Nasal Fracture

What happens to the nose in a nasal injury?

Most cases result from sports injuries, falls or assaults. Patients are usually referred to the ENT clinic from the Emergency Department. There may be associated injuries to the facial bones, or elsewhere, which will have been assessed in the Emergency Department already.

The nose becomes very swollen and bruised and there may be bleeding from the nose soon after the injury, followed by blockage. The nose will be painful to touch and there may be numbness of the tip of the nose, upper lip or upper middle gum.

X-rays of the nose are not routinely taken (unless there are other facial injuries which need to be assessed).

Bruising around the eyes fades over a week or so, and most of the nasal swelling settles within a few days.

Timing of surgery

We like to see patients in the ENT clinic a few days after the injury. This gives time for the swelling to settle down and makes it easier to see if the nasal bones have been broken and are out of line. If straightening of the nose is to be done, this needs to be within a couple of weeks of the injury otherwise the nasal bones will begin to knit together.

What does the operation involve?

The operation would usually be done as a day case. It is performed under a general anaesthetic and takes just a few minutes. Once you are asleep, your nasal bones will be manipulated to put them back into the right place. There are no cuts made in the skin and we would expect very little extra bruising or swelling from the operation. The nasal bones will usually be protected with a plastic moulded splint which is taped across the forehead and across the nose and should be kept on for five days.

Very occasionally there is some bleeding from the nose at the time of the operation and a dressing may be required to deal with this. The dressing would usually be taken out after a few hours.

Your nose may feel a little uncomfortable or sore. Simple painkillers should help with this. You should not drive or operate heavy machinery for at least 24 hours after a general anaesthetic.

Once the plastic splint is removed, the nasal bones will still not be as strong as before the injury, so you should be careful to avoid any contact sport or any other activity which is likely to risk a repeat injury to your nose for at least three weeks after the operation.

We would not normally arrange for any further review in outpatients after the operation, but some patients have a nasal septum injury noted at the time of the procedure and may be reviewed back in the clinic to decide whether surgery to straighten the nasal septum should be planned for a later date.

Where can I find out more about the operation?

We would recommend the ENT UK website: www.entuk.org
This has information about nasal injuries.

Useful contact numbers

Dorset County Hospital Switchboard – 01305 251150

ENT secretaries (Dorchester)
Mr Ford 01305 255138
Mr Tsirves 01305 253167
Mr De Zoysa 01305 255138
Mr Sim 01305 254205
Mr Lale 01305 255510
Mr Kenway 01305 255138
Mr Chatzimichalis 01305 255510

ENT secretaries (Yeovil)
01935 384210

About this leaflet

Author: Mr Glen Ford, ENT Consultant
Reviewed by: Mr Bruno Kenway, ENT Consultant, March 2020
Approved: August 2020
Review date: August 2023
Edition: 2

If you have feedback regarding the accuracy of the information contained in this leaflet, or if you would like a list of references used to develop this leaflet, please email patientinformation.leaflets@dchft.nhs.uk