How Do I Know if my Nose is Broken
The main sign would be epistaxis or nosebleed. Next there would swelling and pain or disfigurement. It is important for the emergency physician to examine inside the nasal passages and look for a septal hematoma and if present then drain it immediately.
An x-ray is virtually a worthless study and a CAT scan of the facial bones should be done to look at the nose and surrounding facial bones.
If there are fractures the swelling should be allowed to subside and then reduction should take place with operative intervention if needed. (Paul Vitenas, Jr., MD, Houston Plastic Surgeon)
Diagnosing a Nasal Fracture
In any case where trauma to the nose has occurred it is possible that the nose has been fractured. Many times it is difficult to determine if a fracture has occurred until swelling has subsided.
I would recommend seeing a nasal surgeon quickly to make sure you do not have a serious problem such as a septal hematoma.
Then you could be re-examined a week to ten days later to reassess the nasal appearance and the position of the nasal septum.
If your nose and septum appear normal, great! If there are problem in either the external nose or septum a surgical repair would likely be indicated. (Jon F. Harrell, DO, Miami Plastic Surgeon)
Is your nose broken?
Is it crooked is there a new bump or hump has the swelling gone down (4-7 days) x rays don’t matter or help has your breathing changed after the swelling if it is straight and you can breath then it doesn’t matter if its broken or not (Jed H. Horowitz, MD, FACS, Orange County Plastic Surgeon)
There are several cardinal signs of a broken nose.
Here are the signs (things you can see) and symptoms (things that you sense or feel) of a broken nose.
- When there is a broken nose, not all may necessarily present. The signs of a broken nose include:
- A change in shape
- Often, a change in breathing
- Bruising and swelling typically occur also
- Possible bleeding from inside the nose
With respect to the clicking, you may have had the clicking before, but that might suggest that, indeed, the cartilage portion of the nose became detached from the bony portion during the accident. Is your nose straight? Typically, you need to wait a few days before making a final decision, unless there is complete blockage of the nose, and that is somewhat of a nose emergency.
Assuming you are not completely blocked, typically, it takes, perhaps, seven days or so, for the major swelling to go down, such that the nose surgeon can feel the nasal bones and get a sense of what the anatomy is, since prior to that it is obscured by swelling. The most important thing is to consult with a specialist – a specialist who deals in noses and has adequate experience with nose injuries. (Robert Kotler, MD, Beverly Hills Facial Plastic Surgeon)
A Broken Nose – How Do I Know?
Anytime you have nasal bones that are broken you will have a nasal bleed. If you do have a nasal bone that is broken it is almost impossible not to have a nasal bleed. (Rod J. Rohrich, MD, Dallas Plastic Surgeon)
Broken nose is usually a clinical diagnosis.
It is possible to crack the bones of the nose traumatically and have them remain stable. Usually no treatment is needed. If the bones are displaced, however, it is generally determined by the surgeon clinically. X-rays can be deceptive but occasionally may be of help. (Vincent N. Zubowicz, MD, Atlanta Plastic Surgeon)
Nasal Fracture, Is my nose broken?
The best idea is to see a board certified plastic surgeon after injury to determine if your nose is broken. I agree that plain x ray films are not helpful. CT images can be very accurate but are probably unnecessary.
Pain, bruising, epistaxis (nose bleeds), obstruction, change in shape may or may not be present. The bottom line is that patients and surgeons generally (but not always) need to allow swelling to diminish before decisions about intervention can be made. I use the following protocol:
- Apply ice immediately, rest, elevate the head.
- Seek consultation with an emergency room or urgent care to be certain no additional injuries are present.
- Seek consultation with a plastic surgeon within 1 to 2 days to be certain that a septal hematoma hasn’t developed. This would require urgent surgery and oral antibiotics.
- Revisit your surgeon after 10 days to allow swelling to decrease and determine if surgical manipulation is necessary.
- If reduction of a fracture is necessary, simplest techniques (closed reduction) will be tried first. Opening the nose is only considered if closed techniques are unsuccessful. (Todd Christopher Hobgood, MD, Phoenix Facial Plastic Surgeon)