Nasal Pain and Unilateral Congestion After Injury

Nasal bridge pain and unilateral nasal congestion?

Hello, doctor.
Five days ago, I hit my nose.
At the time, there was no nosebleed, but the pain has become increasingly noticeable over the past few days.
It hurts when I press on it, and I have started experiencing unilateral nasal congestion, although there are no obvious bruising or swelling.
I would like to know if it is possible that I have a nasal bone fracture or if the impact could have caused a deviation of the nasal septum, leading to unilateral nasal congestion.
Additionally, I have had a recurrence of sinusitis recently and have been receiving treatment at an ENT clinic, so I have been taking medication for sinusitis (antibiotics, etc.) these past few days.
Could my symptoms of "nasal bridge pain and unilateral nasal congestion" be caused by "sinusitis" or by the impact to my nose? Do I need to go to the hospital for X-rays and nasal endoscopy, or can we rule out the possibility of a nasal fracture or nasal septum deviation?

Yun, 20~29 year old female. Ask Date: 2022/02/26

Dr. Zheng Jueyi reply Otolaryngology

Hello, sinusitis and trauma can both cause pain in the nasal bridge or unilateral nasal congestion.
If there is no significant improvement after medication treatment, it is recommended to return for a follow-up examination or to go to the hospital for further evaluation.
Wishing you safety and health.
Sincerely, Dr.
Cheng Jue-Yi, Director of the Department of Otolaryngology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2022/02/26

More Info

In your case, the symptoms you are experiencing—nasal pain, unilateral congestion, and the history of a recent nasal injury—could indeed be indicative of several underlying conditions, including a nasal fracture, nasal septum deviation, or exacerbation of sinusitis.
When you sustained the injury to your nose, even if there was no immediate bleeding, it is possible that the impact caused a fracture or a deviation in the nasal septum, which could lead to the symptoms you are describing. A nasal fracture may not always present with visible bruising or swelling, especially if the injury is minor. The pain you are experiencing, particularly when pressing on the area, suggests that there may be some underlying trauma to the nasal structures.
Unilateral nasal congestion can occur due to several reasons. In the context of your injury, it could be due to swelling of the nasal tissues or a deviation of the nasal septum, which can obstruct airflow on one side. Additionally, if you have a history of sinusitis, it is possible that the injury has exacerbated this condition, leading to increased inflammation and blockage in the sinus cavities.
Given your ongoing symptoms and the recent history of nasal trauma, it is advisable to seek further evaluation. An X-ray of the nasal bones can help determine if there is a fracture present. However, a CT scan is often more sensitive and can provide a clearer picture of both bony structures and soft tissue involvement, including the sinuses.
Nasal endoscopy may also be beneficial, as it allows for direct visualization of the nasal passages and can help identify any structural abnormalities, such as a deviated septum or polyps, that may be contributing to your symptoms.
In terms of treatment, if your symptoms are indeed related to a nasal fracture or septal deviation, management may involve supportive care, such as pain relief and possibly nasal decongestants. If there is significant deviation or obstruction, surgical intervention may be necessary to correct the issue.
It is also important to continue monitoring your sinus symptoms. If you are currently on antibiotics for sinusitis, ensure that you complete the course as prescribed. If your symptoms do not improve or worsen, follow up with your ENT specialist for further assessment and management.

In summary, your symptoms could be due to a combination of factors related to your recent nasal injury and pre-existing sinus issues. It is crucial to have a thorough evaluation to rule out any significant injuries and to determine the appropriate course of treatment.

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