A broken nose or nasal fracture refers to the breaking of one or multiple bones of the nose. The nose structure primarily consists of bone, cartilage, and fibrofatty tissues. A layer of skin covers these structures and gives them an ideal nasal structure with septal division. While the external nasal skeleton comprises nasal and maxillary bones, the internal septum consists of two additional bones. Any deformity or acquired conditions can lead to abnormal structure or fracture of these bones.
Any direct injury to the face and nose, usually in the form of an accident, can lead to a broken nose. A blow to the face, assault, personal fights or driving accidents can result in a crack in either or all of these bones.
But injuries to the mouth and oral cavity can also affect the nasal structure and risk damaging their structure and position. Nasal fractures can be closed or open, with or without skin over the nose, leading to bone exposure.
In a survey regarding the incidence of facial fractures, nasal fractures accounted for 58% of the total fractures. Out of the total sample, men (mean age 45.6 years) were the most predisposed towards a broken nose. Blunt trauma was the predominant reason for 90% of these fractures. Motor vehicle accidents were the next, accounting for 27.5 % of fractures. Closed and open fractures accounted for 93% and 38% of the incidence, respectively. The study proved that you are at risk for nasal fracture if you are into fighting or driving sports. But your risk of fracture is further increased by the anterior prominence of your nose or if you had a nasal fracture previously.
Many patients come to meet Dr. Bizrah and seek his expertise to confirm their candidature for broken nose surgery. You can also consult Dr Bizrah through online consultation or physically at his clinic to know more about your broken nose condition.
A swollen, disfigured nose with pain and tenderness are the first signs of a broken nose. There will be cracking or popping of the noise with mucus and blood flow depending on the severity of the fracture. Due to concomitant damage to surrounding areas and the intensity of blood clots, there will be black eyes or bruises beneath the eyes. If the nasal bone is applying pressure on your nostril portions, you will face trouble breathing through the nose and require your mouth for breathing. Changes or loss of smell are a few other characteristics. However, it’s better to run tests under a qualified surgeon like Dr. Bizrah to confirm your candidature for the condition.
You should consult a physician as soon as you suspect a broken bone to be on the safe side. Early consultation will help you plan an effective treatment of the condition. It will also reduce the incidence of disfigurement owing to delayed consultation. Fever, frequent nose bleeds, a persistent crooked nose, and overall difficulty in breathing are a few signs that require medical attention. But you need urgent medical treatment if your swelling, pain, and bleeding get worse and you have clear fluid running from your nose. This fluid is the cerebrospinal fluid and if left untreated, can be life-threatening. A double vision due to involvements of the orbital structures also needs prompt treatment to prevent irreversible vision loss.
A thorough physical examination by the medical practitioner is usually the first diagnostic step towards treating a broken nose. Usually, nasal bleeding is the first sign of mucosal laceration inside the nose. The surgeon first examines the external surface of the nose through digital palpation (pressing the nose point ).
Any swelling or laceration is a sign of the position of fracture below the skin surface. During this examination, any bumps on the nasal surface in the form of humps, steps, and crepitus are closely monitored as possible fracture points. During this time, the intranasal anatomy is also evaluated using a nasal speculum. Septal deviation, septal hematoma, and mucosal tear or laceration are all evaluated for a proper diagnosis. Any history of previous nasal fracture or preexisting septal deviation should be informed beforehand to the surgeon to diagnose. X-rays and CT scans are also performed for knowing the extent of the damage.
In this regard, Dr. Bizrah has integrated his clinics in Dubai and London with state-of-the-art modalities to properly diagnose a broken nose condition.
Nasal fractures are said to be minor or type 1 when they involve only the nose. These fractures are later classified as type 2 and type 3 when the fracture involves the nasal and other facial and orbital bones.
Minor nasal displacements or fractures are allowed to heal independently with ice packs and medications as the only treatment option during the broken nose healing process. Sometimes the bone displacement is corrected through closed reduction using forceps and other nasal instruments.
Septal hematoma, if acquired with the fracture, is aspirated or drained at the earliest instance. Septal hematomas being formed by rupture of blood vessels, draining them is important to prevent infection and necrosis of the underlying broken nose cartilage support. In the case of open wounds, the area of injury is thoroughly rinsed to prevent contamination of the soft tissues with foreign matter. Type 2 and 3 fractures usually require urgent broken nose surgery. In such cases, the broken nose cartilage healing time may become 3-4 weeks post-surgery. As a part of nose fracture treatment, you should keep your head in an elevated position and limit your movements to allow easy blood flow.
Septoplasty and Rhinoplasty are the two main surgical methods of treating a broken nose. Septoplasty is performed under the administration of anesthesia to correct a fractured or deviated septum. In Rhinoplasty, the skin over the nose is lifted post administration of anesthetics, followed by restructuring and reshaping the nasal structure. Post correction, the skin is sutured or stitched back to its position. A splint or nasal bandage is applied over or inside the nose to keep the operated nose in place.
These two procedures are either performed on their own or in combination, depending on the severity of your condition with the surgeon’s treatment plan. After surgery, your splints will be removed in 5-10 days, after which you can resume your normal activities.
If you’re opting for early treatment, there is a 90% chance that your nose will regain its shape after the fracture. If there are any preexisting hump on your nose or your postoperative nose looks unsatisfactory in appearance, you may opt for reconstructive Rhinoplasty. With the advancement in Rhinoplasty, a nose with long-standing fractures for more than ten years can even be back to normal position. Usually, the reconstructive Rhinoplasty is performed with a gap of at least six months after the fracture correction to witness the best results.
Surgery and closed reduction can take care of your fractured nose. But protective measures can prevent the fracture from occurring in the first place—people into contact sports and into sports driving need to wear a helmet for safety purposes. Wearing good quality traction shoes with proper restraining of belts can prove helpful in avoiding sudden jolts. Driving with a seat belt on and abiding by traffic rules can also protect you and your nose from impacts and accidents.
An untreated broken nose can lead to septal fractures, deformities, and deviations. This can result in frequent headaches and snoring problems that will impact your social and psychological well-being. Frequent nosebleeds with sinusitis can lead to serious ocular problems over time. Sleep obstruction due to breathing difficulties can lead to sleep apnea that can have serious repercussions like increased blood pressure, depression, and an overall lethargic state of being. A crooked nose, if left untreated, can lead to facial deformities and aesthetically affect your self-esteem. That’s why, it is imperative to run necessary tests and go for the surgery, if required, under a qualified surgeon like Dr. Bizrah to fix your broken nose before it starts to affect your normal routine life.