II. Definition
- Blood between septal cartilage and mucoperichondrium
III. Cause
- Nasal Trauma
- Nasal Fracture
IV. Signs
- Soft, fluctuant swelling of septum
- Bilateral is most common
V. Management: General
- Urgent referral to otolaryngology
- Drainage should be done as soon as possible
- Within hours of onset is preferred
VI. Management: Incision and Drainage
- Topical and local anesthetic
-
Incision and Drainage
- Using a number 11 blade, make a small longitudinal incision into hematoma
- Apply pressure or suction to evacuate the hematoma
- Needle Aspiration may be performed as an alternative but risk of reaccumulation
- Bilateral Nasal Packing for several days
- Packing should contain anti-staphylococcal antibiotic
- Start prophylactic antibiotics
- Follow-up for recheck with ENT within 72 hours
VII. Complications
- Infected Septal Hematoma
- Saddle nose deformity
- Results from infection and septal cartilage necrosis
VIII. References
- Wu in Majoewsky (2012) EM:Rap 12(11): 10
- Kucik (2004) Am Fam Physician 70(7):1315-20 [PubMed]
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| Concepts | Disease or Syndrome (T047) |
| SnomedCT | 232377002 |
| English | nasal septal hematoma, hematoma septal nasal, Nasal septal haematoma, Nasal septal hematoma, Nasal septal hematoma (disorder) |
| Spanish | hematoma del tabique nasal (trastorno), hematoma del tabique nasal |
