Broken Nose / Nasal Fracture
What we normally call a “Broken Nose” is a crack or fracture to one, or both of the nasal bones. These bones are small and oblong shaped. The size of these bones vary with the individual. Coming together at the center top of the nose, they form the “bridge” of the nose. Just below the “bridge” is the septum, which is not a bone but cartilage that separates the nose into sides.
A fractured nasal bone is most often the result of a sudden blunt impact. Since the nose is out there, protruding from the face, it is a common facial injury. A mild fracture may only result in minimal swelling and a brief nosebleed. It is quite possible that you won’t even be aware of the break. That is, unless there is deformity to the nose alignment.
A severe fracture will be much easier to notice. The nose is usually deformed. There is a much greater nose bleed. Possibly one, or both of the nostril passages are blocked, with air flow problems caused by a deviated septum.
Treating a Broken Nose / Nasal Fracture
Your doctor may or may not get an x-ray for this injury. X-rays are generally not required. Using a nasal speculum (a lighted instrument which gently spreads the nostrils and allows inspection), they will check out the inside of the passageways and the nasal septum.
If the nose is deformed to the point of nasal obstruction, your doctor will probably refer you to either an otolaryngologist or a facial plastic surgeon.General plastic surgeons generally have minimal or no training with the structures inside the nose. You may find it best to find a doctor board certified in both Facial Plastic Surgery and Otolaryngology.
Broken Nose Complications
When a broken nose is left untreated, there are a number of complications that can affect your quality of life. The bridge of the nose may collapse, or cause a hole in the nasal septum. Permanent difficulty breathing may ensue. Drainage may begin to flow persistently from one nostril or both. This drainage could be cerebral spinal fluid, as in draining from the brain — this is known as a CSF rhinorrhea. You could also lose your sense of smell. It can be common for some with untreated nasal fractures to deal with constant infections of the nose.
Right after the fracture it is best to apply ice and to keep your head elevated. The ice will help in reducing the swelling. You DO NOT want to take any aspirin or ibuprofen (Advil or Motrin) as these are blood thinners and will not help with the bleeding at all. The best pain medicine to take at this point would be Tylenol or some other acetaminophen. Do not take nonsteroidal anti-inflammatory drugs (NSAIDs).
Other Treatment Options for Broken Nose / Nasal Fracture
After this, the treatment is mainly controlling the pain and nose bleeds. Other treatment will be available after the swelling is down and a true assessment of the damage can be made — normally within 24 hours or after 3 days. If you wait more than 14 days from the injury your nose may heal and then you would need to wait 6 to 8 weeks before repair. Many emergency rooms are unaware of this and will have you follow up long after your window for immediate repair has closed.
If your doctor is skilled in this area, they may see fit to realign the bone or cartilage themselves. External nasal taping and splints may be used as well.
Surgery for a Broken Nose
A complicated fracture could require surgery. The crooked and broken bone or cartilage may need to be moved back into place. This can be performed at the office or in an ambulatory surgery center and may use general or local anesthesia.
Will Insurance Cover Broken Nose / Nasal Fracture Surgery?
Yes. Insurance usually does not cover cosmetic surgery, but in cases where surgery corrects or improves the ability to breath properly, major physical deformity or injuries to the area are often covered. Patients should obtain cost information from their surgeons and discuss with their insurance carrier prior to surgery.