Nasal fractures, occurring after either intentional or accidental trauma, are fairly common in clinical practice. Displacement of the nasal bone, epistaxis, local ecchymoses, edema, and tenderness are the main clinical features. The diagnosis relies on details obtained during history taking, findings from physical examination, and if necessary, imaging studies.
Nasal fractures are one of the most common forms of facial trauma in medical practice, with certain reports suggesting that they comprise up to 40% of all skeletal fractures   . They arise from trauma in virtually all cases, the most common form being a blunt trauma during contact sports  . In children, sports-related activities are the events leading to fracture, whereas motor vehicle accidents, falls, and intentional injuries, in addition to sports, are common causes in adults  . Many reports have confirmed that the peak incidence of nasal fractures is seen in adolescents around 20 years of age and that males suffer from nasal fractures much more frequently than women  . Depending on the mode of injury, patients present with a variable appearance of the nasal bone. It may be displaced outwardly after a lateral blow or depressed posteriorly after a direct blow to the nose . In some patients, however, the deformity might not be apparent . In addition to anatomical changes (nasal shortening, widening of the nasal base and malposition are also seen) epistaxis is the prominent symptom, indicating a more pronounced fracture   In addition, ecchymoses, local tenderness, edema, and crepitus are frequently noted   . In severe fracture, leakage of the cerebrospinal fluid (CSF), termed CSF rhinorrhea, changes in mental state, and limited movement of the eyes might be observed, in which case injuries of other anatomical structures should be excluded  . In fact, it is not uncommon for nasal fractures to be accompanied by additional maxillofacial or cervical injuries, especially in severe trauma .
- Saddle Nose
For nasal fracture presenting saddle nose deformity, the nasal septum was fixed with the frontal process of the maxillary bone by Kirschner wire. Good results were confirmed with computed tomography, and there was no secondary deformity. [ncbi.nlm.nih.gov]
Nasal septal cartilage necrosis can result in a saddle nose deformity with nasal obstruction. Nasal trauma can also result in a nasal fracture with resultant nasal obstruction and/or cosmetic deficits such as a saddle or crooked nose. [ttsh.com.sg]
The dead cartilage may disintegrate, causing the bridge of the nose to sag in the middle (called saddle nose deformity). Saddle Nose Deformity Saddle nose deformity occurs when cartilage in the nose dies and disintegrates. [merckmanuals.com]
This may be caused by cerebrospinal fluid draining from the brain into the nose (CSF rhinorrhea) and can occur after a head injury or after surgery on the nose or ears. Infection of the nose, sinuses, or facial bones. [cigna.com]
This may be caused by cerebral spinal fluid draining from the brain into the nose (CSF rhinorrhea) and can occur after a head injury or after surgery on the nose or ears. Infection of the nose, sinuses, or facial bones. [myhealth.alberta.ca]
- Nasal Congestion
Skip to content Find Out More About Nasal Fracture A broken nose is a traumatizing and painful event that can lead to nasal congestion, a cosmetic problem, or both. [breatheclearinstitute.com]
] Symptoms include: blockage in breathing, change in nose shape, painful swelling of nasal septum and nasal congestion. Diagnosis Diagnosis can be made by a physical exam with the use of a nasal speculum or otoscope. [en.wikipedia.org]
Bleeding Nasal congestion but without any production of any drainage Bruising around the nose and eyes A grating sound with trying to move the nose. [epainassist.com]
People suffering from deviated nasal septum often complain about breathing obstruction, congestion, headaches and sinusitis troubles. [play.google.com]
Presentation This may present with [ 10, 11 ] : A nasal whistling sound. Discharge from the nose. Nasal congestion. Infection - eg, cellulitis, fever, discharge. Epistaxis. Aetiology Traumatic: Nose-picking. Trauma. [patient.info]
Such injuries may result in deformities affecting the outside and inside structures of the nose, which can cause problems breathing, sinus infections, nose bleeds, snoring, nasal obstruction and distorted facial features. [entaacare.com]
Some of the most common symptoms of a deviated nasal septum are blockages in either one or both nostrils, obstructed breathing, nasal congestions, chronic sinus, infections, bleeding of the nose, snoring, breathing through the mouth, headaches and facial [play.google.com]
हड्डी Allergy एलर्जी Phono-surgery Phono-सर्जरी Cleft Lip and Palate चीरा हुआ होंठ और तालु Endocrine surgery Endocrine सर्जरी Trauma आघात Skull base खोपड़ी का आधार Anterior skull base पूर्वकाल खोपड़ी का आधार Airway Airway Dizziness चक्कर आना Apnea and snoring [helpebookhindi.wikifoundry.com]
A further historical exploration of breathing difficulties, nasal congestion, snoring, sleep apnea, and nasal drainage will also allude to previous irregularities. [ncbi.nlm.nih.gov]
