The nose is the most prominent part of the face, which is why damage to its anatomical structures occurs in 30% of cases of all injuries to the facial skull. Persistent nosebleeds, facial bruises, difficulty breathing and cutting pains are the main signs of a broken nose. Most often, facial injuries occur in men between the ages of 16 and 45. The causes of damage to nasal structures can be very diverse: from domestic and industrial injuries to a banal fight.
It is quite easy to diagnose pathology by local manifestations - hematomas, tissue edema, deformation of the nasal septum, etc. However, not all trauma results in serious damage to the bone and cartilaginous structures in the organ. Sometimes it is possible to determine the degree of tissue damage only through endoscopic examination and rhinoscopy, which is carried out by a traumatologist or otolaryngologist.
Anatomy of the nose
The visible part of the nose consists of the back (septum), root, wings and apex. The basis of the organ is made up of bone and cartilaginous structures, which give it a strictly defined shape. With facial injuries, it is the nasal septum that most often suffers. Its back is made of bone, and the front is made of cartilage.
Fracture of the nose - mechanical damage to the cartilaginous, bone and muscle structures of the outer part of the organ. Among all injuries to the facial skull, injuries to the nasal septum are the most common. The main causes of the onset of pathology include:
- street fights;
- playing sports;
- work injuries;
- falling from height;
- car accidents;
- war injuries.
A broken nose is a good reason for seeking help from a traumatologist. Trauma almost never remains unnoticed, since damage to the nasal anatomical structures leads to a violation of the olfactory and respiratory function.
Septal deformities become evident only after the edema subsides.
It is strictly forbidden to set bones on your own. Inappropriate manipulations can cause further damage to the soft and bone structures and, as a result, the occurrence of severe nosebleeds.
Fracture classification
Before identifying a broken nose, you need to find out what types of facial injuries are. The most appropriate treatment tactics will be used depending on the type of injury. In traumatology, there is the following classification of nasal bone fractures:
- without displacement - one of the easiest types of damage in which minor cracks and curvatures are found in the bones;
- with displacement - a serious injury characterized by displacement of bone and cartilaginous structures relative to their original location;
- closed - pathologies in which there is no violation of the integrity of the external tissues;
- open - an open wound surface is formed at the site of the injury, from which fragments of bone tissue are visible.
Violation of the anatomical structure of the nasal septum can lead to complications - asthmatic attacks and inflammation of the peripheral nerves.
Open fractures are considered the most dangerous. Wounds provide a suitable environment for the development of bacterial infections. Therefore, children and adults who have received an open fracture of the nose are advised to immediately seek qualified medical help.
Symptomatic picture
How do you know if your nose is broken? Almost everyone who does not have a medical education can determine the presence of fractures in the nasal bones. But even if the diagnosis is obvious, it is still worth seeking help from a specialist. By means of instrumental examination, the degree of tissue damage, the characteristics of pathological processes and, accordingly, a suitable treatment strategy are determined.
Pain syndrome
In case of damage to the intranasal anatomical structures, a person feels a sharp incessant pain. Cartilage and bone formations are covered with muscles that contain pain receptors. Mechanical trauma stimulates the activity of receptors, which causes a person to feel severe pain.
If the fracture is closed, palpation of the nose leads to increased discomfort. If you do not use pain relievers, this can subsequently lead to migraines and painful shock.
When the osteochondral septum is displaced, breathing is impaired. Any attempts to inhale air through the nose lead to an increase in pain and a deterioration in well-being.
Epistaxis
Persistent nosebleeds (epistaxis) are the main symptoms of a broken nose. Damage to anatomical structures inevitably leads to rupture of capillaries inside the organ and, as a result, bleeding. The posterior epistaxis requires special attention, in which blood can rise through the nasolacrimal canal. Signs of severe nosebleeds are:
incessant bleeding from the nasal passages;- redness of the eye proteins (associated with blood flow into the orbit);
- vomiting and nausea (occurs due to the penetration of a large amount of blood into the stomach).
incessant bleeding from the nasal passages;A critical decrease in blood circulating in the body can be fatal. If the fracture is closed, it is recommended to put an ice bag or apply a cold compress to the nose before the ambulance crew arrives. This will reduce the diameter of the vessels and, accordingly, the intensity of bleeding.
Violation of nasal breathing
Disturbed nasal breathing and dizziness are obvious signs of a broken nose. Deformation of the bone-cartilaginous septum leads to blockage of the airways and disruption of normal breathing. Obstruction of the internal nasal openings can also be caused by the accumulation of blood in the nasal cavity.
In the event of an injury, it is highly discouraged to lay the patient on his back. Penetration of blood into the paranasal sinuses can cause severe inflammation and the development of sinusitis. Moreover, clotted blood is a suitable substrate for the development of opportunistic microorganisms in the nasopharynx - pyogenic bacteria, yeast-like fungi, etc.
Changing the shape of the nose
By the deformation of the nasal septum, you can immediately understand that the nose is broken. However, immediately after injury, the soft tissues on the face swell, as a result of which the degree of curvature of the bone and cartilaginous structures is almost impossible to determine. A change in the shape of the nose is indicated by secondary signs of pathology - difficulty breathing, nosebleeds, etc.
Untimely reduction of the nasal bones is the cause of a persistent violation of the shape of the outer part of the organ.
With relatively minor damage to the intranasal structures, patients are in no hurry to visit clinics and trauma centers. But immediately after the edema on the face subsides, it may turn out that the nasal septum is displaced from the normal position by 0.5 cm or more. External cosmetic defects force patients to seek qualified help. But after the fusion of bone and cartilaginous structures, it is possible to eliminate the defect only through an operation - rhinoplasty.
Glasses syndrome (raccoon eyes)
How can you find out if there is a fracture in the nasal bones or not? Glasses syndrome is a clear sign of a violation of the integrity of the intranasal anatomical structures. Internal nosebleeds often cause blood to enter the subcutaneous tissue of the eyelids, resulting in large blue circles under the eyes.
In fact, eyeglass syndrome is a pathological condition characterized by diffuse infiltration of tissue elements with blood.Bruising in the eye area often occurs not only with a violation of the integrity of the nasal bones, but also with injuries to the bridge of the nose or eyebrows. With adequate and timely treatment, hematomas completely dissolve over time, and the skin around the eyes acquires a natural color.
Additional signs
Additional symptoms of a nose fracture are determined by the degree of damage to tissue and bone structures in the organ. In the absence of open fractures, pathology may be indicated by:
dizziness;- migraine attacks;
- deterioration of vision;
- decreased sense of smell;
- asthmatic attacks;
- mucous nasal discharge.
dizziness;A closed fracture of the nose without displacement of the bones can be mistaken for a severe injury to the organ. It is important to understand that the methods of treating pathology depend on the severity of damage to bone, cartilage and muscle tissues. Letting everything go by itself, one can face formidable complications, in particular, subperiosteal abscess (subperiosteal abscess), subcutaneous emphysema (accumulation of air in tissue structures).
How to determine that there is no fracture?
Many people who have received a facial injury ask themselves the question: how to understand that there is no fracture? It should be understood that epistaxis does not always indicate the presence of bone fractures. When severely injured, it is important to distinguish between a fracture and a severe bruise. To do this, you need to do the following:
- Gently feel the protruding part of the nose. With bruises, palpation of the organ does not cause severe pain. If there are no obvious deformities in the septum, most likely, the bone and cartilaginous structures remain intact;
- Assess the degree of difficulty in breathing. In the absence of a fracture, nasal breathing becomes difficult, but not significantly. It may be due to mucosal edema and bleeding. As a rule, the edema subsides as early as 3-4 days after the use of anti-inflammatory drugs, due to which nasal breathing is normalized;
- Evaluate the rate at which bleeding stops. If there is no fracture, bleeding will stop almost immediately after applying a cold compress. In addition, with bruises, glasses syndrome is quite rare, since there are no deformations in the septum that could provoke the penetration of blood into the subcutaneous layers around the eyes.
After injury, it is not recommended to make sudden head movements, as this can lead to the penetration of blood into the paranasal sinuses.
It is rather difficult to independently distinguish a closed fracture without displacement from a contusion. Therefore, if you receive a severe injury, it is recommended to seek specialized help from a medical facility.
Conclusion
Fracture of the nasal bones is a serious injury that is characterized by a violation of the anatomical structures of the outer part of the organ. The cause of the pathology can be a domestic fight, sports training (kickboxing, martial arts, boxing), car injuries, falling from a height, blows to the face with heavy objects, etc. Like most mechanical injuries, fractures can be open or closed.
Open fractures can be diagnosed by the presence of wound surfaces on the face. A closed fracture can be identified by concomitant symptoms: impaired nasal breathing, severe pain in the nose, bruising under the eyes, deformation of the nasal septum, severe nosebleeds, etc. Some forms of nose fractures are difficult to distinguish from bruises. Therefore, when injured, it is advisable to undergo an instrumental examination in a polyclinic and receive recommendations for the treatment of pathology.
