Nasal Trauma

Aetiology

  • Mechanism of injury - fight, sport, falls

Clinical presentation

Important questions to ask

  • When trauma occured
  • Loss of consciousness
  • Epistaxis
  • Breathing

Signs

  • Bruising, swelling
  • Tenderness
  • Deviation
  • Epistaxis
  • Infraorbital sensation
  • Cranial nerve examination

Investigations

  • Nasal fracture is a clinical diagnosis based on deviation
  • Exclude septal haematoma
    • Stops blood supply getting to the cartilage
    • Must be drained to prevent nasal collapse
    • Can get infected and infection can spread into cranial cavity
notion image
notion image

Management

  • Review nasal fracture in ENT clinic 5-7 days post-injury
  • Consider digital manipulation in < 3 weeks

Complications

  • Epistaxis - particularly anterior ethmoid artery
  • CSF leak, meningitis
  • Anosmia- cribriform plate fracture