Hyposmia 5. Watery rhinorrhoea 6. Visual disturbance 7. Diplopia 8. Epiphora 9. Altered bite 10. Loose teeth 11. Trismus. Examination Key issues to consider when examining a patient include: 1. Deviation, depression, step deformities 2. [slideshare.net]
[…] s): location, magnitude, and direction of -nose before injury (appearance and function) -previous injuries to nose (30% of patients had pre-existing nasal deformities).........Photographs -focal symptoms: nasal obstruction, loss of smell (anosmia or hyposmia [ent.com.au]
Persistent anosmia or hyposmia may occur in as many as 5% of individuals who suffer head injury with or without nasal trauma and has been observed to resolve spontaneously in only a third of cases. 36 A review of a patient’s medical history includes any [clinicalgate.com]
Nasal fracture Other names Broken nose Plain X-ray showing a nasal fracture Specialty Emergency medicine, otorhinolaryngology Symptoms Nose bleed, swelling, bruising Complications Septal hematoma, other facial fractures, meningitis Usual onset [en.wikipedia.org]
Nasal fractures are one of the most common forms of facial trauma in medical practice, with certain reports suggesting that they comprise up to 40% of all skeletal fractures. [symptoma.com]
[…] for evaluating nasal fracture in children. [ncbi.nlm.nih.gov]
- Periorbital Ecchymosis
ecchymosis Palpation and direct visualization of nasal septum to rule out septal hematoma Helpful to see photo of patient prior to injury Does not require radiographic imaging. [medicine.uiowa.edu]
The presence of epistaxis, nasal swelling, and periorbital ecchymosis are signs that are suggestive of significant nasal trauma and warrant a thorough internal and external examination. [clinicalgate.com]
Physical examination findings include swelling over the nasal bridge, grossly apparent deviation of the nasal bones, and periorbital ecchymosis. [emedicine.medscape.com]
Face, Head & Neck
Displacement of the nasal bone, epistaxis, local ecchymoses, edema, and tenderness are the main clinical features. The diagnosis relies on details obtained during history taking, findings from physical examination, and if necessary, imaging studies. [symptoma.com]
Acute nasal injury often occurs as a result of trauma and can lead to epistaxis, nasal fracture, or even nasal septal haematoma. [bmj.com]
One of the most frequently used packing materials in closed reduction of a nasal bone fracture is the hydroxylated polyvinyl acetate sponge (PVAS; Merocel(®)); however this may cause synechia, epistaxis, and pain. [ncbi.nlm.nih.gov]
The diagnosis of a nasal fracture can be easily made with a proper clinical workup consisting of a detailed patient history and a physical examination. The exact mechanism of injury, including the direction, the intensity and circumstances under which it occurred, should be revealed during history taking, whereas a detailed inspection and palpation of the nose, but also the surrounding structures (the orbit, the mandible, the teeth, zygomatic arches and the cervical spine) are vital steps in recognizing the extent of trauma    . If an apparent displacement of the nose is evident during the exam, a definite diagnosis is made solely on clinical criteria, but in the setting of an apparently normal anatomical appearance, imaging studies are necessary to validate clinical suspicion   . Plain radiography is considered to be a useful initial method for the detection of nasal fractures, with very high rates of diagnoses . Certain reports, however, have established that ultrasonography (US), particularly high-resolution (HRUS), may be a superior method compared to X-rays in this particular setting   . Computed tomography (CT), a definite imaging procedure that can confirm the exact site of the fracture, but also identify additional head injuries, is not widely used due to its high radiation dose and exposure to the lens and the thyroid gland   . Despite the important role of imaging studies in the evaluation of nasal fractures, clinical awareness is pivotal in making an early diagnosis  .
[…] of an uncomplicated fracture of nasal bones is not urgent—a referral for specific treatment in five to seven days usually suffices—an associated injury, nasal septal hematoma, occurs in about 5% of cases and does require urgent treatment and should be [en.wikipedia.org]
Preferred Name Open treatment of nasal fracture; with concomitant open treatment of fractured septum Synonyms Open reduction of fracture of nasal bone with open repair of fracture of nasal septum ID http://purl.bioontology.org/ontology/CPT/21335 altLabel [bioportal.bioontology.org]
Currently, millions of people seek treatment for nasal fractures every year. Because of the typically uncomplicated nature of nasal fracture repair, patients can usually return to their normal activities within days after treatment. [ohniww.org]
How long is the recovery after treatment for a nasal fracture? Patients who have closed nasal reduction have some swelling and discomfort for 5-7 days after treatment. It is important to avoid heavy activity during the recovery. [syracuseoto.com]
Treatments are performed under quick IV sedation or general anesthesia on an outpatient basis. [entaacare.com]
