Nasal trauma is an injury to the nose or the areas that surround and support the nose. Internal or external injuries can cause nasal trauma.
The position of the nose makes the nasal bones, cartilage, and soft tissue vulnerable to external injuries.
Nasal trauma that results in nosebleeds occurs because the nose has many blood vessels positioned close to the surface. This makes them easy to injure.
Bleeding, swelling, blood clots, and fractures can result from injuries to the nasal area. Physical deformity, infections, and obstructed breathing are potential complications of nasal trauma.
Common types of nasal trauma include:
- swelling and bruising
- blood clots
- chemical injuries to the nasal interior
- obstruction by foreign object
External nasal trauma can occur when force is exerted on the nose. Common causes of external nasal trauma are:
- motor vehicle accidents
- sports injuries
- physical assaults
- child abuse
Internal nasal trauma can occur when there is damage to the cartilage or the blood vessels inside the nose. Common causes of internal nasal trauma are:
- infections from nasal piercings
- inhaling irritating substances
- sniffing cocaine or other illegal drugs
- foreign objects lodged in the nose
- picking or scratching
Nasal trauma caused by accidents can occur to anyone at any time. Men are twice as likely to experience nasal trauma as women. The highest incidence of nasal trauma in men is among men ages 15 to 25. Among women, most nasal trauma occurs after age 60, when the rate of accidental falls increases (Mathog et al., 1995).
Sniffing cocaine, abusing inhalants, or using toxic chemicals without nasal protection can put you at risk for internal nasal trauma. Children can be at risk for nasal trauma by putting objects in their nose by accident.
Symptoms of nasal trauma can range from mild to severe depending on the type and extent of the injury. Common symptoms of nasal trauma are:
- blood coming from the nose
- bruising around the eyes
- swelling of the face, particularly around the nasal area
- trouble breathing through the nose
- distortion of the shape of the nose
- pain and tenderness in the nose
- loss of sense of smell
- clear fluid coming from the nose
A physician can diagnose the severity of nasal trauma and the presence of a nasal fracture. Based on the type of your injury, a physician may diagnose nasal trauma by:
- gently touching the bridge of the nose to feel for irregular alignment, movement of bones, and tenderness
- examining the inside of the nose for obstructions or chemical damage
- using a computed tomography (CT) scan to assess broken bones.
Nosebleeds that last longer than 20 minutes or occur frequently may require treatment. A doctor may use the following techniques to stop a nosebleed:
- Cauterization: Silver nitrate is applied to the bleeding vessel with a heating device to seal the vessel closed.
- Packing: Gauze or an inflatable balloon is placed into the nose, exerting pressure on the vessel to stop the bleeding.
A doctor may recommend antibiotics to prevent infection. Painkillers may also be recommended.
Nasal fractures that are diagnosed within 10 days of the injury can be repaired by a technique called reduction. In this procedure, the broken pieces of the bone are pushed back into place. This may require waiting a few days to allow the swelling to decrease so that the physician can judge proper bone alignment.
Reduction can be done in a doctor’s office with local anesthesia or in an operating room with general anesthesia. After the nose is put into place, it is stabilized with an external splint.
After two weeks post-injury, reconstructive plastic surgery may be necessary to repair the broken bones in the nose. This may require a waiting period of up to six months to allow for the swelling to end.
If your nasal fracture is accompanied by a leak of cerebrospinal fluid, you will be admitted to the hospital. A drain will be inserted near the spinal cord in your lower back to remove the fluid.
The following techniques may be helpful in treating nasal trauma:
- Sit upright and lean forward to reduce blood pressure in your nose.
- Pinch both nostrils shut at the soft portion of your nose for five to 10 minutes.
- Breathe through your mouth.
- Repeat these steps for up to 15 minutes.
- Keep your head higher than your heart.
- Refrain from picking or blowing your nose for several hours.
- Apply ice packs for two days to help reduce swelling. The packs should be applied every two hours for 15-minute intervals.
- Sleep with your head raised to reduce pain and swelling.
Foreign Objects in the Nose
- Don’t pick at the object.
- Don’t use a cotton swab or other tool to probe at the object.
- Try to gently blow the object out of your nose.
- If the object is visible and can be easily grasped, try to remove it with tweezers gently.
- Seek medical help if the object remains in place.
Most types of nasal trauma have a good prognosis. In some cases, nasal trauma caused by a severe blow may result in other facial injuries. Complications of nasal trauma can include a septal hematoma. This is a collection of blood that forms inside the nose. If left untreated, the blood can cause the cartilage to die. The result is a deformed, collapsed nose.
In some cases, a nasal fracture can damage the bones that attach your nose to your skull. This injury can allow cerebrospinal fluid to leak. It also presents an opportunity for bacteria from your nose to reach your brain and spinal cord. This can cause meningitis.
You can prevent many types of nasal trauma with simple precautions:
- Wear appropriate protective headgear when playing sports or participating in activities such as bicycling and skateboarding.
- Always use seatbelts and car seats in motor vehicles.
- Quit smoking.
- Use protective masks when working with toxic substances.
- Do not abuse drugs.