How can a Dr. tell is a broken nose is causing breathing problems?

When the outside of the nose is traumatized enough to break the bones, the internal wall called the septum very often is knocked off center at the same time. This is called a deviated septum. Crooked nasal bones are fixed via a closed reduction within the first two weeks of trauma. This helps the bones but does not fix the accompanying deviated septum, that may require surgery at a later date.A surgeon who is adept at nasal surgery inside and out can look inside your nose with a headlight and/or nasal endoscope and tell if you have a deviated septum without any other tests needing to be done.

Nasal obstruction can be thoroughly evaluated via physical exam.  Routine nasal exam will evaluate the septum, the the nasal airways.  The internal nasal valve can also be examined and testing can be performed to assess if there is a degree of valve collapse leading to obstruction.  Nasal endoscopy will provide another level of evaluation to exam the nasal airway in its entiriety.  If there are further questions regarding the status of the sinuses or the nasal bones, CT scans can be ordered to help provide further information.  I suggest you find a board certified surgeon who specializes in nasal surgery to evaluate your condition.  Good Luck  

On examination it is often clear which nostril is letting less air through the passages and where the injury was based on poorly lined up nasal bones or a fracture and deviation in the nasal septum.  Sometimes a CT scan can be helpful as well.    Best of luck,
Dr. Michael OmidiAn in-person exam with a
board-certified plastic surgeon is the best way to assess your needs and
provide true medical advice. The response to the question does not constitute
a doctor patient relationship or formal advice.

Examination of the nose, both external and internal, can identify breathing problems caused by deviated septum, collapsed internal nasal valves, weakened and collapsing nasal side walls, and overgrowth of turbinates  which all can be a cause of nasal airway obstruction. The remedy for each of these problems is specific to the problem.  Other testing may be required such as a CT scan.  Discuss your surgical plan thoroughly and make sure the surgeon is experienced in the correction of airway deformities. 

 A thorough internal and external examination of the nose is required before making any determination about what may be the cause of breathing problems. There are many issues inside the nose can cause nasal obstruction, such as a deviated nasal septum, turbinate hypertrophy, valve collapse, vestibular stenosis, allergies and chronic sinusitis. Each one of these are treated differently with either medications or surgery. Medical management is always tried first, and if patients have failed medical therapy, consideration for surgical therapy is entertained.  Straightening a crooked nose is performed with a rhinoplasty which includes osteotomies and possible spreader graft placed underneath the concave upper lateral cartilage in the mid- portion of the nose.

rhinoplasty is a difficult surgery. secondary rhinoplasty is even worse.internal scarring make the surgery more difficult.sometimes there is anatomical abnormality, but it doesn't mean that this is what causing the symptoms.waking up and feeling tired is very vague symptoms.it can be multiple thing causing it. like sleep apnea and other possible metabolic problems.so there is no guaranty that fixing your nasal anatomical disorder will help.good luck

Hello. With a complete physical exam, an experienced rhinoplasty surgeon is usually able to determine the cause of nasal obstruction. Nasal obstruction is usually caused by either septal deviation, nasal valve collapse, or inferior turbinate hypertrophy (sometimes a combination of all 3). In my experience, in those patients with prior surgery, nasal valve collapse is usually the causative factor. I generally give patients a trial of breathe rite strips. If these are mildly effective, and patient desires surgical correction, nasal valve surgery is often helpful.Lastly, if you wake up tired, and your nasal breathing seems adequate, consider sleep apnea as a diagnosis. Discussing a sleep study with your primary care doctor may be helpful.

Physical examination of the airway, before and after a decongestant is sprayed will allow visual inspection of the airway. If the airway is straight and clear, the nose and septum are usually not the problem.

That's why you see a very experienced Board Certified Plastic Surgeon.  Training and experience speak volumes.  Find a surgeon that you are comfortable with and you trust.