Clinical features
These will depend upon the severity of the fracture but may include:
- nasal deformity
- nasal obstruction
- epistaxis
- in some nasal fractures, epistaxis without obvious nasal deformity may be the only clinical finding.(1)
- oedema and ecchymosis of the nose and periorbital structures
- this may be seen if examination is performed more than several hours after the injury.
- palpation of the nasal structures may elicit any crepitus, indentation, or irregularity of the nasal bone.
- soft tissue injury - swelling and discolouration about the nasal bones and the vicinity
- nasal injury may be associated with other head and neck trauma (1)
- the possibility of an associated facial or mandibular fracture must be considered
- this requires computed tomography (CT)
- all bony structures of the face( malar eminences, orbital rims, zygomatic arches, mandible, and teeth) should be carefully examined
- eyes - symmetry and mobility of gaze should be looked for(1)
- the possibility of an associated facial or mandibular fracture must be considered
- a thorough internal examination requires the folowing:
- good lighting
- suction
- anesthesia
- vasoconstrictive nasal sprays.
- a nasal speculum
- a headlamp
References:
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