Please read the following for advice on caring for a fractured nose at home. We are here to answer any questions or concerns you may have regarding a fractured nose.

Injuries to the nose

Fractures to the nose are common, making up over 50% of all fractures to the face. Most are either related to sporting injuries, assaults or road traffic accidents. Swelling of the soft tissues over the nose and face occurs relatively quickly and dramatically, as a response by the body to protect and repair itself. There will usually also be substantial bruising. It can take anything up to 3 weeks for swelling to reduce but we would advise that a doctor assesses the injury as soon as it happens. Often the extent of the swelling can camouflage or mask the true severity of the injury or position of the nose.

There are several options available, depending on how well you feel or whether you have any additional symptoms. You can see your GP as an urgent patient or visit your nearest A&E department, who will examine you and advise as to the next steps.

If you have any of the symptoms below then further more urgent tests are likely to be required:

  • Bruising over the sclera (whites) of your eyes
  • Other facial fractures
  • Severe nose bleeding
  • Clear watery discharge from the nose
  • Visual disturbance
  • Reduction in consciousness
  • A completely blocked nose due to a blood clot/haematoma

If you think you have any of these, you are advised to go straight to A&E. If there are none of the above features, then it is likely that you will be asked to attend an appointment at the ENT (Ear, Nose and Throat) clinic approximately 7 to 10 days after the injury. This is necessary to determine whether any further treatment to the bone or cartilage is needed, as by this time the swelling will have subsided and a clearer assessment of the position of the nasal bones can be made.

Immediate care:

  • Use ice packs for 10 minutes at a time, 3 times a day, to reduce swelling. Frozen peas wrapped in a damp towel work really well
  • Take pain relief if needed
  • Pinch the soft lower part of your nose if you are having nose bleeds, whilst breathing through your mouth.

Medical procedures

Most nasal fractures do not require X-rays. Only if complications arise will an X-ray be required. A nose fracture tends to heal by itself and swelling will eventually go down. In the case of a deformed nose, after swelling has been reduced, a medic can carry out a manipulation procedure, which will be under anaesthesia, to reposition the nose. A CT scan may be required if there is evidence of other facial injuries or fractures, if your consciousness is reduced or if there is a clear watery discharge from the nose.

What is a manipulation of a fractured nose (MUA)?

A MUA (manipulation under anaesthesia) is a procedure to improve the appearance of the nose. It may also prevent further complications to the nasal passage. The most successful manipulations are performed within 14 days of the injury, but some cases may be performed up to 21 days after the day of the injury. In the majority of cases, a MUA is performed under a general anaesthetic, although they can be performed whilst you are awake, under local anaesthetic, particularly if the procedure is carried out immediately or very soon after the injury has occurred, and before any swelling has developed.

Nosebleeds

It is not unusual for patients to experience nosebleeds after a fracture to the nose. We would advise that you sit forward and pinch firmly the soft part of your nose (around the nostrils). This should be done for around 15 minutes. Seek medical advice or help if bleeding continues for longer. Nasal packing treatment at a hospital may occasionally be required if bleeding does not stop.

Septal haematoma

Blood collects between the septum (central partition wall) of the nose and lining and causes it to swell. Patients may experience pain, cartilage damage and nasal obstruction and will need to be referred to the ENT (Ears, Nose and Throat) Department for urgent drainage.

Nasal blockage

Common problems occurring from nasal fractures include a blocked nose, which can be due to swelling of the nasal lining, or due to a deviated nasal septum. Sometimes surgery is needed several weeks later to repair a deviated septum particularly if the nasal blockage persists.

Complications

A rare occurrence may happen which is called a CSF (cerebrospinal fluid) leak. This is where a thin plate of bone in the roof of the nose is fractured and causes clear fluid that surrounds the brain to leak through your nose. If this happens, you are likely to require an urgent CT scan and a review by an ENT (Ear, Nose and Throat) specialist and sometimes a neurosurgeon, in case a repair may be required.

Sense of smell

It is possible to develop a reduced sense of smell, especially during the maximum period of swelling. It often recovers fully; however, a permanent loss of smell can occur due to injury to the delicate nerve endings. Recovery times can vary widely between different people.

Ongoing care after a fractured nose

  • Sleep on a few pillows with the head of the bed elevated for 2-3 nights so that your head is slightly propped up, which will encourage the swelling to reduce faster
  • Avoid playing contact sports for 6 weeks

If you wish to book an appointment or get in touch, please contact us on 0203 865 7225 or email: contact@london-ent.co.uk