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Nasal Injuries
Understanding Nasal Anatomy: Outside View
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Why does your nose look the way it does? And what goes on inside a nose to let a person breathe easily? Learning the anatomy of the nose can help you better understand the answers to these questions.
The outside view
One way to tell if a nose fits well with a face (aesthetics) is to divide the face into 3 equal parts (thirds). The nose should fit in the middle third. Then, thinking of the nose as a triangle can help you see the best size and shape for the nose.
- From the front. Imagine a triangle starting at the top of your nose and extending to the outer corners of your mouth. Does your nose fit inside that triangle? The nose itself should also be shaped like a triangle. It should balance with the length and width of your face.
- From the side. Imagine a triangle with one side going along the bridge of the nose and another going out from the base of the nose. Does your nose fit within this triangle? The tilt of the tip should also balance with the forehead and chin.
- From beneath. The nostrils and tip of the nose should also form a triangle.
If you’re going to measure your nose, don’t use a picture from a selfie. The short distance from the camera to the face distorts the image. Most of the distortion occurs around the nose.
Understanding Nasal Anatomy: Inside View
A lot happens under the surface of the nose. The bone and cartilage under the skin give the nose most of its size and shape. Other structures inside and behind the nose help you breathe. Learning the anatomy of the nose can help you better understand how the nose works.
- Bone. This supports the bridge of the nose. The upper cartilage supports the side of the nose. The lower cartilage adds support, width, and height. It helps shape the nostrils and the tip of the nose.
- Skin. This also helps shape the nose.
- Nasal cavity. This is a hollow space behind the nose that air flows through.
- Septum. This is a thin wall made of cartilage and bone. It divides the inside of the nose into 2 parts.
- Mucous membrane. This is thin tissue that lines the nose, sinuses, and throat. It warms and moistens the air you breathe in. It also makes the sticky mucus that helps clean the air of dust and other small particles.
- Turbinates. These are curved, bony ridges on each side of the nose. They are lined with mucous membrane. They warm and moisten the air you breathe in.
- Sinuses. These are hollow, air-filled chambers in the bone around your nose. Mucus from the sinuses drains into the nasal cavity.
Nosebleed: How to Care for Your Child
Nosebleeds are common in children and are rarely serious. They can happen from nose picking, scratching, injury, dry air, or having a cold that irritates the inside of the nose. Most nosebleeds can be easily treated at home. If your child has another nosebleed, follow the steps below to help it stop.
- Stay calm and comfort your child.
- Have your child sit up and tilt the head slightly forward to keep blood from running down the back of the throat. It might help for your child to lean over a sink or pail to catch the blood.
- Have your child pinch the bottom of the nostrils (soft part of the nose) together using the index finger and the thumb. Hold it without stopping for 10 minutes.
- After 10 minutes, check for bleeding. If the nose is still bleeding, pinch the nose closed for another 10 minutes.
Care Instructions
- Remind your child not to blow, rub, or pick the nose for at least 12 hours after a nosebleed.
- For the next 2–3 days, your child should avoid lifting or straining.
- Don't give your child ibuprofen for 3–4 days because it can make it harder to stop a nosebleed.
- If the health care provider packed your child's nose with gauze, be sure to schedule an appointment to get it removed.
- Because warm, dry air can dry the lining of the nose and make it bleed more easily:
- Don't overheat your home. If you can adjust the temperature, set the thermostat around 68°F (20°C).
- Use a cool-mist humidifier in your child's room and clean it every day to prevent mold from growing.
- Use a cotton swab to put a small amount of petroleum jelly in the lower part of the nostrils twice a day to help keep the nose moist.
Call Your Healthcare Provider if...
Your child:
- has blood going down the back of the throat even with the head tilted forward. This could be a more serious problem called a posterior (back of the nose) nosebleed that needs a doctor's care.
- keeps having nosebleeds
- gets a nosebleed after starting a new medicine
- has nosebleeds along with bruising of the skin or a red or purple rash
Go to the ER if...
Your child:
- still has bleeding after pinching the nose for a total of 20 minutes
- is bleeding heavily or has lost a large amount of blood
- has a new nosebleed after an injury or blow to the head or face
- feels weak or dizzy
More to Know
What causes nosebleeds? Nosebleeds happen when the tiny blood vessels that line the inside of the nostrils are injured. When a blood vessel in the nose tears, blood may come out of the nostril. Blood coming from the nose often looks more serious than it is.
How does a nosebleed stop? A nosebleed stops when blood forms a clot (clump of cells and protein) that plugs the torn blood vessel. Then, a scab forms on top. Nosebleeds can start again if the scab comes off.
When does a child who has nosebleeds need testing? Kids who have nosebleeds once in a while don't need testing.
Kids need testing if they:
- have nosebleeds that last longer than 30 minutes when pressure is applied
- have nosebleeds more than 2 or 3 times a week
- are younger than 2 years old
Nose Fracture: How to Care for Your Child
A broken nose usually heals well with proper care. Sometimes surgery is needed, but this is uncommon.
Your Child's Diagnosis
A broken (fractured) nose typically occurs from a blow to the face. The fracture can be just a crack in the bone or the bone could be out of place and might need to be straightened.
Health care providers often diagnose a nasal fracture by examining the injured nose. Most times an X-ray is not needed because only a small portion of the nose is made of bone (which can be seen on an X-ray); the rest is made of cartilage (which cannot). If your child had X-rays on this visit, the results were reviewed with you.
A broken nose may look crooked, swollen, and bruised. In the first few days after the injury, the bruising and swelling may spread to the area around the eyes.
The health care provider may want your child to see an otolaryngologist — an ears, nose, and throat (ENT) doctor. It is best to see the specialist after a few days, when the swelling has gone down. At that time, if the nose appears crooked the ENT doctor may want to straighten it, which is done in the operating room.
Care Instructions
- Give your child any prescribed medicine or ointment as directed by the health care provider.
- If your child is uncomfortable, a medication may help:
- For children under 6 months, you may give acetaminophen.
- For children over 6 months, you may give acetaminophen OR ibuprofen, if recommended by your health care provider.
- To reduce swelling:
- Your child should sleep sitting up or with the head propped on pillows.
- Hold a cold pack wrapped in a towel to your child's nose for 15–20 minutes a few times each day. Do not apply ice directly to the skin.
- If your child has a nosebleed, tip your child's head forward (not back) and pinch the soft part of the nose gently for 10 minutes.
- Discourage your child from blowing the nose.
Special Instructions
- Make any follow-up appointments as directed.
- Bring a recent photo of your child to the follow-up visit so the health care provider can see the shape of the nose before the injury.
- Ask your health care provider when your child can return to sports.
Call Your Healthcare Provider if...
Your child has:
- A fever.
- A very heavy nosebleed or one that doesn't stop after applying pressure two times for 10 minutes each.
- Blurry or double vision.
- A problem smelling things after the swelling goes down.
- New or increasing pain.
- Increasing difficulty breathing through the nose.
Go to the ER if...
Your child:
- Has trouble breathing.
- Becomes dizzy, disoriented, or loses consciousness.