Septal hematoma


Introduction to septal hematoma

Nasal septum hematoma refers to hemorrhage under the subchondral or subperiosteal on one or both sides of the nasal septum. Spontaneous hematoma is rare. If the blood is infected, it becomes a septum abscess. Hemorrhage in the subperitoneal or subperiosteal of the nasal septum is mostly bilateral. Often due to nasal trauma, fractures in the septum, rupture of the blood vessels and the formation of mucosa without bleeding; nasal septum submucosal resection can also be complicated.

basic knowledge

The proportion of illness: 0.02%

Susceptible people: no special people

Mode of infection: non-infectious

Complications: abscess


Causes of septal hematoma

Nasal trauma (30%):

Nasal trauma such as head and face injury or fall when nasal bone fracture or nasal septal fracture dislocation, blood vessels are broken and the mucosa is not broken, forming a hematoma, submucosal resection of the nasal septum can also be complicated by hematoma.

Surgical factors (10%):

Nasal septum hematoma can be caused by poor hemostasis during nasal septum surgery or postoperative sneezing. If the nasal septum hematoma is not treated in time and infection occurs, it can continue to develop abscess.

Hemorrhagic disease (10%):

Hemorrhagic diseases such as blood diseases, hemophilia, purpura, etc., may also occur in the septum.


Nasal septum prevention

1, no special precautions, only pay attention to trauma.

2. Remove the stuffing 24 to 48 hours after the operation.

3. Adjust daily life and workload, and regularly carry out activities and exercise to avoid fatigue. 4. Keep your mood steady and avoid emotional excitement and tension. 5. Keep the stool smooth, avoid using stools, eat more fruits and high-fiber foods.


Nasal septal hematoma complications Complications

The septal hematoma was not treated in time, and an infection became an abscess.


Symptoms of nasal septum hematoma Common symptoms Turbinate swelling nasal congestion with bloody pus

1, the nasal septum is a semi-circular bulge, the mucosa color is as usual or slightly red, the touch is elastic, the puncture can extract blood, the hematoma can be caused by infection, the nasal septum abscess, local redness and pain, the nose tip is obvious, the nasal puncture can draw the pus Liquid, after the formation of abscess can have chills, fever and other systemic and local acute inflammation.

2, hematoma is mostly bilateral, so the performance of bilateral nasal congestion, nasal drops after ephedrine still does not reduce, the frontal headache, the nose has a sense of oppression, touch soft.


Examination of nasal septum hematoma

Nasal endoscopy: It is not difficult to make a diagnosis based on clinical manifestations and signs. If the hematoma is located in the posterior part, and the anterior mucosa is swollen, or there is a clot, it is often difficult to find a hematoma. At this time, nasal secretions or clots should be removed. Carefully examine the posterior portion of the septum using a nasal endoscope.

Local examination: The hematoma is mostly bilateral, so it shows bilateral nasal congestion. After the intranasal drip with ephedrine, it still does not relieve. The frontal part of the headache, the nasal bridge has a sense of pressure, and the touch is soft.


Diagnosis and differentiation of septal hematoma


The nasal septum has a semi-circular bulge, the mucosa is as usual or slightly red, and the touch is elastic. The puncture can extract blood. Hematoma can be caused by infection of the nasal septum abscess, local redness and pain, nose tenderness is obvious, nasal puncture can extract pus. After the formation of abscess, there may be systemic and local acute inflammation manifestations such as chills and fever.

Differential diagnosis:

Nasal septum should be differentiated from nasal septum abscess, nasal septum deviation, and nasal septum mucosa hypertrophy.

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