A broken or fractured nose should be treated promptly whilst the nasal bones are still mobile.
Patients may notice a cosmetic deformity (where the shape of the nose has changed) or they may experience a blocked nose if the nasal septum has been fractured and moved position. During the first few days, the nose may be swollen and may feel blocked – a formal assessment is therefore made about 1 week after the injury, once the swelling has subsided.
All patients with a suspected fractured nose need to be assessed by an ENT surgeon to rule out a septal haematoma (blood clot that has developed inside the nasal septum). This needs urgent drainage as it can result in a serious infection or abscess forming in the nose and may affect the blood supply of the septum. This can lead to permanent drooping of the tip of the nose if left untreated.
X-rays and CT scans are usually not helpful unless they are performed to rule out other facial fractures. Nasendoscopy (looking inside the nose with a small camera) is far more helpful, as this can rule out a septal fracture or haematoma.
A fractured nose should generally be assessed after about 1 week, once the acute swelling has subsided. The management may be conservative, or patients may need to have the fracture reduced. This should to be done before about 2 weeks or the nasal bones will have set and cannot be manipulated.
In general, indications for treatment include a change in the shape of your nose or worsening nasal obstruction. If you feel that your nose has changed shape, it is helpful if you bring in a photo of yourself before you sustained trauma.
Dr Levin can assess your fractured nose and advise whether treatment is necessary.