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Nasal Fractures, Emergency Medicine

David W. Munter Reviewed 06/2017



  • Fractures of nasal skeleton are the most common body fractures.

  • Most nasal fractures are result of blunt trauma, frequently from motor vehicle crashes, sports injuries, and altercatio...


Signs and Symptoms

  • Nasal deformity, asymmetry, swelling, or ecchymosis

  • Epistaxis

  • Periorbital ecchymosis (“raccoon eyes”) from damage to branches of ethmoidal artery:

    • May indicate nasofrontoethmo...



  • Management of airway takes precedence.

  • Nasotracheal intubation is contraindicated.

  • Consider orotracheal intubation or cricothyroidotomy if definitive airway control is needed.

  • Cervi...


Follow-Up Recommendations

  • Follow up with ENT, plastic surgery, or oral maxillofacial (OMF) surgeon in 3–5 days for management:

    • Patients with septal hematoma should follow up in 24 hr for re-ev...

Pearls and Pitfalls

  • The absence of a septal hematoma must be documented in every case.

  • Every patient discharged with nasal packing should be placed on antistaphylococcal antibiotics.

  • Consider cribriform...

Additional Reading

  • Atighechi  S, Baradaranfar  MH, Akbari  SA. Reduction of nasal bone fractures: A comparative study of general, local, and topical anesthesia techniques. J Craniofac Surg.  2009...



  • 801.00 Closed fracture of base of skull without mention of intra cranial injury, unspecified state of consciousness

  • 802.0 Closed fracture of nasal bones

  • 920 Contusion of face, scalp, and neck ...

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