Old Nose Injury and Breathing Problems

A football to the face. A bicycle accident. A fall during childhood. Perhaps even some rough play that ended with a hit in the nose.

Once the pain, bruising and swelling went away, you may not have thought about it again. However, an old nose injury can sometimes permanently change the nose, even when everything looks normal from the outside.

Years later, you may notice that one side of your nose always feels blocked, you breathe through your mouth while sleeping or you struggle to get enough air through your nose during exercise. Not every injury causes a lasting problem. However, when nasal blockage continues long after the injury has healed, it may be worth taking a closer look.

How Do Nose Injuries Happen?

The nose occupies a central location of the face, and is therefore easily injured during everyday activities.

Common causes include:

• Football, basketball and other ball sports
• Martial arts and contact sports
• Cycling or scooter accidents
• Falls at home or on the playground
• Fights or rough play among children
• Motor vehicle accidents
• An accidental blow to the face

A significant hit to the nose may injure the nasal bones or the cartilage inside it. Some fractures are obvious, especially if the nose looks crooked or there is heavy bruising. Others may be less noticeable while the area is just swollen.

Even after the swelling disappears, the bones or cartilage may not return to their original position. A nasal fracture can sometimes shift the wall between the nostrils and narrow one or both nasal passages.

Can an Old Nose Injury Cause Problems Years Later?

The effects of an old injury may not always be recognised at the time. You may have become used to breathing through one side of your nose or assumed that your blocked nose was caused by allergies, frequent colds or sinus problems. In other cases, a structural narrowing may become more noticeable when the tissues inside the nose are swollen because of an allergy or infection.

Possible nose injury symptoms that may continue or become noticeable later include:

• One nostril consistently feeling more blocked than the other
• Difficulty breathing through the nose
• Mouth breathing, especially during sleep
• Snoring or noisy breathing at night
• A reduced sense of smell
• Repeated sinus infections
• A visibly crooked nose together with breathing difficulties

A persistent blockage on one side is a common feature of a deviated septum, although other conditions can cause similar symptoms.

Snoring, headaches and poor sleep can have many possible causes. They should not automatically be blamed on an old injury, but ongoing nasal blockage may be one factor worth assessing.

Is It an Old Injury or Just Allergies?

Allergies are a common cause of a blocked nose. They may also cause:

• Sneezing
• A runny nose
• An itchy nose or eyes
• Symptoms that change with the weather, environment or exposure to dust
• Blockage that moves between the two sides of the nose

A structural problem may be more likely when one nostril is consistently more blocked, particularly if the problem began after a hit to the nose.

However, it does not always have to be one or the other. An old injury and allergies can occur together. For example, a narrow nasal passage may already restrict airflow, while swelling caused by allergies makes the blockage feel worse.

Other possible causes of persistent nasal congestion include sinus infections, nasal polyps and swelling of the tissues inside the nose.

Can an Old Injury Be Causing Nasal Obstruction?

Nasal obstruction means that airflow through one or both sides of the nose is restricted. After a nose injury, blockage may be caused by changes to several structures, including:

• The nasal septum
• The nasal bones
• The cartilage supporting the nose
• The nasal valve, which is the narrowest part of the nasal airway

One possible cause is a deviated septum. The nasal septum is the wall of bone and cartilage that separates the left and right nasal passages. If an injury shifts it to one side, one passage may become narrower and restrict airflow.

An injury may also weaken or change the cartilage around the nasal valve. In some people, the side of the nose may pull inwards when they breathe, particularly during exercise or when taking a deep breath.

Not every nasal obstruction following an injury is caused by a deviated septum. Allergies, swollen nasal tissues, sinus inflammation and nasal polyps may also contribute to the blockage.

When Should You See an ENT Specialist?

Consider arranging an assessment if you:

• Have ongoing nasal blockage following an earlier injury
• Consistently breathe better through one nostril
• Frequently breathe through your mouth
• Find it difficult to breathe through your nose during exercise
• Snore or regularly wake with a dry mouth
• Experience repeated nosebleeds or sinus infections
• Have a crooked-looking nose together with breathing difficulties
• Continue to have symptoms despite appropriate allergy treatment

Persistent blockage on only one side should also be assessed rather than assumed to be an allergy, particularly if it is worsening or accompanied by bleeding, facial swelling or changes in vision.

Does a Nasal Obstruction After an Injury Need Treatment?

Not every old nose injury requires treatment. If breathing is comfortable and there are no troublesome symptoms, treatment may not be necessary.

When allergies or swelling are contributing to the blockage, treatment may include saline rinses, antihistamines or a prescribed nasal spray. These treatments can reduce swelling but cannot correct changes to the bones or cartilage.

If persistent breathing difficulty is caused by structural changes involving the septum, nasal valve or supporting framework of the nose, surgical treatment may be discussed.

Septorhinoplasty may be considered when both the internal airway and the shape or support of the nose need correction.

Septorhinoplasty is surgery that corrects the septum inside the nose and reshapes or strengthens the outer nose. It is not required for every deviated septum or blocked nose.

The appropriate treatment depends on which structures are restricting airflow and how much the symptoms affect daily life.

Your Nose May Have Healed, but the Effects Can Remain

Not every hit to the nose causes lasting damage. However, an old injury may still be relevant if you have persistent nasal blockage, uneven airflow or difficulty breathing through your nose.

The injury may have affected the nasal septum, nasal valve, cartilage or supporting structure of the nose. Allergies and inflammation may also make an already narrow airway feel more blocked.

An ENT specialist can assess whether your symptoms are caused by allergies, inflammation, nasal valve collapse, an old injury such as a nasal fracture, or another structural problem inside the nose.

At Nobel ENT Centre, our specialist provides personalised assessment and treatment to help identify the cause of your breathing difficulties and discuss the options that may be suitable for you.

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