Ask a doctor

Do I Need to Have Surgery on my Nasal Bone?

I was in a car accident 3 weeks ago which left me with a broken nasal bone. I visited and oral and maxillary surgeon a week after. He went over my x-rays and checked nose and teeth. He stated that both nose and teeth look fine and should heal with no surgery needed. I am now feeling a tightness in my teeth. Though the broken nose is not visible I feel the bone sticking out, I am now having some nasal dripping and constant headaches. Do I need to have surgery on my nasal bone?

Doctor Answers (10)

When surgery on nasal bones is necessary

+1

Since you had your nose broken from a car accident, surgery is sometimes needed to reset the nasal bones. If the nose bones are sticking out, twisted, or there is a noticeable deviation of the bridge of the nose, then a reduction of the nasal fracture should be performed. The x-ray will document the fracture for insurance purposes. Headaches can be related to the trauma, and usually subside over time.


Seattle Facial Plastic Surgeon
5.0 out of 5 stars 55 reviews

Nasal Drainage after Trauma

+1

 I strongly support the recommendation of others on this site. This should be done as soon as possible. An otolaryngologist  will be able to determine if this is cerebral spinal fluid dripping through a fracture in the base of the skull, immediately above your nose.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 14 reviews

See an ENT doctor

+1

I would definitely agree with Dr. Persky that an evaluation by an otolaryngologist (ENT) physician is necessary. The drainage you have from your nose may indicated a very serious condition called a cerebrospinal fluid leak. This is where the fluid which surrounds your brain leaks through your nose through a fracture sustained in the skull. Left untreated it can lead to meningitis (an infection of the envelope around the brain) which can be life threatening. The dripping may also represent a less severe but just as troubling problem of sinus disease. In either case, an ENT physician can diagnose and treat the problem. As for the nose itself, I woudl agree that if there is no cosmetic concern, I would not undergo a rhinoplasty procedure.

D.J. Verret, MD
Dallas Facial Plastic Surgeon
4.0 out of 5 stars 12 reviews

You might also like...

You've heard it all before

+1

Liah,

You need to see a board certified plastic surgeon for a second opinion.  You may have sustained more than just a nasal fracture and oral surgeons are not equipped to manage such advanced injuries.  Good luck!

Kenneth R. Francis, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 31 reviews

Nasal Surgery for Car Accident Trauma Resulting in Nasal Dripping, Headaches, and Tooth Pressure?

+1

Hi Liah,

Sorry that you had to go through the trauma of your car accident.

The most important thing that you first need to do is see a board certified otolaryngologist (Ear, Nose, and Throat doc) to evaluate your "runny" nose and make sure that you do not have a cerebrospinal fluid leak that may also be the cause of your head aches.

The teeth pressure may be related to sinus problems.

Without any visible cosmetic deformity of your nose, I would not recommend rhinoplasty or any surgery on your nasal bones. You may need septoplasty in the future depending on what is found.

Good luck and I hope that your symptoms resolve soon.

Dr. P

Michael A. Persky, MD
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 23 reviews

Nasal fracture

+1

Make sure that the nasal fracture is the only thing that you have wrong. I assume that you had a CT scan. Have it reviewed to make sure that nothing was missed. Swelling in your mouth may be just that and nothing more. The dripping from your nose could be a leak of fluid from your skull like one of the other doctors suggested or could just be normal post fracture drainage. If you feel a bone is not aligned get a second opinion NOW!.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 15 reviews

Get evaluated for a CSF leak

+1

Although uncommon, CSF leaks (cerebrospinal fluid leaks) occasionally occur after high-speed impacts to the face, such as in a motor vehicle crash. The symptoms of a CSF leak from the cribriform plate or the fovea ethmoidalis are typically clear discharge from the nose (usually only on one side) and headache.

Of course, those could also be the symptoms of a common cold or irritation after a nasal fracture. A high-resolution maxillofacial CT scan is a good place to start in evaluating a patient for that. In highly suspicious cases, collecting some of the fluid and testing it for beta2-transferrin can make the diagnosis with a high degree of certainty. An untreated nasal CSF leak risks meningitis.

So even though it's unlikely, someone with those symptoms after a significant nasal and facial impact injury needs to be evaluated. An otolaryngologist (ear, nose, & throat) would be a perfect place to start.

Good luck,

--DCP

David C. Pearson, MD
Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 14 reviews

See your doctor

+1

If you have palpable bones, then you may need surgery to correct them. Also, since you have continued headaches and nasal dripping, you may have more serious fractures which need attention. You should see your doctor and, if you have not had it already, get a CT scan of your head and face to inspect for other fractures.

David Shafer, MD
New York Plastic Surgeon
5.0 out of 5 stars 54 reviews

Nasal injury after car accident

+1

Most important thing is to make sure nothing serious occurred. Perhaps a CT scan of the nose region would be helpful to rule out something serious that would be causing nasal drainage. It would also document any "fracture." Then, once the extent of the problem is known, you can deal with the reconstructive portion. Sometimes there can be a change in the shape of the nasal cartilage as the injury heals.

Hope this helps

Michael Kulick, MD
San Francisco Plastic Surgeon
2.5 out of 5 stars 3 reviews

Drainage and headaches following nasal injury could be sinus disease

+1

Frractures at the base of the nose can impair drainage of the frontal sinuses due to interruption of the fbony ducts or just from inflammation. This can cause sinusitis with drainage and headaches. Frequently this will respond to decingestants and occasionally antibiotics are required. However, I would consider seeing a plastic surgeon or Otolaryngologist in follow up to make this diagnosis. You may benefit from having an x-ray or CT scan.

In regards to the nasal fracture, as long as you do not have any external deformity, it is generally not wise to consider any surgical treatment at 3 weeks after your injury because the bones have already begun to heal. I t is more likely that you should wait about 4-6 months before considering any revisions.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 41 reviews

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.