Broken nose symptoms
- Bruises around the eyes and/or a slightly crooked nose following injury usually indicate a fractured nose
- If the bones are pushed over or out to one side, immediate medical attention is ideal, but once soft tissue swelling distorts the nose, waiting 48-72 hours for a doctor’s appointment may actually help the doctor in evaluating your injury as the swelling recedes – apply ice while waiting to see the doctor
- What’s most important is whether the nasal bones have been displaced, rather than just fractured or broken – imaging with an x-ray or CT scan may help confirm a displaced nasal fracture
CT scan showing a displaced nasal fracture
Broken nose surgery
- For noticeably displaced bones, surgeons often attempt to return the nasal bones to a straighter position under local or general anesthesia
- This is usually done within seven to ten days after injury, so that the bones don’t heal in a displaced position
- Because so many fractures are irregular and won’t “pop” back into place, the procedure is successful only half the time
- Displacement due to injury often results in compromised breathing so corrective nasal surgery, typically rhinoplasty surgery, may then be needed
- Rhinoplasty surgery is typically done on an outpatient basis, and patients usually plan to avoid appearing in public for about a week due to swelling and bruising
Broken nose causes
- A broken nose, also called a nasal fracture, is a break or crack in a bone in your nose — often the bone over the bridge of your nose
- Common causes of a broken nose include contact sports, fighting, falls and motor vehicle accidents that result in trauma
- Signs and symptoms of a broken nose include pain, swelling and bruising around your nose and under your eyes – your nose may look crooked, and you may find it difficult to breathe
- Treatment for a broken nose may include procedures to realign your nose
Symptoms of a broken nose
- Signs and symptoms of a broken nose may appear immediately or may take up to three days to develop
- Signs and symptoms may include:
- Pain or tenderness, especially when touching your nose
- Swelling of your nose and surrounding areas
- Bleeding
- Bruising around your nose or eyes
- Crooked or misshapen nose
- Difficulty breathing through your nose
- Discharge of mucus from your nose (rhinorrhoea)
- Feeling that your nasal passages are blocked
Causes of a broken nose
- As the nose is the most prominent feature on your face — protruding unprotected— it’s also the facial feature most at risk of injury
- Broken noses account for approximately 40% of all facial fractures
- Your nose is supported by cartilage (in the front) and bone (on the back and bridge) – when this framework of bone and cartilage is struck with a force, the bones can crack or fracture — resulting in a broken nose
- Common causes of a broken nose include:
- Injury from contact sports, such as football, basketball or soccer
- Fighting, when punches are thrown
- Motor vehicle accidents
- Falls
- A broken nose can even be caused by activities such as walking into a fixed object or by rough, wrestling-type play
Complications of a broken nose – other broken nose symptoms
Deviated septum
- A nose fracture may cause a deviated septum, a condition that occurs when the thin wall dividing the two sides of your nose (nasal septum) is displaced to one side, narrowing your nasal passage on that side
- Medications can help you manage a deviated septum, though surgery is required to correct the condition
Collection of blood (nasal septal haematoma)
- Sometimes, a collection of blood called a septal hematoma may accompany a nose fracture
- A septal hematoma can block one or both nostrils
- Septal hematoma requires emergency surgical drainage to prevent cartilage damage
Cartilage fracture
- If your fracture is due to a forceful blow, such as from an automobile accident, you may also experience a cartilage fracture
- If your injury is severe enough to warrant surgical treatment, the surgery would address both your bone and cartilage injuries
Neck injury
- Likewise, nose fractures resulting from high-velocity injuries — like those experienced in motor vehicle accidents — may be accompanied by injuries to your neck (cervical spine)
- If a blow is strong enough to break your nose, it may also be strong enough to damage the bones in your neck
- If you suspect a neck injury, see your doctor immediately
When to see an ENT doctor
Seek emergency medical attention if you experience a nose injury accompanied by a head or neck injury, which may be marked by severe headache, neck pain, vomiting or loss of consciousness
- Difficulty breathing
- Bleeding you can’t stop
- A noticeable change in the shape of your nose that isn’t related to swelling, such as a crooked or twisted appearance
- Clear fluid draining from your nose
What you can do before your appointment
- Immediately after your injury, apply ice to the area to help keep swelling down
- Use light pressure to keep the ice on your nose
- Over-the-counter pain relievers, such as paracetamol, can help reduce pain. Ibuprofen can also help relieve inflammation
Your appointment
- If you’re injury is severe, you’ll need to seek immediate medical attention and won’t have time to prepare for your appointment
- But, if the injury to your nose is minor — accompanied only by swelling and moderate pain — you may choose to wait before seeing your doctor
- This allows time for the swelling to subside, so you and your doctor can better evaluate your injury
- However, it’s best not to wait longer than a week before seeing your doctor if your signs and symptoms persist – during this waiting period, get medical attention if:
- The pain or swelling doesn’t progressively get better — and eventually disappears
- Your nose looks misshapen or crooked after the swelling recedes
- You can’t breathe efficiently through your nose even after the swelling subsides
- You experience frequent, recurring nosebleeds
- You have a fever
- You’ll probably start by seeing your family doctor or general practitioner – however your doctor will likely refer you to an ENT specialist (Otolaryngologist)
- If your nose is broken and requires repair this surgery is done as an outpatient procedure
- You will need to have the repair done within two to three weeks for best results
Surgical repair of a broken nose
Fixing displacements and breaks your doctor may use several approaches:
Closed reduction – broken nose surgery
- If the break has displaced the bones and cartilage in your nose, your doctor may be able to manually realign them with a nonsurgical procedure called closed reduction
- For best results closed reduction should be conducted no more than 14 days after the fracture
- During this procedure, your doctor uses a nasal speculum to open your nostrils
- Special instruments are used to help realign your broken bones and cartilage and return them to their original positions.
- Surgery for broken nose pain relief – you will need pain medications, including local injections and nasal sprays, before the procedure
- Broken nose surgery recovery – if you experience persistent bleeding related to any nasal fracture, you may need to have your nostrils packed with moistened gauze strips – these strips will contain an antibiotic ointment to help prevent infection
Surgery – rhinoplasty or septorhinoplasty
- Severe breaks, multiple breaks or breaks that have gone untreated for more than 14 days may not be candidates for closed reduction
- In these cases, surgery to realign the bones and reshape your nose (rhinoplasty) may be necessary
- If the break has damaged your nasal septum, causing a deviated septum with resulting obstruction or difficulty breathing, then reconstructive surgery called septorhinoplasty (rhinoplasty and deviated septum surgery) may be recommended
- Both surgeries are typically performed on an outpatient basis
- Many people choose to stay home for a few days during the recovery process since considerable swelling and bruising are common side effects
- Discomfort, swelling and bruising usually improve significantly after around one week