Bopped in the Beak
Do you have difficulty breathing from your nose? Or has your ability to smell been reduced? How about your voice, has it changed or does it always sound like you have a cold?
Nasal bones are the most commonly fractured bones in the face. The nose, being the most projecting feature of the face, is the leading structure encountered in a traumatic event. It is estimated that there are on average 51,200 nasal fractures per year in the United States. However, there probably exists a greater incidence, as many patients with nasal fractures do not seek treatment. Infant or childhood nasal trauma is notorious for being overlooked. Following nasal trauma, children are especially susceptible to internal injuries and its subsequent complications. The cartilages of the nose tend to buckle and twist, which can result in formation of a blood clot on the nasal septum. The septum is made up of cartilage and bone. It provides structural support to the nose in addition to serving as a midline partition. A blood clot blocks the septum of its nutrients and the septum can become weakened, develop a hole, and even collapse. This can occur in the absence of nasal bone fractures and also with minimal external evidence of nasal injury (i.e., no bruising or swelling). Unfortunately, nasal trauma is often unappreciated, eventually manifesting as nasal deformities. Internal structural damage can lead to voice changes, snoring, and even a sensation of shortness of breath. By the time most people seek medical advice they have already suffered the effects of a nasal fracture.
Others who have undergone nasal reshaping (rhinoplasty) may develop consequences of internal nasal structural collapse from over-reduction of the nasal framework. Unfortunately, for many interested in rhinoplasty, little thought is given to the primary function of the nose. Many patients who request nasal reshaping only focus on achieving a nicer appearing nose. However, it is all too common that they later return to a nasal surgeon because they cannot breathe. Many consider Rhinoplasty the most difficult of all the cosmetic surgical procedures. The nose continues to change over many years. Subtle changes to the underlying structures of the nose can lead to dramatic differences in its outward appearance.
The nose has two valves - an internal and an external; they provide a delicate balance in allowing air to enter the nose. The slightest change in these valves can cause collapse and symptoms of obstruction. We now realize that nasal sculpting techniques popular in the 60s and 70s can lead to nasal obstruction years later.
If you suffer from nasal blockage, a deviated nasal septum, or a collapsed distorted appearing nose and can remember sustaining an injury to your nose, you may have suffered a nasal fracture. Additionally, if you have undergone a rhinoplasty and are recognizing increasing difficulty breathing through your nose, you may be experiencing nasal valve collapse. Through a variety of minor procedures, you can enjoy the benefits of normal breathing again.
Inquire with your insurance company, as third party payers traditionally will reimburse the expenses for treatment of nasal injuries or obstructed breathing. There is no need to agonizes unnecessarily from the effects of nasal injuries. Consult with a nasal physician.
Originally published in the November 1999 issue of HealthCare Times.