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Have you suffered a nasal fracture? Read on for tips on diagnosing a broken nose and treatment options.
What we normally call a “Broken Nose” is a crack or fracture to one or both of the nasal bones. These bones are small and oblong shaped. They are the thinnest bones in the body and the most often fractured. The size of these bones varies with the individual. Coming together at the center top of the nose, they form the top of the “bridge” of the nose. The lower part of the “bridge” is the septum, which is not a bone along the nasal dorsum but cartilage that separates the nose into sides.
A fractured nasal bone is most often the result of a sudden blunt impact. Since the nose is out there, protruding from the face, it is a common facial injury. A mild fracture may only result in minimal swelling and a brief nosebleed. It is quite possible that you won’t even be aware of the break. That is unless there is deformity to the nose alignment which could change the shape of the nose or your ability to breathe well.
A severe fracture will be much easier to notice. The nose is usually deformed appearing. There is generally a much greater nosebleed. Possibly one, or both of the nostril passages could be blocked, with airflow problems caused by a deviated septum or valve collapse.
Nose Anatomy Side View
Common causes of a broken nose include:
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.
Risk factors leading to a fractured nose are similar to the causes, contact sports, physical fight, motor vehicle accident, or a fall.
Your doctor may or may not get an x-ray for this injury. X-rays are generally not required. Using a nasal speculum (a lighted instrument which gently spreads the nostrils and allows inspection), they will check out the inside of the passageways and the nasal septum.
If the nose is deformed to the point of nasal obstruction, your doctor will probably refer you to either an otolaryngologist or a facial plastic surgeon. General plastic surgeons generally have minimal training with the structures inside the nose. You may find it best to find a doctor board certified in both Facial Plastic Surgery and Otolaryngology.
A broken nose may cause complications that can affect your quality of life. The bridge of the nose may collapse or bleed in the septum may cause a hole in the nasal septum. Permanent difficulty breathing may ensue. Persistent clear drainage may be a cerebral spinal fluid which is the fluid surrounding the brain — this is known as CSF rhinorrhea. You could also lose your sense of smell from the delicate olfactory nerves being damaged. Some nasal fractures may be more prone to sinus infections as well.
Remember NOT to take aspirin or ibuprofen after suffering a nasal fracture, as these medications can increase bleeding.
Right after the fracture, it is best to apply ice and to keep your head elevated. The ice will help in reducing the swelling. You DO NOT want to take any aspirin or ibuprofen (Advil or Motrin) as these are blood thinners and will not help with the bleeding at all. The best pain medicine to take at this point would be Tylenol which is acetaminophen. Do not take nonsteroidal anti-inflammatory drugs (NSAIDs).
After this, the treatment is mainly controlling the pain and nose bleeds. Another treatment will be available after the swelling is down and a true assessment of the damage can be made — normally within the first 24 hours or after 3 days. If you wait more than 14 days from the injury your nose may heal and then you would need to wait for 6 to 8 weeks before repair. Many emergency rooms are unaware of this and will have you follow up long after your window for immediate repair has closed.
If your doctor is skilled in this area, they may see fit to realign the bone or cartilage themselves. This procedure can be performed in the office or in the operating room, depending on the degree of fracture and on your and your doctor’s comfort level. External nasal taping and splints may be used as well.
This patient of Dr. Bennett underwent surgery for a fractured nose. Notice how the patient’s nose appears distinctively straighter in the “After” photograph.
A complicated fracture could require surgery. The crooked and broken bone or cartilage may need to be moved back into place. This can be performed at the office or in an ambulatory surgery center and may use general or local anesthesia.
Dr. Bennett’s staff of trained insurance experts will ensure that you receive the best coverage under your policy.
Yes. Insurance usually does not cover cosmetic surgery, but in cases where surgery corrects or improves the ability to breathe properly or alleviates a major physical deformity, the procedures are often covered. Patients should obtain cost information from their surgeon or by contacting your insurance. You need to be cautious about having procedures performed without full knowledge of your insurance benefits. If you are a patient of Dr. Bennett then his office staff will check your benefits for you to let you know what your financial responsibility will be.