Anatomy
The nasal bone (Latin translation: Os nasale) is double in humans; both parts ossify in the course of life. Together the two nasal bones form the nasal cavity. The front part, however, consists of cartilage, which is connected to the respective nasal bone at the front.
This reduces the risk of the nose breaking. The nasal septum (septum nasi) is attached to the inside of the nasal bone, which divides the nasal cavity into two cavities of approximately equal size. Each nasal cavity in turn is divided into a nasal vestibule (vestibulum nasi) and the actual nasal cavity (cavitas nasi).
Violent force applied from the front (e.g. blow, impact, etc.) causes both nasal bones to break, often involving the cartilaginous part and the nasal septum. The patient is usually in pain, and there is also nosebleed.
If the broken bone parts are displaced against each other, the nose is deformed (deviation to the side, indentation). In addition, swelling may occur due to the formation of a hematoma. In most cases, a fracture of the nasal bone can be diagnosed without an x-ray; simply by palpation and observation of the nose.
Nevertheless, an x-ray of the facial skull is recommended in order to rule out further bone fractures. If the fragments are not displaced, the nasal bone heals by itself. If the fragments are displaced or the bridge of the nose is deformed or the nasal septum is deviated, this should be treated surgically.
This must then be temporarily fixed with a splint. If the fracture of the nasal bone causes severe nosebleeds that do not stop on their own, a nasal tamponade should also be inserted. This would compress the vessels so that the bleeding stops.
A septal hematoma (nasal septum hematoma) can also occur if the septum is involved. This is a bleeding between the bone/cartilage and the periosteum or cartilage skin, which can lead to a complete obstruction of nasal breathing. In addition, the cartilage/bone can be destroyed, as the blood supply is ensured by the periosteum or cartilage skin.
If the skin is detached, the cartilage/bone can no longer receive nutrients and can die. A nasal septum hematoma must therefore always be surgically opened and the coagulated blood clots removed so that the periosteum or cartilage skin can reattach. In the saddle nose there is a depression of the bridge of the nose.
This deformity can be congenital, e.g. in trisomy 21 or a syphilis infection during pregnancy. But also fractures or tumors of the nose can lead to a saddle nose due to a change in the nasal bone. In some cases, those affected also have impaired nasal breathing.
The saddle nose can be corrected surgically (rhinoplasty). A crooked nose often results from a fracture of the nasal bone and is usually only discovered when the initial swelling of the nasal bone fracture has subsided. Uneven growth during childhood can also lead to a crooked nose.
The nasal septum is also crooked, which leads to an obstruction of nasal breathing. It can then be corrected surgically. The hump nose is characterized by a hump on the bridge of the nose and a tip of the nose that is bent downwards.
This deformity of the nose also has various causes and can be corrected by plastic surgery. In the tension nose, the nasal septum is too long in relation to the bridge of the nose, thus pulling the tip of the nose downwards. Often these patients suffer from restricted nasal breathing due to nostrils that are too small. This can also be corrected surgically.
