Broken nose

The nose consists partly of hard bone tissue and partly of cartilage. In a broken nose, the bony part of the nose is fractured and may be displaced. This is almost always the result of a hard blow, such as a punch or bump to the nose.

How does a broken nose occur?

A broken nose is usually caused by external force, for example in a (traffic) accident or during contact sports such as boxing.

In very rare cases, a broken nose occurs during birth. The bone fragment breaks when there is too much pressure against the birth canal. However, this hardly ever happens because the nasal bone in a newborn has not yet fully converted into hard bone and is therefore very flexible.

Symptoms of a broken nose

Symptoms of a broken nose are pain, a nosebleed, swelling and possible deformity of the nose. The swelling and deformity are often the immediately visible effects of a displaced nasal bone. In addition, the nose can become blocked on one side. This happens if the nasal bone shifts and blocks one nostril. Due to internal bleeding, a bruise can develop around the nose.

Risks of a broken nose

In severe cases, secondary damage can occur as a result of a broken nose. An example is blood accumulation around the nasal septum. The nasal septum consists of cartilage and can be severely damaged by this accumulation of blood and even die off. Without cartilage, the nasal bridge can collapse, resulting in a saddle-shaped deformity (saddle nose).

Other possible complications of a nasal fracture are (persistent) breathing problems and reduced or complete loss of the sense of smell. There is also a significantly increased risk of infection of the nose or the sinuses.

How is a broken nose diagnosed?

The diagnosis of a broken nose is often made after a physical examination by a doctor, although this can be difficult initially because of bleeding or swelling. The doctor looks for any deformity of the nose and will feel the nose to assess whether it is broken.

An X-ray is generally not necessary unless there is suspicion of damage to surrounding bones such as the eye socket or cheekbone. A CT scan may be done to map possible deformities and to exclude other associated head injuries, such as brain injury.

Treatment of a broken nose

After evaluation by a specialist, it may be decided to surgically 'set' the nose. This is done under local anesthesia or, if necessary, under general anesthesia.

In less severe cases, non-surgical treatment is preferred. In that case, advice will be given to use pain relievers and to apply ice to the nose to reduce swelling.