19 Oct Broken nose: Is surgery necessary for a broken nose?

A ball bouncing in the face, a blow or a fall ... there are many ways to suffer a broken nose. This is because the nose, as a protruding organ, is often the first to be affected by an injury. The bony and cartilaginous structure is delicate. In this article, you can find out how to recognise that your nose is broken, what to do if this happens and when surgery is required.

What happens with a broken nose

Three structures can be affected by a nasal fracture: the bony nasal bone (nasal bone fracture), the nasal cartilage and the nasal septum. A blunt frontal or lateral impact on the nose can lead to a nasal bone fracture. In addition to the nasal bone, the so-called zygomatic bones are sometimes also affected.

A blow to the front part of the nose from the front can cause a fracture of the nasal septum. This can cause both the bony nasal bone and the nasal septum to break and shift. It is also possible for the septum to become detached from the bony groove at the bottom of the nasal cavity.

Broken nose: These are the symptoms

A broken nose is usually accompanied by the following typical symptoms:

• Nosebleed
• Severe pain
• Large-scale swelling
• Bruising
• Changes in shape

If the nasal septum has been injured and heals in the displaced form, this can manifest itself as follows:

• Snoring
• Frequent nosebleeds
• Increased susceptibility to infections, e.g. sinusitis and middle ear infections
• Obstructed nasal breathing due to an organised haematoma in the nasal septum

Broken nose: how the diagnosis works

The diagnosis is usually made by carefully palpating the bridge of the nose. We immediately notice any irregularities in shape and alignment, unusual movements of the bones and a rough feeling of the broken bones rubbing against each other. We also perform an endoscopy of the nose (rhinoscopy) and the nasopharynx (ENT endoscopy). In this way, we can check whether cartilage tissue (e.g. the nasal septum) is damaged.

X-rays of the nose are rarely taken as they are often not informative enough. The images often do not depict fractures of the nose accurately enough.

If the findings are unclear or if injury to other facial bones or the skull is suspected, we will order a computerised tomography (CT) scan.

Types of nasal fracture and their treatment

Closed nasal bone fracture

The broken bone lies beneath the skin. A misalignment of the nose usually clearly indicates a broken nasal bone. Cooling compresses and the administration of painkillers bring relief. Conservative treatment measures are usually sufficient. A slightly displaced bone can be repositioned by hand under local anaesthetic. If the findings are more pronounced, a major operation under general anaesthetic is required.

Open nasal bone fracture

In this case, bone fragments penetrate the skin. They are therefore visible. It is also possible that the fragments protrude into the inside of the nose. An open nasal bone fracture should be treated surgically as quickly as possible. During the operation, the wound is carefully cleaned and the bone fragments are realigned accordingly.

This means that a broken nose can often be treated without surgery. If bone fragments have shifted or the nose is crooked, then surgery is necessary.

Functional plastic rhinoplasty after nasal fracture

In some patients - despite timely medical treatment - visible and noticeable consequences remain after the nasal fracture.

Crooked nose

A common consequence of a broken nose is the so-called crooked nose. In this case, the axis of the nose is uneven and clearly tilts to the right or left. The fact that the nose is crooked is often due to a curvature of the nasal septum. This also restricts breathing.

If the crooked nose is caused by the bone, we can surgically straighten the bony bridge of the nose. If the nasal septum is affected, we treat it.

After the operation, the nose is straight again and looks more aesthetic. In addition, you can breathe much more easily again.

Saddle nose

A so-called saddle nose is also possible. In this case, the bridge of the nose is sunken or dented in the centre. In profile, it appears stepped and is reminiscent of a saddle. In contrast to the past, the nose appears wider and smaller.

As part of a reconstructive nose operation, we fill the indentation on the bridge of the nose with the patient's own body material. To do this, we use cartilage mass that we take from your nasal septum or the back wall of your pinna, for example. However, the operation can only take place one year after the nasal hernia has healed.

A saddle nose often not only results in visual impairments, but also functional ones. The dented bridge of the nose can hinder nasal breathing. After healing, you can breathe freely again.

Broken nose: Treatment at the Goethe10 practice clinic in Frankfurt

If you are dealing with an acute nasal fracture or would like to have the consequences removed: In our Goethe10 Practice Clinic in Frankfurt we will be happy to help you. Dr Thomas Fischer is your experienced specialist for ear, nose and throat medicine and an expert for the Functional plastic nose surgery.

ENT Frankfurt: Dr Thomas Fischer & Dr Albrecht Linke

Your specialists for ear, nose and throat medicine, who will provide you with professional and individualised advice, examinations and treatment in all matters relating to ENT medicine, functional plastic surgery and the aesthetic treatment of changes to the facial skin.

Our news articles are prepared for you to the best of our knowledge and belief and are intended for general education. They are in no way a substitute for medical advice, diagnosis and treatment and are not intended to encourage self-diagnosis or self-treatment. Please always contact your ENT specialist in Frankfurt directly if you have any health complaints!

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