A swollen, deformed nose: diagnosis, treatment and ENT referral of nasal fractures

Ned Tijdschr Geneeskd. 2026 Jan 26;169:D8694.

ABSTRACT

Nasal fractures are the most common facial fractures, with a higher incidence in males. They typically result from trauma related to sports, accidents, or physical violence, often involving alcohol. Accurate assessment requires knowledge of nasal anatomy, as fractures may involve both bony and cartilaginous structures. Presentation includes swelling, epistaxis, deformity, and nasal obstruction. The trauma’s mechanism and patient’s age influence the fracture type. Diagnosis is primarily clinical, as imaging has limited diagnostic value and does not alter management. Closed reduction is ideally performed within 3-10 days post-trauma, once swelling subsides. In children, repositioning often requires general anesthesia, and rhinoplasty is avoided or delayed until adulthood due to iatrogenic growth retardation concerns. Septal hematomas must be urgently drained to prevent necrosis and warrant immediate ENT referral. Timely recognition and appropriate management are essential to avoid long-term consequences such as deformity, obstruction, or septal perforation.

PMID:41642099