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Clinical features

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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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)
  • a thorough internal examination requires the folowing:
    • good lighting
    • suction
    • anesthesia
    • vasoconstrictive nasal sprays.
    • a nasal speculum
    • a headlamp

References:

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