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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How Should Nose Injury With Cuts, Bleeding, Swelling, Difficulty Breathing Be Treated?

Hi, Fell on Wed night and hit the bridge of my nose and the center of my forehead. Heard it make a noise. There are cuts on the bridge and on the nose itself. Initially, there was a great deal of blood followed by swelling of lower nose. Had to breathe through mouth most of the night. Swelling down by Thursday but had darkness under eyes, not quite black eyes. Had some headaches and dizziness from Thursday to today but only occasionally and briefly. Yesterday started having unexpected drainage which is clear. I think it is getting better every day but just want to check as I am a diabetic. Thanks.
Fri, 19 Sep 2014
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General Surgeon,  's  Response
Hi.
Thanks for an elucidate history.
This is a serious matter since you have a clear nasal discharge and this may indicate CSF Rhinorrhea. This is due to fracture of the nose and at the skull so possibly the brain fluid called CSF is now draining into the nose through a defect.
I would advise you the following.
Collect the clear fluid in a test tube to be sent for examination as to whether this is CF or not.
Routine bloos and urine tests.
MRI of the brain to see for the injusry and Cysternography to see for CSF rhinorrhea.
CT scan of the facial skeleton and -D reconstruction to know the extent of the fractures, deformity and to plan for a surgery.
Antibiotic cover.
Head up position.
No nose blowing please.
Plan for the surgery .
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How Should Nose Injury With Cuts, Bleeding, Swelling, Difficulty Breathing Be Treated?

Hi. Thanks for an elucidate history. This is a serious matter since you have a clear nasal discharge and this may indicate CSF Rhinorrhea. This is due to fracture of the nose and at the skull so possibly the brain fluid called CSF is now draining into the nose through a defect. I would advise you the following. Collect the clear fluid in a test tube to be sent for examination as to whether this is CF or not. Routine bloos and urine tests. MRI of the brain to see for the injusry and Cysternography to see for CSF rhinorrhea. CT scan of the facial skeleton and -D reconstruction to know the extent of the fractures, deformity and to plan for a surgery. Antibiotic cover. Head up position. No nose blowing please. Plan for the surgery .