Nasal septal hematoma


Nasal septal hematoma is a condition affecting the nasal septum. It can be associated with trauma.
Because the septal cartilage has no blood supply of its own and receives all of its nutrients and oxygen from the perichondrium, an untreated septal hematoma may lead to destruction of the septum. Immediate drainage is necessary. Failure to recognize septal hematomas, or treat in a timely fashion, can cause a saddle nose deformity.
This condition appears more in children because of the septum is thicker and the lining is more flexible.

Causes

Some causes of nasal septal hematoma include: broken nose, medication, surgery or injury to the soft tissue area.

Symptoms

Symptoms include: blockage in breathing, change in nose shape, painful swelling of nasal septum and nasal congestion.

Diagnosis

Diagnosis can be made by a physical exam with the use of a nasal speculum or otoscope. Sometimes palpatation is used to diagnose the hematoma.

Treatment

To treat a septal hematoma it is incised and drained to prevent avascular necrosis of the septal hyaline cartilage which depends on diffusion of nutrients from its attached nasal mucosa. Small hematomas can be aspirated with a wide-bore needle. Large hematomas are drained by an incision parallel to nasal floor. Systemic antibiotics are given after the incision and drainage to prevent local infection.