Dear Dr. Roach: I walked into a glass wall and hurt my nose. It swelled up immediately and later developed bruising. My friend told me to ice it, but that an emergency room visit wasn’t necessary. Now I’m wondering if I should have gone. What’s the right thing to do when you think you might have broken your nose? — A.T.G.
Answer: Moderate to severe facial trauma may have other injuries besides the nose, so an evaluation is appropriate, especially if there is also trauma to the cheekbones or eye. It is likely you did fracture your nose. Bruising is highly suggestive. If the bruising involves the septum — the inside part between the nostrils — then that may need to be drained to prevent damage.
X-rays are not usually necessary with a simple fracture of the nose. Also, the immediate swelling makes an evaluation of the cosmetic consequences of the fracture unreliable. A visit with an ENT doctor several days after the trauma is reasonable.