The nose is the most commonly broken bone of the face. In the case that you or someone you know breaks their nose, it is important to know how to treat the injury. Immediately after the injury, it is most important to ensure that the patient has not developed a more serious injury. If the patient has lost consciousness, is acting unusual, or has any other concerns, someone should call 9-1-1 immediately.
Many times after breaking the nose, it will begin to bleed. In this instance, pressure should be applied to the soft part of the nose towards the tip as one leans their body forward. It is very important for blood to come out of the nose as one leans forward as opposed to leaning backwards and having blood go down the throat. If blood goes down the throat it can cause difficulty breathing or nausea. I recommend keeping pressure on the nose for at least 20 minutes to stop the nose bleed.
An ENT, also known as a head and neck surgeon, or a facial plastic surgeon are the most knowledgeable doctors to treat a broken nose. During an initial evaluation of a broken nose, a full medical history is taken and an understanding of all surrounding events leading up to the broken nose are important. During the examination, the entire face is examined to ensure that there are not any other injuries. The nasal septum is examined in order to ensure that the it did not fracture or a collection of blood did not form in the septum, a condition known as septal hematoma. A septal hematoma needs to be treated immediately. The pressure from the hematoma can cause the cartilage in the nose to weaken or die, resulting in severe nasal collapse.
The nasal bones connect to the base of the skull. Sometimes during a severe nasal fracture, it can cause a break at the skull resulting in leaking of the fluid around the brain into the nose and down the throat, a CSF leak. This results in constant nasal dripping or a salty taste in the mouth. This is easily treated if diagnosed promptly and correctly.
After correctly diagnosing the broken nose, there are many treatment options. If the broken nose has not caused a significant change in the appearance of the nose, I recommend ice packs, keeping the head elevated, and nasal sprays. If there appears to be a change in the appearance in the nose, then a procedure may be recommended. If the patient is seen within 2-3 hours of the nasal fracture, before the start of nasal swelling, the nasal bones can be “popped” back into position. This can be done in the office, but it can be painful. Patients that require their bones popped back into place, closed reduction of a nasal fracture, can be placed under twilight anesthesia in the outpatient surgery center. If the patient is evaluated after the formation of nasal swelling, the patient will have to wait 3-10 days before preforming a closed reduction of the nasal fracture. The swelling camoflauges the appearance of the nose and therefore the surgeon cannot accurately correctly the nasal deformity. The bones remain loose enough to be able to be moved back into place for up to 10 days. If the septum has been fractured as well, then it may also be moved back into place during the closed reduction of the nasal fracture. There are many additional procedures that may need to be preformed to get the nose back into position, including but not limited to rebreaking the nasal bones (nasal osteotomies), septoplasty, spreader grafts, onlay grafts, or even a rhinoplasty.
Patients that have broken their nose years before are treated differently than a patient who recently broke their nose. They normally have aesthetic or functional concerns, such as nasal breathing. Depending on their anatomy, they may need their septum removed, a procedure known as septoplasty, or may require a rhinoplasty, which is a nose job.
Carolina Facial Plastics has offices in Southpark, North Carolina and Irmo, South Carolina serving patients in the surrouding areas including Dillworth, Meyers Park, Ballentyne, Lake Norman, Huntersville, Moorseville, Columbia, Lexington, and Lake Murray.