The nose, because of its projection from the face, is exposed to traumas, especially in children. These injuries have a very rich aetiology, which depends on the mobility and the developmental stage of the child. The rapid development in social life and the chance of practising more and more sports has given rise to a growing number of injuries of this region of the bony face in children. The possibility of permanent deformation of the nasal bones if untreated makes it important to think seriously about nasal injuries in children. The aim of our work was an analysis of the circumstances and consequences surrounding nasal trauma in children. We analysed the frequency of nasal injuries by age of child, the most common causes of nose injuries in children, the primary consequences of nasal injuries, accessibility of ENT help, and the nature of first treatment needed by for affected children with nasal injuries.

We examined 70 children with nasal trauma, 45 males (64%) and 25 (36%) females, aged from 6 months to 11 years, admitted to the laryngological emergency service in our hospital. All patients were examined laryngologically and paediatrically. In reasonable cases we made an X – ray examination.

Patients were divided by age into three groups:

1^st group 6 months – 3 years

2^nd group 4 years – 6 years

3^rd group 7 years – 11 years

The mean age was 6 years.

Nose injuries were most frequent in the 7 to 11 year – old group – 34 (49%) children. In 13% of patients it wasn´t the first nose injury.

The most common cause of nasal injury in the first group was a fall during crawling on all fours or playing (77% of children in this group). In the 2^nd group nasal traumas occurred in 43% of children during playing with other children. In the 3^rd group accidents at school were the most common cause of nasal trauma (47% of children).

The most common direct cause of nasal trauma in the total number of children was hitting by another child during play or sport activities – 15 (21%) children.

The most common place for the accident to occur was at school – 25 (36%) cases, with 20 (29%) taking place at home and 15 (21%) in the playground.

In 51 patients (73%) bleeding from the nose immediately after an accident was present, but nasal packing was necessary in any case. Oedema of the soft tissue and lividity of the nasal region was present in 61 cases (87%). Deformation of the nasal skeleton was present in 15 cases (21%). Lividity of the lateral wall of the nose was present in 7 children (10%). Abscess of the nasal septum had developed in 1 case.

Nine children (13%) complained of difficulty in breathing through the nose after the nasal injury.

Access to the emergency department was estimated – during the first twenty – four hours after having suffered injury 74% of patients came to the ENT doctor, the remainder 26% coming on the second day or later.

Laryngological care was in the emergency service department, with examination every second day. On the 6^th-7^th day it was possible to decide on the setting of nasal bones. In 11% of cases oral antibiotic therapy was started because of lividity of the lateral nasal wall. A closed reduction of nasal fracture was performed in 14 children (20%). In this, 5 children didn´t have an earlier X-ray examination, as the nasal fracture was recognized by being palpable, and in 5 cases a palpable fracture was confirmed by X-ray examination. In another 4 cases X-ray examination did not confirm nasal fracture, although it was assumed on palpation.

The most frequent cause of nasal injury in children was hitting by another child during playing and sport activities at school. These injuries most often occurred in boys of early school age (7-11 years). Bleeding from the nose and oedema of the nasal region was present in most cases of nasal injuries (over 70% of patients). Most patients came to the ENT doctor in the first twenty – four hours after an accident. Restricted usefulness of X-ray examination in diagnosis of nasal trauma was demonstrated: in 28% of cases a detection of the fracture by X-ray examination was not possible, although it was possible by palpation. In 36% of cases a closed reduction of the nasal bones was done without an X-ray examination.