Nasal injury can be caused by trauma due to a car accident, a fight, physical abuse, hitting the nose while falling, walking into something or during a collision while playing sports. After trauma to the nose, some symptoms may appear immediately after the accident. However, it may take a couple of days for the full extent of the swelling and bruising to appear in some cases.
Signs of a broken nose from nasal trauma include acute pain in the nose or soreness in and around the nose, swelling of the nose and cheeks, bruising that may affect the nose, cheeks and eyes, nose bleeds, a crooked appearance to the nose and decreased ability to breathe through the nostrils.
Trauma to the nose can cause significant nasal pain, bruising and swelling regardless of whether the nasal bone itself is fractured or not. It may be difficult to tell whether the bone is broken unless the nose appears to be visibly out of place. However, uneven swelling of the nose can also make the nose appear more crooked than usual even if the nose is not broken. A doctor can usually determine if the nose is broken after an injury with a clinical examination of the nose. Although X-rays can detect fractures, in the majority of cases it is obvious without X-rays whether the nose is broken. X-rays may be used if other facial fractures, such as a cheek or orbital fracture, are also suspected.
If the nose is not broken, or if the fracture is minor and without complications or without much nasal displacement, the best course of treatment is to take over-the-counter non-steroidal anti-inflammatory drugs to reduce pain and swelling of the nose, and to use ice to control the swelling. An ice pack should be applied to the injured nose for about 15 minutes every couple of hours. If the nose is severely displaced, a doctor may recommend a procedure called a closed reduction or surgery to repair the nose. A closed reduction is done in a doctor’s office as an outpatient procedure. A local anesthetic is given to numb the area and the doctor realigns the misplaced bones by going in through the nostrils. A closed reduction is not a surgical procedure; it is less invasive because no incision or general anesthesia is necessary. Cases that can not be fixed with a closed reduction may require surgery to repair and reshape the bridge of the nose, and sometimes to reopen the nasal passages.