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Septal hematoma

A septal hematoma is collection of blood within the septum. The septum is the part of the nose between the two nostrils. An injury disrupts the blood vessels so that fluid and blood may collect under the lining.

Causes

A septal hematoma can be caused by:

  • A broken nose
  • Injury to the soft tissue of the area
  • Surgery

The problem is more common in children because their septums are thicker and have a more flexible lining.

Symptoms

  • Blockage in breathing
  • Nasal congestion
  • Painful swelling of the nasal septum
  • Change in the shape of the nose

Exams and Tests

Your health care provider will look into your nose to see if there is swelling of the tissue between the nostrils. The health care provider will touch the area with an applicator or a cotton swab. If there is a hematoma, The area will be soft and able to be pressed down. The nasal septum is normally thin and rigid.

Treatment

Your health care provider will make a small cut to drain the blood. Gauze or cotton will be placed inside the nose after the blood is removed.

Outlook (Prognosis)

You should heal fully if the injury is treated quickly.

Possible Complications

If you have had the hematoma for a long time, it may become infected and will be painful. You may develop a septal abscess and fever.

An untreated septal hematoma may lead to a hole in the area separating the two nostrils. This can cause nasal congestion. Or, the area may collapse, leading to a deformity called a saddle nose.

When to Contact a Medical Professional

Call your health care provider for any nasal injury resulting in nasal congestion or pain. You may be referred to an ear, nose, and throat (ENT) specialist.

Prevention

Recognizing and treating the problem early can prevent complications and allow the septum to heal.

References

Chegar BE, Tatum SA III. Nasal fractures. In: Flint PW, Haughey BH, Lund LJ, et al, eds. Cummings Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, PA: Mosby Elsevier; 2010:chap 35.

Krakovitz PR, Koltai PJ. Pediatric facial fractures. In: Flint PW, Haughey BH, Lund LJ, et al, eds. Cummings Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, PA: Mosby Elsevier; 2010:chap 189.

Haddad J Jr. Acquired disorders of the nose. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 369.

Updated: 8/12/2013

Ashutosh Kacker, MD, BS, Associate Professor of Otolaryngology, Weill Cornell Medical College, and Associate Attending Otolaryngologist, New York-Presbyterian Hospital, New York, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team


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