Injuries involving other structures (Types 2 and 3) must be recognized and treated surgically. Prognosis Bone stability after a fracture occurs between 3 and 4 weeks. Full bone fusion occurs between 4 and 8 weeks. [en.wikipedia.org]
Plain radiograph sensitivity ~80% 6 best detected on the lateral view Waters view is useful in assessing the nasal arch 4 CT sensitivity is 100% 6 Treatment and prognosis Treatment depends on the degree of displacement. [radiopaedia.org]
Prognosis In most cases, the outlook is good, even when surgical treatment is necessary to realign or reconstruct the nose. [drugs.com]
"Nasal bone fracture: etiology, diagnostics, treatment and complications". Laryngorhinootologie. 88 (11): 711–6. ^ Sethi, Neeraj; Pearson, Amy; Bajaj, Yogesh (2016). Key Clinical Topics in Otolaryngology. 191: JP Medical Ltd. ISBN 9781909836358. [en.wikipedia.org]
Less common causes include falls and motor vehicle accidents. [7, 8] In a retrospective study, Erdmann et al investigated the medical records of 437 patients with 929 facial fractures.  These authors noted that the most common etiology of facial trauma [emedicine.medscape.com]
Abstract Nasal Bone Fracture: Etiology, Diagnostics, Treatment and Complications Background: The aim of the present evaluation was to analyse a large patient population with nasal bone fractures leading to surgical reposition of the nasal bone. [thieme-connect.com]
Etiology and chaging patterns of maxillofacial trauma. In: Boothb PW, Dchendel SA, Hausamen JE. Maxillofacial surgery. Ed 2. St. Louis: Churchill Livingstone Elsevier; 2007. H. 3. Ellis E, El-Attar A, Moos KF. [jurnal.ugm.ac.id]
Detailed knowledge of the epidemiology and diagnostic and therapeutic methods becomes imperative for the effectiveness of patient care. [scielo.br]
Is there a change in the epidemiology of nasal fractures in females in the UK? J Laryngol Otol 2013 ; 127 : 1084 -7. ↵ Joshi H, McPartlin D. Management of nasal fractures in a rural district general hospital: a completed loop. [bmj.com]
Epidemiology of US high school sports-related fractures, 2005-2009. Clin J Sport Med. 2010 Jul. 20(4):293-9. [Medline]. Hanba C, Svider PF, Chen FS, Carron MA, Folbe AJ, Eloy JA, et al. Race and Sex Differences in Adult Facial Fracture Risk. [emedicine.medscape.com]
Nasal Fractures EPIDEMIOLOGY AND AETIOLOGY M:F = 2:1 Peak at 15 to 30 yrs of age Compound and comminuted fractures are more common in the elderly who are prone to falls. PATHOPHYSIOLOGY 1. [slideshare.net]
In addition to an overall review of maxillofacial trauma pathophysiology, associated injuries, and physical examination, this review will also discuss relevant imaging, treatment, and disposition plans. [ncbi.nlm.nih.gov]
Pathophysiology: 1. Nasal bones and underlying cartilage are susceptible for fracture because of their more prominent and central position in the face. 2. These structures are also pretty brittle and poorly withstands force of impact. 3. [drtbalu.co.in]
PATHOPHYSIOLOGY 1. Nasal bones and underlying cartilage are susceptible for fracture because of their more prominent and central position in the face. 2. These structures are also pretty brittle and poorly withstands force of impact. 3. [slideshare.net]
Pathophysiology of post-traumatic anosmia. Laryngorhinootologie. 1996 Mar;75(3):154-9. [Article in German] 6. Sumner D. Post-traumatic anosmia. Brain 1964; 87:107–120. 7. Zusho H. Posttraumatic anosmia. Arch Otolaryngol 1982;108: 90–92 8. [ispub.com]
Pathophysiology If the primary buttresses of the nasoorbitoethmoid (NOE) complex are violated, comminution of the entire complex may occur. This may result in telecanthus, enophthalmos, diplopia, and apparent midface retrusion. [emedicine.medscape.com]
Prevention You can help prevent a nose fracture with these guidelines: Wear your seat belt when traveling in a motorized vehicle, and keep children restrained in age-appropriate child safety seats. [mayoclinic.org]
You should also avoid taking aspirin generally if you are under the age of 20 to prevent Reye syndrome. [suncoastentsurgery.com]
To prevent more severe consequences of a nasal fracture, it’s important to seek immediate medical assistance from a primary care physician or the emergency room. [advancedfacialplastic.com]
Prevention A cooler house and a vaporizer, to return humidity to the air, help many people with frequent nosebleeds. Nasal saline spray and water soluble jelly (such as Ayr gel) can help prevent nosebleeds, especially during the winter months. [tampaent.com]
If a fluctuant reddish-blue swelling is noted on the anterior part of the nasal septum, drainage of the hematoma should be performed urgently to prevent complications as mentioned above. [ttsh.com.sg]
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- Javadrashid R, Khatoonabad M, Shams N, Esmaeili F, Jabbari Khamnei H. Comparison of ultrasonography with computed tomography in the diagnosis of nasal bone fractures. Dentomaxillofac Radiol. 2011;40(8):486-491.
- Mohammadi A, Ghasemi-Rad M. Nasal bone fracture--ultrasonography or computed tomography? Med Ultrason. 2011;13(4):292-295.
- Gürkov R, Clevert D, Krause E. Sonography versus plain x-rays in diagnosis of nasal fractures. Am J Rhinol. 2008;22:613–616.