How to effectively diagnose a broken nose

Many people may suffer from a broken nose due to accidental injuries, so you should pay attention to correct judgment and generally check these parts to see if the nose is crooked, collapsed, or has bleeding symptoms.

1. Visual examination

Observe the external nose for deformity, swelling, congestion, orbital edema, eyeball displacement, and normal movement. Depending on the severity of the trauma, some or all of the following manifestations may occur: laceration of the external nasal skin; crooked or collapsed nose bridge; collapsed or bulging nasal dorsum and root; swelling and ecchymosis of the external nose and surrounding tissues; nasal congestion or active bleeding; bulging nasal septum; deviated nasal septum; and damage to the nasal mucosa.

2. Nose palpation

The fracture site may be tender to the touch and may also feel like bone friction. If the patient has repeatedly blown his nose forcefully, and air escapes into the external nose and surrounding subcutaneous tissue, subcutaneous emphysema may occur, with a twisting sensation upon palpation.

3. Anterior rhinoscopy

Pay attention to whether the nasal mucosa is damaged or bleeding. If the nasal septum is deviated, it indicates dislocation of the septal cartilage.

4. Nasal bone imaging examination

It can show the location and nature of the fracture, whether the bone fragments are displaced, and the direction of displacement. High-resolution CT and three-dimensional reconstruction can further show the damage to the nasal bone and its adjacent parts.

(1) Lateral nasal radiograph: The lateral nasal radiograph is generally used to determine whether there is a nasal bone fracture. It can directly observe displaced transverse fractures, depressed fractures, comminuted fractures and bilateral nasal bone fractures with obvious displacement of fracture ends; it is easy to miss the diagnosis of bilateral nasal bone fractures with unclear separation of fracture ends, small bone fragments and occult fractures.

(2) CT scan of the nasal bone has great diagnostic value for fractures of the lateral edge of the nasal bone, especially for combined injuries to surrounding tissues such as effusion in the sinuses, fractures of the orbital wall, hematoma in the soft tissue, fractures of the skull base, blood accumulation in the orbit, and for evaluating the possibility of long-term bleeding.

5. Nasal endoscopy

It can visually determine whether there is nasal septum deviation, hematoma and abscess, determine the bleeding site and whether there is cerebrospinal fluid leakage.