II. Definition

  1. Blood between septal cartilage and mucoperichondrium

III. Cause

IV. Signs

  1. Soft, fluctuant swelling of septum
  2. Bilateral is most common

V. Management: General

  1. Urgent referral to otolaryngology
  2. Drainage should be done as soon as possible
    1. Within hours of onset is preferred

VI. Management: Incision and Drainage

  1. Topical and local anesthetic
  2. Incision and Drainage
    1. Using a number 11 blade, make a small longitudinal incision into hematoma
    2. Apply pressure or suction to evacuate the hematoma
    3. Needle Aspiration may be performed as an alternative but risk of reaccumulation
  3. Bilateral Nasal Packing for several days
    1. Packing should contain anti-staphylococcal antibiotic
  4. Start prophylactic antibiotics
  5. Follow-up for recheck with ENT within 72 hours

VII. Complications

  1. Infected Septal Hematoma
  2. Saddle nose deformity
    1. Results from infection and septal cartilage necrosis

VIII. References

  1. Wu in Majoewsky (2012) EM:Rap 12(11): 10
  2. Kucik (2004) Am Fam Physician 70(7):1315-20 [PubMed]

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Ontology: Nasal septal hematoma (C0339842)

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