What is a Nasal Fracture? Symptoms, Treatment Methods, and Surgical Options

Nasal fracture is among the most common bone fractures in the facial region. It usually occurs as a result of sudden traumas such as falls, sports injuries, traffic accidents, or assault. While nasal fractures can sometimes be isolated, they may also be accompanied by fractures in other bones of the head and facial region. Therefore, especially in serious traumas, comprehensive evaluation of neurological and facial bone structures is important.

Nasal fractures that are not diagnosed and treated in time can not only impair aesthetic appearance but also cause permanent breathing problems.

What Are the Symptoms of Nasal Fracture?

The symptoms of nasal fracture may vary according to the severity of the trauma. If one or more of the following findings are present, the possibility of nasal fracture should definitely be evaluated:

• Sudden curvature or asymmetry in the shape of the nose
• Nosebleeds
• Pain, tenderness on the nose, and pain that increases with touch
• Bruising and swelling under the eyes (especially noteworthy if bilateral)
• Difficulty breathing through the nose
• Crackling sound when pressure is applied to the nose (crepitation)
• Feeling of displacement in cartilage or bone structures

If these findings are present, an Ear, Nose, and Throat (ENT) specialist should be consulted without delay.

How is Nasal Fracture Diagnosed?

The foundation of diagnosis in nasal fracture is clinical examination. Detailed physical examination and endoscopic evaluation performed by an ENT specialist reveals the extent of damage that has occurred in both the external and internal structures of the nose.

In some cases, correct evaluation may be difficult immediately after trauma due to swelling in the nose. In such cases, waiting for the swelling to decrease and performing the examination 5-7 days later may yield healthier results.

If the location and extent of the fracture needs to be seen in detail, CT (computed tomography) imaging covering the facial bones is preferred. Traditional X-ray (plain radiography) is generally not recommended as it does not provide sufficient information.

How is Nasal Fracture Treated?

The treatment plan is determined according to the severity of the nasal fracture, whether there is displacement, and the patient’s functional complaints.

Simple Nasal Traumas

If the fractured bone fragments have not moved from their place and breathing function is preserved, usually conservative methods such as:

• Cold application
• Keeping the head elevated
• Use of painkillers

are sufficient for monitoring.

Closed Reduction (Setting Fractured Bones Back in Place)

If the bone fragments have displaced, closed reduction within the first 7-10 days may be necessary. This procedure is performed under local or general anesthesia. The aim is to bring the nasal bone back to its natural anatomical position.

Note: Although closed reduction procedure may seem theoretically possible with local anesthesia, it can be quite painful and uncomfortable for many patients. As Prof. Dr. Gediz Murat Serin, in my practice, I prefer to perform this procedure under general anesthesia in operating room conditions to treat my patients comfortably and painlessly.

Surgical Intervention: Functional and Aesthetic Rhinoplasty

If there is shape deformity and breathing difficulty accompanying the nasal fracture, just correcting the fracture may not be sufficient. In such cases, detailed correction of both external and internal structures of the nose may be necessary. This procedure is performed with:

• Septum deviation (nasal septum curvature)
• Turbinate hypertrophy (enlargement of nasal turbinates)
• Nasal dorsal hump or nasal tip drooping

functional rhinoplasty that addresses problems such as these.

Performing such surgeries 3 to 6 months later, when the nasal tissues have healed and edema has decreased, rather than during the acute trauma period, yields much healthier results.

Septal Hematoma: A Condition Requiring Emergency Intervention

In some nasal fractures, the septum (nasal septum) may also be fractured. Due to these fractures, blood may accumulate under the septal mucosa. This condition is called septal hematoma and requires emergency intervention. If not intervened, infection, cartilage erosion, and serious deterioration in nasal structure may occur.

Recovery Process After Nasal Fracture

The process after closed reduction generally proceeds as follows:

• Surgery duration: 15-30 minutes
• Incision: None, the entire procedure is performed from inside the nose
• Recovery:
  • Swelling usually decreases in the first week
  • Bruising resolves within 10-14 days
  • The settling of the nose’s new form and complete resolution of edema may take 2-3 months

After surgery, silicone may be placed inside the nose, and tape and protective splint are applied to the external part. During this period:

• Protection from sun
• Being careful against impacts
• Adhering to the care protocol recommended by the physician

accelerates the healing process and increases success.

Nasal Fractures with Functional and Aesthetic Approach with Prof. Dr. Gediz Murat Serin

Many people may have pre-existing slight curvatures, humps, or nasal tip drooping in their nose. After a nasal fracture, the patient may perceive these existing problems as if they occurred after the fracture. However, a nose that was already crooked before the fracture will continue to appear crooked even when set back in place with reduction.

I evaluate the situation in detail in patients with nasal fractures, sometimes just waiting for the fracture to heal, and 6 months later I aim for permanent and satisfying results with both functional and aesthetic rhinoplasty.

With endoscopic examination and imaging methods such as tomography when necessary, I clearly determine the internal and external structural damage caused by trauma; when necessary, I provide long-term solutions in terms of both function and aesthetics with rhinoplasty.

Conclusion: Early and Correct Intervention is Very Important in Nasal Fracture

If you notice pain, shape deformity, bleeding, or breathing difficulty in your nose after a trauma, you should take these symptoms seriously. Delayed or inadequate interventions can lead to serious problems both aesthetically and health-wise.

Early diagnosis, correct treatment, and detailed evaluation under the guidance of an experienced ENT specialist is the most effective way to prevent long-term problems that nasal fracture can cause.