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Septal haematoma

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Nasal septal haematoma

  • is a blood-filled cavity between the cartilage and the supporting perichondrium (1)
  • it is a condition with similarities to the subchondral haematoma seen in ear injuries - and in fact may have similar clinical consequences.
  • it occurs when there has been a shearing injury causing the perichondrium to be stripped from the underlying cartilage. Unless corrected, necrosis results as the cartilage is dependent upon the perichondrium for its blood supply, by diffusion.
  • treatment
    • urgent drainage and firm nasal packing to ensure adherence of the perichondrium to the cartilage.
    • it should be aspirated immediately or can be incised with the aid of local anesthesia (1)
    • antibiotics are recommended.
  • complications of a neglected haematoma include:
    • septal abscess - causing accelerated cartilage necrosis, and possibly, intracranial sepsis
    • collapse of the nasal bridge - from septal fibrosis; also known as saddle nose

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