Condition: Nasal Injuries

An injury to your nose can cause damage to the skin, bone, cartilage or any combination of these.

If you have cut your skin it will need to be cleaned and closed with either sutures or self-adhesive strips. If your tetanus vaccination is not up to date (required every 10 years), it is recommended that you have an injection.

Almost half of all facial fractures are bony fractures of the nose. These can cause a lot of swelling and may take around 5 days for the swelling to reduce enough for the bones to be examined. Your doctor will check your nose to rule out a septal haematoma (see below) and an ENT specialist should check your nose within 7-10 days of your injury to see if any further treatment is required.

Most nasal fractures do not require an x-ray as they are often simple, but more serious injuries will require one that includes the skull and face.

Usually there will be little or no change to the shape of the nose once any swelling has gone down. However, if your nose does appear differently after swelling has reduced, manipulation can take place under anaesthesia. This must be done no longer than 14 days after the injury and the manipulation may not fully correct the deformity, so further surgery could be required a year or more after the injury.

Septal Haematoma

This occurs when blood collects underneath the lining of the septum (the central partition of the nose), it is stripped off either side and causes a purple swelling inside the nose. This will cause a painful nasal obstruction and needs to be treated as soon as possible by surgically draining away the blood and taking a course of antibiotics.

If the blood is not drained, it can become infected or damage the underlying cartilage that supports the nose. This may ultimately result in a saddle nose deformity, caused by the nose no longer being supported by the septum.

Nasal obstruction

A nasal obstruction can occur after an injury due to swelling inside the nose which may take a few days to go down. However, if there is still an obstruction after three days, it could be an indication of a deviated septum (i.e. the septum is crooked/off-centre), which may need to be corrected surgically.

Nosebleeds (epistaxis)

Nosebleeds are common and can usually be stopped using the technique of applying pressure to the fleshy part of the nose for 15 minutes.

Cerebrospinal fluid leak

A rare complication of nasal trauma can occur when the nasal bones are pushed into the face and cause the thin cribiform plate at the roof of the nose to fracture, resulting in the cerebrospinal fluid that bathes the brain leaking out. Small fractures will seal automatically with conservative management, usually within two weeks. Antibiotics will only be given if an infection is found to be present. If fluid leaks, more treatment may be required.

Loss of sense of smell (anosmia)

In other rare cases, the smell organ in the roof of the nose may be damaged, causing loss of the sense of smell, which very rarely returns.