What is a nose fracture?

Trauma to the nose can fracture the nasal skeleton or the cartilage. There are different patterns of nose fractures depending on the direction (side or front) and the strength of the force (moderate or severe) applied.

Is a nose fracture serious?

If the bone is only cracked, the fracture is usually not as serious. But if a bone is pushed out of position, the fracture is more serious.

What are the symptoms of a nose fracture?

Symptoms include:

• Crooked or bent nose
• Pain
• Swelling
• Nose bleeding
• Clear fluid coming from nose
• Difficulty breathing thought the nose
• Inability to smell

What if I am nose bleeding?

Perform self-care methods to arrest the bleeding.

• Position
  • Sitting and leaning forward
  • Do NOT lie down or tilt your head back
• Pressure
  • Apply to the fleshy part of the nose for 10-15 minutes
  • Do NOT press on just one side or the bridge of your nose
• Swallowing
  • Breathing gently through mouth
  • Do NOT swallow any blood
• Place
  • Apply ice or a cold pack on the injured area for 10-15 minutes every 1-2 hours

Do I need an X-ray or a CT Scan to diagnose my nose fracture?

The ENT doctor will inquire about your injury and symptoms and will perform a physical exam. Thereafter depending on the degree of injury and the complaints, an X-ray or a CT scan will be ordered.

What is the treatment of a nose fracture?

Swelling is first allowed to settle. It takes 3-5 days and is facilitated by:

• Elevating your head
• Cold packs or ice on the area of injury
• Pain medications (paracetamol, diclofenac, ibuprofen or stronger if necessary)

Once the swelling has settled, other treatment depends on how mild or severe the fracture is. Associated injurie to the surrounding region are considered too.

Mild nose fracture is when the nose bones are not out of position, you can breathe through both nostrils and there’s no collection of blood in your nose. This may not warrant any further treatment; however, a re-evaluation may be necessary after the swelling subsides.

Serious nose fractures occur when the injury has pushed the nose bones out of position, you can’t breathe through the nostrils and there’s a collection of blood in the nose. This warrants nose surgery to correct the injury.

If you have a collection of blood (septal haematoma) in your nose, the ENT will drain it and place packing material in your nose then remove it after several days.

How long do nose fractures heal?

A nasal fracture takes weeks to heal, depending on the severity.

Return to play

Refrain from all sports activities for 2 weeks and contact sports (rugby, basketball or football) for 6 weeks.

Can I do anything to help the healing process?

Yes, follow the ENT doctor’s instructions as well as refrain from contact activities for the duration of time stipulated.

When should I call my ENT doctor?

After treatment, contact the ENT surgeon if:

• Pain and swelling gets worse
• Excessive nose bleeding
• Clear fluid leaking through the nose
• Inability to breathe through the nose

References

1. Theissing J, Rettinger G, Werner AJ. ENT –Head and Neck Surgery: Essential Procdures. 2011. Thieme. p52-53.
2. Wei JJ, Tang ZL, Liu L, Liao XJ, Yu YB, Jing W. The management of naso-orbital-ethmoid (NOE) fractures. Chinese Journal of Traumatology. 2015 Oct 31;18(5):296-301.
3. Kühnel TS, Reichert TE. Trauma of the midface. GMS current topics in otorhinolaryngology, head and neck surgery. 2015;14.
4. Cannon CR, Cannon R, Young K, Replogle W, Stringer S, Gasson E. Characteristics of nasal injuries incurred during sports activities: Analysis of 91 patients. ENT: Ear, Nose & Throat Journal. 2011 Aug 1;90(8).
5. Trauma to the face. 2013.

Disclaimer

The content on the Nairobi ENT website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions.