Definition

Nasal trauma is defined as an injury to the nose or the area around the nose, including the supporting components such as the skin, cartilage, and nasal bones. The term "nasal" comes from Latin, meaning nose. Nasal trauma can be caused by internal or external injuries. The position of a person's nose makes the nasal bones, soft bones, and soft tissues more prone to external injuries.

There are several types of nasal trauma, including:

• Nosebleeds
• Lacerations or cuts in the nasal area
• Fractures or broken bones
• Blood accumulation in the septum (the bone between the two nostrils)
• Chemical irritation or injury to the inside of the nose
• Blockage due to a foreign object

Nasal trauma can occur at any age. Children are particularly prone to nasal trauma because they often scratch the inside of their noses and insert foreign objects into them. Significant nasal trauma can lead to complications.

Causes

Nasal trauma can be caused by external factors such as environmental influences and internal factors related to the structure of the nose.

External Causes

Several external factors can cause nasal trauma, including:

• Falls
• Sports injuries
• Motor vehicle accidents
• Physical violence
• Collisions with stationary objects, such as doors, windows, or trees

Internal Causes

Internal injuries occur when the cartilage or blood vessels inside the nose are injured or disrupted. Common internal causes of nasal trauma include:

• Infections from nose piercings
• Irritation caused by irritating compounds
• Inhaling cocaine or other illicit drugs
• Scratching or picking the inside of the nose too hard
• Blockage caused by a foreign object

Risk Factor

Several risk factors can increase the risk of experiencing nasal trauma, including:

• Playing sports like soccer, hockey, or boxing, especially without facial protection
• Engaging in physical fights or brawls
• Riding bicycles and motor vehicles without protective gear such as helmets or seat belts
• Weightlifting without supervision from a trained person

Symptoms

Symptoms of nasal trauma can range from mild to severe, depending on the type of injury, the mechanism of injury, and the severity. Common symptoms include:

• Pain inside and around the nose
• Blood or clear fluid discharge from the nose
• Bruising around the eyes
• Headache
• Swelling of the face, especially around the nose
• Difficulty breathing through the nose
• Disturbed or lost sense of smell
• Changes in the shape of the nose

Diagnosis

Your doctor will use various methods to diagnose nasal trauma. Initially, the doctor will ask about your complaints and symptoms, when they started, the circumstances leading to the injury, and any treatments you have already received.

A physical examination and supporting tests will be conducted to establish the diagnosis. During the physical examination, the doctor will palpate your nose from the base to detect crepitus, misalignment, blockages, signs of fracture, or displacement of nasal structures upon touch.

Further, your doctor may perform imaging studies such as X-rays or CT scans of the face and sinuses to view the internal structure of your nose. In severe trauma cases involving areas other than the nose, a head CT scan may be performed to check for injuries.

Management

The doctor can provide pain relief treatment. If the nasal trauma is minor, not causing the nose to be crooked or deformed, the doctor may recommend simple self-care measures such as applying ice compresses to the injured area.

Applying an ice compress immediately after the nasal trauma aims to reduce swelling. Compress the area with ice for 10 to 15 minutes, four times a day, for the first 1-2 days. Wrap the ice in a towel or cloth when applying it. Keep your head elevated, especially while sleeping, to minimize swelling after nasal trauma.

If there is a fracture or displacement of the nasal bones, your doctor will suggest realigning your nose through surgery. For cases of blood or pus accumulation in the nasal septum, prompt intervention is necessary to prevent severe, widespread infection. In such cases, the doctor may prescribe antibiotics and drain the blood or pus immediately.

Complications

Most nasal trauma cases do not worsen and heal well. However, nasal trauma can lead to complications such as nasal deformities, scar tissue formation, nasal tissue tears, nosebleeds (epistaxis), and other issues.

Cerebrospinal Fluid Leakage

Nasal trauma, such as a nasal fracture, has the potential to damage the bone that connects your nose and head. This can cause cerebrospinal fluid to leak. The leak can provide a pathway for bacteria from the nose to enter the brain and spinal cord, leading to bacterial meningitis.

Nasal Cartilage Damage

Trauma to the nose can result in blood accumulation in the nasal septum cartilage, known as a septal hematoma. If untreated, this can lead to cartilage tissue death, potentially causing nasal deformity and collapse.

Anosmia

Anosmia, or loss of the sense of smell, can be a complication of nasal trauma. This usually occurs immediately after the trauma due to nasal blockage by blood. Persistent anosmia may indicate nerve damage in the nose responsible for smell, which is irreversible.

Prevention

Nasal trauma can be prevented by taking simple measures such as:

• Wearing appropriate head protection during sports
• Always using seat belts in cars and helmets while riding motorcycles
• Wearing protective masks when working with toxic substances to prevent inhalation of irritants
• Not smoking and avoiding illegal drugs
• Not inserting or attaching foreign objects into the nose

When to See a Doctor?

Seek medical attention immediately if you experience nasal trauma accompanied by:

• Neck trauma, indicated by severe headache, neck pain, vomiting, or loss of consciousness
• Difficulty breathing
• Unstoppable bleeding
• A change in the shape of your nose, such as bending
• Clear, colorless fluid discharge from your nose

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