Traumatic nasal injuries in general practice

Traumatic nasal injuries are common in all age groups of the community. Significant nasal trauma can cause nasal fractures and a range of complicating injuries.

This article provides general practitioners (GPs) with a succinct overview of pathology arising from nasal trauma, and a framework on the assessment and management of common nasal injuries.

During assessment of traumatic nasal injuries, it is essential to exclude a septal haematoma, which requires urgent drainage. Undisplaced nasal fractures without functional symptoms can be managed conservatively. Displaced fractures should be referred for reduction. There is a window of two weeks before the displaced nasal bones start uniting. Investigations are rarely indicated for traumatic nasal injuries. Blood tests, including full blood count and coagulation screening, may be indicated in severe epistaxis. X-rays are not helpful for the assessment of traumatic nasal injuries. Computed tomography (CT) scans are only indicated if there is a suspected orbital, maxillary, frontal or zygomatic fractures.