On tuesday night I had a head-on-collision playing football that resulted with a misalignment of my nose, went to the minor injury clinic yesterday to have it looked at by the Doctor and he referred me to the ENT but I know its definately out of position because my air passage doesn't feel the same when breathing, its swelling a bit but I've no pain I tried pressing on it and I could hear abit of clicking?So all said what kind of injury have I gotten and should this be a straight forward repair
Doctor Answers (10)
From your discriptions, it sound like fracture but need to be examined. You don't need to waste money on CT scan. If your nose is displaced, it is a fracture, either of nasal bones or nasal cartilages displacement or both. Can be corrected right away with closed reduction or open reduction after several weeks when swelling subsided.
Web reference: http://www.cosmeticsurgery4you.com
Sounds like it
Hearing a crack, significant bleeding and immediate deformity all suggest this is likely a fracture. You have 7-10 days to have it "set," which significantly improves the appearance and function of the nose. This repair is relatively straightforward. If you allow that time window to elapse, don't despair, it is still fixable. Most surgeons would prefer to wait until 6 weeks after the injury in that case in order to repair the fracture and improve your breathing. That surgery is a little more involved but can sometimes result in your best outcome. Good luck!
Repairing a fractured nose
Visible misalignment, swelling and bleeding all indicate that it is a pretty good bet that a nose is broken. However, a physical exam is needed and preferably a CT scan in order to confirm a nose fracture and determine how serious the injury is. The best time to fix a broken nose is in the first 24 hours. After that, excessive swelling and inflammation will prevent intervention again until it settles down after about a week. If you think your nose is broken you should be seen by a plastic surgeon or ENT doctor right away or go to an Emergency Room if you don't already know one. If early enough, it can be set straight (reduced) in the office or ER or it may need to be reduced in the operating room depending on how extensive the injury is.
Web reference: http://www.drhamawy.com/face/rhinoplasty-westchester-ny/
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Nose fracture- how can you tell if your nose is broken?
There are a lot of different signs that can help you find out if your nose is broken.
Broken nose, bleeding and nasal congestion are sometimes related or could be separate entities.
With a fracture, you could have visible deformity or sometimes because of the swelling it is not obvious. Typically, using a closed reduction a simple fracture can be repaired. Sometimes surgery will be needed to re-position the bones into a better alignment, using osteotomies.
Bleeding can happen with nasal fracture or as an unrelated issue and can be fixed by office evaluation/ cautery/ or packing and taking anti-hypertensives meds if needed.
An x-ray is not very helpful at times. Ct scan can be more precise.
Fracture or bleeding can cause congestion. However, the majority of congestion is formed by allergies and this condition can be corrected with medical treatment.
Lastly, sometimes septal deviation, nasal valve collapse or turbinate hypertrophy can create congestion or difficulty breathing and these conditions can also be corrected by specific procedures.
I would recommend that you would be seen by a nose specialist with passion for rhinoplasty.
Triple Board Certified Plastic Surgeon
Nose Injury/Fracture - what to do
The best advice I can give ia See a Surgeon as soon as possible After Nasal Injury
Nasal trauma that deforms the nowe should be examined by a Plastic Surgeon or ENT/ facial plastic surgeon to see what has been injured, that there is no septal hematoma that may have to be evacuated, and to evaluate if there is a nasal or septal fracture. It is far easier to repair any injured cartilage or bone displacement in the first few weeks following an injury.
Nasal bone fracture
It sounds as though you have a nasal bone fracture and that your septum (the wall separating the two sides of your nose) has deviated. You will likely first need a closed reduction of your nasal bones. This will place your nasal bones back into position. If you continue to have nasal airway obstruction, you may require a septoplasty and nasal airway surgery. I hope that helps.
Web reference: http://www.funkfacialplastics.com
Nasal fracture will most likely require a Rhinoplasty
From what you are describing, it does sound like you have a nasal fracture of your nasal bones at the very least. The inside, of the nose, should be examined to rule out a septal hematoma which will obstruct the nasal passages and breathing but if left unattended could cause cartilage damage and nasal collapse. An experienced ENT surgeon can do the exam. IMHO, I would avoid a closed nasal reduction because it's not only uncomfortable but the likelyhood of moving the nasal bones and cracked nasal cartilages back together, in that manner, is zero IMHO. Wait for the swelling to subside and at that time you could have the nose fixed with a Rhinoplasty.
Web reference: http://www.drfpalmer.com
Early treatment of nasal fractures
Nasal fractures and nasal septal fractures can be treated early and potentially avoid the need for any further surgery down the line. The key is to get in to a surgeon early and to get in to someone who knows what they are doing when it comes to closed reductions. For the most part, these operations are damage control operations and will still require you to have further treatment in the future. However, we know that since you cannot breathe well now, the only hope of avoiding that second operation is to do a closed reduction now.
Hi Francie. It sounds like there is a good chance that you have fractured your nose. However, an exam is required to make that diagnosis. Your description of misalignment and audible clicking with palpation (pushing) suggests a structural injury to the bones and/or cartilage. Your difficulty breathing may be partly due to swelling which will resolve with time. In many cases, a misaligned nose may be reduced by a nasal surgeon without more complicated surgery. That is typically done either within the first 24 hours, or otherwise between 7-10 days post-injury after the swelling dissipates but before significant healing takes place. Such reduction minimizes the nasal deformity and is often all that is required for uncomplicated injuries. A followup with the ENT is in order to further assess your nose. If the misalignment is not addressed until after the 2 week mark, more involved procedures may be required to repair your nose. Good luck!
Web reference: http://www.pearsonmd.com/nasal-fracture.htm
How to tell if nasal injury is a fracture
The best method to diagnose a nasal fracture is via a clinical exam. If the external nasal structure (bone and/or cartilage) is newly deviated (accounting for tissue swelling) then there is a fracture. This is easier to diagnose, obviously, in the earlier stages after the injury before the swelling really sets in. I don't typically recommend any imaging studies (x-ray or CT scan) as this doesn't usually add much information for uncomplicated nasal trauma.
Sometimes the trauma will lead to internal septal deviation which can cause breathing issues. The swelling from nasal trauma can cause congestion on its own, though, and this would improve on its own.
You really need an in person evaluation to see what needs to be done and how complicated repair would be.
Web reference: http://www.drlamperti.com/facial-plastic-surgery/rhinoplasty
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.
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