Septal Haematoma

Aetiology
It is collection of blood under the perichondrium or
periosteum of the nasal septum . It often
results from nasal trauma or septal surgery. III bleeding
disorders, it may occur spontaneously.
Clinical Features
Bilateral nasal obstruction is the commonest presenting
symptom. This may be assoc iated with frontal headache
and a sense of pressure over the nasal bridge.
Examination reveals smooth rounded swelling of the
septum in both the nasal fossae. Palpation may show the
mass to be soft and fluctuant.
Treatment
Small haematomas can be aspirated with a wide bore
steriie needle. Large r haematomas are incised ai1d
drained by a small antero-posterior incision parallel to
the nasal floor. Excision of a small piece of mucosa from the
edge of incision gives better drainage. Following drainage,
nose is packed on both sides to prevent reaccumulation .
systemic antibiotics should be given to prevent septal abscess.
Complications
Septal haematoma, if not drained, may organise into
fibrous tissue leading to a permanently thickened septum.
If second::!ry infection supervenes, it results in septal
abscess with necrosis of cartilage and depression of
nasal dorsum.