Septal Hematoma Drainage
A septal hematoma is a collection of blood in the septum or area between the two nostrils. A hematoma is similar to a bruise or blood clot but if it’s not treated, it can damage the tissue and lead to infection.
An injury to the nose can break open the blood vessels in and around the septum. As the blood clots to end the bleeding, it forms a hematoma.Hematomas in most other areas of the body are normally reabsorbed over time. Septal hematomas tend not to heal on their own and need to be drained quickly in most cases.
Symptoms of hematoma
People who have been hit in the nose can develop a hematoma hours, days, or at times weeks after the injury occurred.
When the hematoma develops right after the injury, a person might mistakenly see their symptoms as being a result of the injury, not from the hematoma. For this reason, it is important for a person to seek medical care for any serious nose injury.
Anyone who has broken their nose can develop a nasal hematoma. It is vital that they check for the symptoms of a broken nose, including the following:
Bleeding following a blow to the nose.
Swelling around the nose.
Bleeding some hours after the initial injury.
Clear drainage from the nose.
Changes in the shape/size of the nose.
The major symptom of a septal hematoma is a blockage in the nose. The blockage can be on one side or both sides. It may be worse on one side depending on the place of the hematoma. There may be a visible, red mass inside the nostril, but the hematoma is not always visible.
Because a septal hematoma requires quick treatment, people having difficulty breathing, major swelling, a feeling of fullness or a blockage in the nose after an injury should seek out prompt medical care.
When a hematoma becomes infected, it can cause intense pain, fever, inflamed lymph nodes and heat near the nose. Tissue death can lead to deformity of the nose.
In newborn babies and very young children, who must breathe through the nose, a septal hematoma can cause intense pain. Parents should seek immediate medical care after any injury to a child’s nose. If a baby is crying and restless without a known cause, a septal hematoma is one possibility.
Causes of hematomas
Doctors are not sure why some people develop hematomas after a nose injury while others do not.
One factor is how a nose injury affects the mucous membranes. When blood vessels rupture but the mucous membranes do not, it allows blood to accumulate inside the mucous membranes, leading to a hematoma.
Risk factors of hematoma
A nasal hematoma may occur if someone has fractured their nose. Researchers have not identified any particular genetic or lifestyle risk factors for a septal hematoma. The main risk factor is simply an injury to the nose.
Causes of nose injury risk include:
Playing contact or fighting sports like football or boxing.
Being in a car accident.
A recent blow to the nose, such as in a fight or after a fall.
Recent surgery to the nose.
A break to the nose Top of Form Bottom of Form.
Prevention of hematoma
An individual can aim to reduce the risk of nose injuries by wearing the right protective equipment during sports and protecting the nose against blows.
People who have recently had a nose injury should seek prompt treatment. Proper care for a broken nose, specifically having the injury set if necessary, can prevent a hematoma.
If a hematoma has already formed or is forming, early medical care can drain the injury before it causes permanent damage.
Treatment of hematoma
Draining may be a recommended surgical procedure that can be done under local anesthetic.
Draining is a surgical procedure that, in most cases, can be done with a local anesthesia, this allows a person to stay awake during the drainage.
A doctor will cut into the nose to drain the blood and then may pack it with gauze to decrease bleeding and keep it stable.
In certain cases, the surgery might need to be done under general anesthesia, especially when dealing with babies and very young children.
Babies, who must breathe through their noses, may need extra care, including the placement of a tube to help them breathe while the hematoma heals.
If a septal hematoma is not treated, the treatment required later on becomes more complicated.
Infections are common when there is a delay in treatment, and they may need antibiotics, either in pill form or given intravenously or through a tube in a vein.
A doctor may also have to drain swelling surrounding the infection or take out damaged or dead tissue.
An untreated septal hematoma may cause the septum of the nose to collapse or to separate, leading to a deviated septum. This can make breathing difficult and cause chronic sinus problems.
Surgery can at times correct problems with the septum and may even improve the appearance of the nose. However, it is not always possible to return the nose to its original look.
When large pieces of tissue are distorted or dead, it may be possible to use a graft to replace cartilage or other parts. A graft is when a doctor replaces tissue, usually with tissue from anywhere on the person’s body.
After drainage of a septal hematoma, a person may experience pain and swelling. Ice packs and pain medications like ibuprofen may help. If the pain is intense or suddenly gets worse, they should consult their doctor.
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