor for a broken nose?
If the nose looks about the same and your breathing is fine then you may not need to see a doctor. If you lost consciousness, have other severe injuries, have a mental status change, or won’t stop bleeding then you should seek emergency care. For all others like those with difficulty breathing or a change in the shape of the nose, it is important to see a doctor as soon as possible after the injury occurs. A septal hematoma is a medical emergency where a collection of blood applies pressure to the nasal septum. This can cause an infection that can erode the cartilage and collapse the nose. It is best to see an Otolaryngologist as they can diagnose and treat the condition at the same time. Diagnosis of a broken nose is usually made by physical examination and an X-ray is rarely necessary. Emergency room physicians may tell you to wait more than 2 weeks to get a specialist opinion. Waiting with an actual nasal fracture may not be in your best interest. The best time to evaluate a broken nose is in the first 24 hours or after the swelling goes down at day 3 or 4.
How quickly should I fix my broken nose?
For most people the fractured nasal bones are mobile for the first two weeks. The bones can sometimes be easily moved back into a normal appearing position. This procedure can be performed with local anesthesia at either an office or ambulatory surgery center. Not treating a nasal bone fracture for greater than two weeks can result in a need for a greater level of management. You may need to wait over two months to completely let the nasal bones heal. Trying to fix a partially healed nasal bone can result in greater deformity of the nose. The patient must then have a septo-nasal repair of the nose the return appropriate function and cosmesis.
What are the main complications of a broken nose?
Complications of a nasal fracture are mainly permanent nasal obstruction and cosmetic deformity of the nose. Fracture of the bones or bending of the septal cartilage can twist the nasal tip or make the nose look like its off to one side of the face. A septal fracture can cause a hole in the septum (septal perforation) and subsequent nasal collapse (saddle nose deformity). The fluid that surrounds the brain, cerebrospinal fluid or CSF, can leak if the lining above the sinuses is cut. You can have loss or decrease in your sense of smell. Infections of the nose or sinuses may occur or become permanent. Other facial bones may be fractured and your doctor should check carefully for any addition head or neck injuries. Obtain emergency medical attention if you suspect you may have a CSF leak, septal hematoma, loss or change of consciousness or a severe nosebleed (epistaxis).
How can I treat my nose at home?
A bag of ice or frozen peas across the nose as well as head elevation can reduce swelling. With bleeding of the nose applying constant pressure to with a thumb and forefinger for at least 15 minutes without letting go. Decongestant drops inside the nose like oxymetazoline may decrease or stop bleeding. Tylenol (acetaminophen) is the only OTC pain medication that should be used. Non-steroidal pain medicines like Advil/Motrin (ibuprofen), aspirin, and Aleve (naproxen) can increase bleeding.
Does my insurance pay to fix my broken nose?
Yes. Insurance almost always cover the cost of broken nose, sinus surgery and deviated septum repair. These are considered functional issues and improving nasal function is currently treated as medically necessary. Insurance will never cover a purely cosmetic surgery, although the appearance of your nose may be improved after functional surgery. At Dr. Bennett’s office, our helpful staff will check your benefits for you and let you know what they are.
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