Nasalseptumhematom

Nasalseptumhematom, or nasal septal hematoma, is a collection of blood within the cartilaginous nasal septum, between the septal cartilage and its mucoperichondrial covering. It typically follows nasal trauma, such as a blow to the nose, and may accompany a nasal fracture. The accumulating blood separates the perichondrium from the cartilage, impairing blood supply and raising the risk of cartilage necrosis and subsequent saddle nose deformity if not treated.

Clinical features include nasal obstruction, localized tenderness, swelling of the septum, and sometimes a fluctuating or bluish lump seen inside the nostril. Nosebleeds and fever may occur in some cases. The condition is often diagnosed on physical examination and via nasal endoscopy; imaging is reserved for suspected fractures or complications.

Management is urgent and aims to drain the hematoma and prevent reaccumulation. The standard treatment involves incision and drainage of the collection under local or general anesthesia, removal of clotted blood, and placement of nasal packing or a drain. Antibiotics are commonly prescribed to reduce infection risk. The underlying injury, such as a septal fracture, is addressed as needed, and careful follow-up is essential to monitor healing and recurrence.

Complications from delayed or inadequate treatment include septal abscess, continued cartilage necrosis, perforation of the septum, and long-term saddle nose deformity. With prompt recognition and management, the prognosis is generally favorable. Prevention focuses on prompt evaluation after nasal trauma and protective measures to reduce recurrent injury.