Broken Nose Without Bleeding: Symptoms, Diagnosis, and Treatment

A nasal fracture can occur without epistaxis. Key signs include:

• Deformity (crooked, flattened bridge)
• Periorbital ecchymosis (raccoon eyes)
• Crepitus on palpation
• Nasal obstruction
• Pain, swelling
• Septal hematoma (emergency – requires drainage to prevent cartilage necrosis)

Evaluation

• Clinical exam (inspection, palpation, speculum).
• CT if complex or associated facial fractures suspected.

Treatment

• Closed reduction (within 2 weeks, ideally 3–10 days).
• Open reduction for severe displacement or delayed presentation.
• Septal hematoma: immediate incision and drainage.

Early ENT or plastics referral optimizes cosmetic and functional outcome.