A nasal bone fracture is not always accompanied by externally visible deformations of the nose. However, to prevent any complications that may arise during the healing process, an early visit to the doctor may be advisable.
What is nasal bone fracture?
Nasal bone fracture (also known as nasal bone fracture in medicine) is one of the most common injuries in the facial area. This is caused, among other things, by the fact that the nose protrudes and that the bones of the nasal bone are relatively finely bony; thus, they can break even under comparatively light force. A nasal bone fracture is not always visible to the outside. However, in the case of a nasal bone fracture, it is often observed that the nose is displaceable to a small degree. Often, a fracture of the nasal bone is initially manifested by a severe swelling of the nose; in many cases, this swelling is also accompanied by pronounced pain after some time. A broken nose usually reacts particularly painfully to touch. In some cases, a fractured nasal bone may be accompanied by severe bleeding from the nose.
Causes
In most cases, a fractured nasal bone is caused by external force. For such force impacts can be responsible, for example, accidents and falls, as well as physical assaults. Various sports with frequent physical contact and high speeds (such as American football and, of course, boxing) are also associated with increased risks of suffering a nasal bone fracture. Furthermore, a nasal bone fracture can be deliberately induced in the course of cosmetic surgery: If the nose is to be corrected in its appearance, the bones of the nasal bone can be modeled accordingly after a fracture.
Symptoms, complaints and signs
A nasal bone fracture is accompanied by distinct symptoms. First, the nose usually begins to bleed profusely and the affected person feels severe pain. Subsequently, there is usually extensive swelling, as well as bruising and clearly visible changes in shape. The nose may become crooked and bumps and dents may form. In most cases, the patient’s breathing is severely impeded by the bent nasal septum and the swelling, and it is not uncommon for the ability to smell to be impaired as well. If individual bone fragments have slipped, the so-called “boxer’s nose” develops, because in this case the bridge of the nose can sink in. In the case of a strong impact, surrounding bones such as the ethmoid bone or the upper jaw bone can also be affected by the fracture. It is quite possible that symptoms such as bruising or swelling do not appear until several hours after the accident. Therefore, only an actual crooked nose is a clear sign of a nasal bone fracture. In addition, the fracture often occurs together with a septal hematoma. These are bruises in the nasal septum caused by bleeding between the nasal mucosa and the cartilage. The bleeding causes the nasal septum to swell, which subsequently either impedes nasal breathing or even makes it impossible. As a possible complication, septal necrosis may occur. In this case, the tissue dies because the cartilage is no longer sufficiently supplied with blood. In addition, a bacterial infection hematoma is also possible, which can lead to an abscess (accumulation of pus and a septal perforation (hole in the nasal septum).
Diagnosis and course
If the nose is deformed after external force, this already allows for a very definite diagnosis of nasal fracture. If a patient’s nose does not show any deformation despite a suspected diagnosis of nasal bone fracture, or if it is to be determined which bone areas are affected by a fracture, further examinations must be performed. For example, the inside of the nose can be viewed using a procedure called rhinoscopy; during rhinoscopy, the nasal passages are held open using medical instruments while a medical professional views the inside of the nose with a light source. In addition, to diagnose a nasal fracture, a medical professional may use a method called palpation: The exterior of the nose is palpated to detect, for example, mobility or fracture edges. As a rule, the fractured bones of the nasal bone form cartilage quite quickly, so that the nasal bones have often reconnected after about 5 days.Appropriate medical measures help to ensure that a nasal bone fracture does not lead to malpositioning of the nose or impaired breathing. Possible complications of open fracture wounds in nasal bone fracture include infections due to invading pathogens.
Complications
Of course, a fracture of the nasal bone can also bring up various complications, which should always be treated by an appropriate physician, as a rule. If a nasal bone fracture is left without any treatment, then complications are bound to arise. Often, the fracture does not grow back together properly, which can lead to stabbing and long-lasting pain. The formation of an abscess is also possible. In such a case, extreme caution is required, because an abscess can cause very unpleasant secondary damage. In an abscess, there is an increased accumulation of pus fluid. In some cases, the pus fluid enters the human bloodstream, so that it can even lead to blood poisoning. If you want to avoid these complications right from the start, you should not put off a visit to the doctor. With early treatment, the above complications can be avoided. For this reason, the following applies: a fracture of the nasal bone is naturally associated with various complications, so that a visit to the doctor becomes inevitable. In this way, possible discomfort and complications can be nipped in the bud. A complete and quick recovery is therefore 100% guaranteed.
When should you go to the doctor?
