A broken nose is a fracture or crack/ break of the nasal bones. In most cases, there is also some damage to nearby nasal cartilage, particularly the nasal septum which causes pain and swelling around the nose, bleeding, nasal discharge, and difficulty breathing. In this article, we look at how to tell if your nose is broken , the causes, treatment and recovery.
How To Tell If Your Nose Is Broken (Nasal Fracture)
Because the nose has such a prominent and unprotected position in the center of the face, it is particularly vulnerable to acts of impact. Common causes of a broken nose include:
- Injuries from contact sports, such as boxing, wrestling, football or hockey
- Physical altercations
- Motor vehicle accidents
- Walking into an object
If your nose is broken it could have been a mild fracture where the injury causes only some mild swelling and a brief nosebleed. In this instance, you may be unaware of the break unless your nose heals with a slight deformity.
In the case of severe fractures, however, the nose can be obviously deformed or shifted out of its normal midline position immediately after impact. In addition to that, there is severe bleeding, a blocked nostril or air-flow problems related to a deviated septum (a shift of the nasal septum toward the left or right nostril).
What Does A Broken Nose Look Like?
Symptoms of a broken nose are similar in kids and adults. Signs include:
- Bruising, swelling and tenderness around the nose
- Nosebleed that lasts for more than 15 minutes
- A deformed, twisted or crooked nose i.e shifted out of its normal midline position
- Blockage of one or both nostrils
- A deviated septum
- A bruise-like discoloration under the eyes
- A runny nose
- Difficulty breathing through the nose
- A crunching noise when touching the nose
- You notice a small, grape-like swelling on the side of your nasal septum, inside your nostril. This may be a septal hematoma.
Even if your nose is injured only mildly, the area can swell significantly within one to two hours after the impact. Until this swelling goes away, you or your doctor may not be able to accurately assess the extent of any damage.
When To Visit The Doctor:
An adult or child with a suspected broken nose should see a doctor if the symptoms or signs above persist for longer than a day or two. Although tenderness and swelling usually subside within one to two weeks, any deformities of the nasal bones or cartilages are permanent unless you seek the treatment of a doctor.
It is also important to see a doctor if it is difficult to breathe through the nose once the swelling goes down or fever occurs.
Head to the ER/ Call 911 if:
- there is severe or persistent bleeding
- it becomes difficult to breathe
- there is a large open wound on the face
- broken glass or other debris is inside the nose
- there are large cuts or gashes on their face, as stitches or a medical dressing may be necessary to close and protect the wound while it heals.
Immediate medical attention is necessary for head injury signs such as:
- clear, watery fluid coming out of the nose
- a severe headache
- blurred vision
- loss of consciousness
- difficulty speaking or moving
- confusion or memory loss
Upon reviewing your symptoms, your doctor will ask how you injured your nose, whether you have broken or severely injured your nose before, and whether you have had nasal surgery prior to this visit.
Next, your doctor will examine your nose, looking at its shape and symmetry, the alignment of its bones, the position of the nasal septum and any obvious areas of deformity or tenderness. Using a bright light and a nasal speculum, he/she will gently spread open your nostril. Then the doctor will inspect the inside surface of each nostril and check your nasal septum for a bruise or blood clot. In many cases, no other tests are needed. X-rays are not always necessary.
Your doctor may refer you to an otolaryngologist (ear, nose and throat specialist) or a plastic surgeon if your nose is deformed, the air flow through your nose is obstructed, or you have other symptoms that require specialized care.
If the case is less severe, your doctor may wait for a few days to allow swelling to subside before assessing the situation. In many cases, the broken nose can be realigned within the first 10 days post injury in a nonsurgical procedure.
If your injured nose is deformed or misaligned, your doctor may attempt to realign your nose immediately. This can be done with or without surgery. Realigning the bones will restore the appearance of the nose and resolve any difficulties in breathing through it. If it has been above 2 weeks since the injury occurred, manual realignment is usually no longer an option, and a doctor may recommend surgery to repair the nose instead.
For persistent bleeding, the doctor may insert and stuff the front of your nose with a hemostatic sponge or gauze. If there is a bruise or blood clot on your nasal septum (a septal hematoma), the doctor will make a small incision to allow the blood clot to drain. If it is not drained, it can cause a permanent deformity of the nose.
A doctor may recommend surgery to individuals with a broken nose if:
- Injury is severe
- Nose injury involves multiple broken bones
- Your nose has damage to the nasal septum or has breathing difficulty.
Realignment can be done surgically with a procedure called a rhinoplasty.
Nasal fractures typically begin to heal within a few days, but it may take a week or so for the pain and swelling to go away completely. While recovering from a broken nose, it is advisable to avoid activities that could further damage it, such as playing contact sports.
If there are complications, recovery may take longer. Complications arising from a broken nose can include:
- A deviated septum, which is where the thin wall between the nostrils moves out of alignment. A person may require surgery to fix a deviated septum, particularly if it is affecting breathing through the nose.
- Cartilage damage depending on the severity of the damage.
- Septal hematoma, where pools of clotted blood block the nostrils. It is important for people to seek prompt medical treatment for this condition.
Nasal deformities that arise from a broken nose are usually permanent unless you do not receive corrective treatment.
It is not always possible to prevent a broken nose. However, a person can take certain steps to reduce their risk. These include:
- wearing protective clothing and a helmet when playing contact sports and engaging in activities with a risk of falls or collisions, such as skiing, horse riding, and using a bicycle or motorcycle
- wearing a seat belt at all times when traveling in a motor vehicle
- wearing suitable shoes to prevent falls
- using walking sticks or other mobility aids if unsteady when moving about
Parents and caregivers may wish to take extra precautions to safeguard children against falls and other accidents. These precautions can include:
- installing stair gates and other safety aids in the home
- removing rugs and other fall hazards
- ensuring that children wear appropriate and well-fitting shoes
- discouraging children from running or playing on slippery or uneven surfaces
- encouraging children to play on soft surfaces, such as grass