Check-up : Help, my nose is broken

March 28, 2017

Dear Readers,

Sandra emailed Check Up with an unusual concern. She broke her nose while playing netball over a month ago and her nasal septum has shifted. It's healed now and she's not experiencing any problems breathing.

Fixing the nasal septum will require surgery. She feels OK and finding the funds for surgery would be onerous. Can she just ignore this episode and get on with her life?

If the shift in the nasal septum is minor, then the answer is probably 'yes'. But there is no seeing down the future and allergic rhinitis and sinus issues may also feel different in the future, with a sensation of blockage on the narrower side of the nose.

Ideally, it's always best to return the body to as normal as possible after an injury. But, in truth, it is the ear, nose and throat (ENT) doctor who should best answer Sandra's question and she should seek their opinion on this matter.

A broken nose usually occurs from an athlete getting hit in the face either by a sports opponent or equipment in use in a game play. It also frequently occurs in altercations between people and in motor vehicle accidents.

When a nose breaks it usually bleeds. Blood can come from the inside of the nose, where it is fractured, or from outside from lacerations and abrasions to the nasal region. Also, the alignment of the nose often changes as it is pushed off from the centre of the face.

This observation should be made as soon as possible by looking in a mirror before swelling to the area occurs. The nasal airway may also be obstructed, making it difficult to breathe through the nostrils, and the area may become discoloured. Of course, the area is painful and tender to touch.

Any force which can break the nose can also possibly cause brain concussion, so Brain CT scan is advised later to rule out more serious head injury.

When the nasal injury occurs, a towel or gauze should be applied across the nasal bridge with mild pressure to help stop any bleeding. The person should sit with head bent forward to ensure that any blood runs out and not down the back of the throat. If the person is on the ground, roll them on to their side to allow the blood to drain out on to the ground. If a head injury is suspected, call emergency services immediately!

 

SYMPTOMS

 

Symptoms of a concussion would include:

- Headache

- Dizziness

- Confusion

- Nausea

- Ringing in the ears

Once the bleeding has stopped, an ice pack should be applied to the nose to reduce swelling to the face.

When the nose is broken, it should be repositioned in the emergency room by the emergency physician or by an ENT specialist within three to seven days of the injury to avoid surgical repair. After this time healing is occurring and surgical repair may be required to reset the fracture straight.

Most broken noses will heal without problems, and when problems do develop they will more commonly include:

- A crooked or bent nose.

- Nasal stuffiness or troubled breathing.

- Infection of the nose, sinuses or facial bones.

- Deviated nasal septum.

- Perforation of the nasal septum.

- Brain infection, such as meningitis or brain abscess.

Other treatment of the broken nose will include:

- Nasal decongestants

- Painkillers

- Nasal packing

- Nasal splint

- Antibiotics

Duncan is 44 years old and suffers with stuttering since birth. He says it's always worse when he is feeling stressed or pressured. He asks Check Up if there is any cure for the stuttering.

Stuttering is a speech disorder characterised by repetition of sounds, syllables and words. It includes interruptions of speech known as blocks. An individual who stutters knows exactly what they want to say but has trouble producing a normal flow of speech. The truth is that researchers are still trying to define the underlying causes of persistent stuttering.

There is at this time no cure for stuttering, but some treatment is available. Working with a speech therapist and a psychologist may be the best options available in Jamaica.

Current therapies tend to focus on learning ways to minimise stuttering during speech by training, involving speaking more slowly and regulating breathing.

These therapies also address the matter of anxiety.

There are also drugs used to treat other conditions such as epilepsy, anxiety and depression which are also used to treat stuttering.

 

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