If there is pain in the nose or deformation of the shape of the nose after an accident or fall, there is cause for concern. If there is a lot of bleeding from the nose, sensory disturbances in the face, and changes in the appearance of the skin, the affected person needs medical help. In the case of a nasal bone fracture, severe pain occurs in the area of the face even with a light touch, as well as when the patient is at rest. In most cases, the pain radiates over the entire face and extends into the head. This results in disturbances of concentration and attention. Thinking is restricted due to the discomfort. In order to avoid an increase of the complaints and to reduce the existing pain, a doctor should be consulted. The patient should refrain from taking any medication until the doctor has been consulted in order to avoid complications. A displacement of the nasal bones can be seen by mere visual contact and should be treated immediately. The sooner a nasal bone fracture receives medical attention, the better the healing process. If bruising occurs or breathing is impaired, a doctor is needed. If there is a taste of blood in the mouth or swelling in the face, a doctor should be consulted. The discomfort causes further deterioration of breathing, so urgency is needed.
Treatment and therapy
What medical treatment becomes necessary after a nasal bone fracture depends first of all on the form of the nasal bone fracture: if the bones of the nasal bone have not shifted during a fracture, medical intervention is often not necessary; as a rule, the ends of the fracture join together again independently. However, since such a nasal bone fracture can still be accompanied by severe pain and swelling, pain-relieving medication is occasionally prescribed by the attending physician. Immediately after a nasal bone fracture, rapid cooling of the nose can help to limit the risk of swelling. If severe bleeding occurs from a fractured nasal bone that does not subside on its own, tamponades (bandages placed in the nostrils) may be necessary. If the nose is deformed after a nasal bone fracture and bone fragments have shifted, a specialist usually straightens the fracture. In addition to the cosmetic direction, it is also important to ensure that the airways are not impaired. If a nasal bone fracture needs to be straightened, it is important that this procedure is done quickly. If treatment is delayed, the nasal bones may have already consolidated in a displaced position.
Outlook and prognosis
A nasal bone fracture has an excellent chance of complete recovery without permanent damage if treated as soon as possible. In such cases, proper straightening and care of the fracture can ensure that the nose heals without damage within a few weeks.If the nasal bone is well rested for another four to six weeks, the nasal bone fracture is then considered to be completely healed. In other cases, where the nasal bone fracture also affected other structures of the nose, the prognosis is even more dependent on rapid treatment. For example, a deformed nasal septum is a risk for breathing and speaking problems if left untreated. In addition, a deformed nasal septum almost always leads to snoring and an increased susceptibility to infection. Likewise, detachment of the nasal mucosa from the nasal septum is associated with a rather negative prognosis. Tissue death and hemorrhage can occur here, which can visually lead to a sunken nose. Prompt treatment improves the prognosis. A nasal bone fracture can also heal without treatment. However, there is then a very high chance that deformities will remain. These depend on the type of nasal bone fracture and the angle of the fracture. In most cases, a boxer nose or a crooked nose remains. In retrospect, this can only be corrected surgically.
Prevention
A nasal bone fracture as a result of accidents usually cannot be prevented. To prevent a nasal bone fracture in the context of risky sports, appropriate protective clothing serves. Complications can be prevented by, among other things, the earliest possible medical diagnosis and treatment of a nasal bone fracture.
Aftercare
One goal of follow-up care is to prevent the recurrence of symptoms. This may not be true for a nasal bone fracture, as sudden accidents and violence cannot be predicted. Patients can, however, be a little more careful in their daily lives if such an accident has happened to them. For example, certain sports are more prone to re-fracture. Masks can provide protection. If necessary, the physician informs his patients about protective measures, which the affected person is responsible for on his own. On the other hand, a progress control takes place in order to realize a permanent treatment and everyday support. Often expected complications are related to this. In the case of a nasal bone fracture, such follow-up care extends to a good six weeks from the time of diagnosis; the patient can then continue his regular life. Since the patient is then free of symptoms, there is no need for follow-up care. A follow-up appointment includes an analysis of the acute symptoms. In addition, imaging techniques may be used to determine the growth of the nasal bone. Medications to relieve pain are prescribed regularly.
What you can do yourself
To avoid permanent deformation of the nose, adequate rest and relief are necessary after the doctor’s visit. The doctor’s instructions and recommendations should be followed to avoid causing undesirable secondary damage. Sports activities or intensive physical activities should be avoided for the period of recovery. Situations in which violence or other physical assaults could occur should be avoided in good time. Weights should not be lifted and jerky movements should be avoided. Hopping, jumping or running should be completely avoided during the healing phase. The movements can lead to unwanted bone displacement as well as triggering pain. Breathing should temporarily be done exclusively by mouth until the end of the treatment period. This prevents the absorption of particles from the immediate environment as well as airborne foreign bodies into the nose. If the nose fills up with excessive nasal secretions, the head can be placed on the back of the neck for a few minutes. This initiates the removal of the fluid through the throat and bypasses the painful blowing out. Wearing a mask can be considered helpful and relieving. This is visually very conspicuous in everyday life, protects the injured region very well from external influences.