The nose is divided into left and right nostrils by a wall of fibrous tissue and cartilage called the septum. The septum has a rich blood supply and can therefore bleed profusely when injured. A septal hematoma refers to a collection of blood within the septum due to blunt trauma. A hematoma or collection of blood may occur anywhere in the body. It generally gets absorbed on its own with time. A septal hematoma, however, needs to be drained by the doctor. If not drained, a septal hematoma can cause serious complications such as infections, nasal perforation (formation of holes in the nasal septum), abscess formation (collection of pus), and deformities of the nose (crooked or saddle-shaped nose).
Causes of a septal hematoma may include:
- Fracture involving the nose due to a blow
- Soft tissue injuries involving the nose, especially during sports
- Bleeding disorders
- Blood-thinning medications
- Surgeries involving the nose
What are the symptoms of a septal hematoma?
A septal hematoma may present with the following symptoms:
- Swelling between the two nostrils (involving the septum)
- Pain
- Difficulty in breathing
- Change in the size or shape of the nose
- Stuffiness or nasal congestion
- Fever (if there is associated infection)
How do you drain a septal hematoma?
A septal hematoma must be urgently drained to avoid the development of complications. The doctor will generally diagnose a septal hematoma based on the patient’s medical history and physical examination. They may order tests such as computed tomography (CT) scan or magnetic resonance imaging (MRI) in cases where the diagnosis is not confirmed by examination.
Drainage of a septal hematoma is done by the doctor under local anesthesia. In children and apprehensive adults, the doctor may use general anesthesia (the patient sleeps during the procedure) for draining a septal hematoma.
During the procedure:
- The patient lies on the bed/operating table with their face upward.
- The head end of the bed/operating table is slightly raised. This allows the blood and other secretions to drain out from the septum easily.
- The doctor cleans the nasal area with antiseptics.
- They administer local/general anesthesia.
- The doctor uses a thin needle (18-20 gauge) to drain a small hematoma.
- If the hematoma is large, the doctor gives a small incision (surgical cut) over the softest part of the hematoma.
- The doctor uses suction to remove the clots from the nasal septum.
- The septum is then irrigated with a saline solution using a thin tube called a catheter.
- A small tubular structure called a drain is placed in the opened hematoma site and secured with sutures (stitches).
- The doctor then packs the nose with a sterile bandage doused in antibiotic ointment to prevent the re-accumulation of the blood.
After the procedure:
- Antibiotics and pain medications are administered.
- The nasal packing is kept as such and removed only when there is no further drainage for at least 24 hours.
- The patient may be asked to keep the head end of the bed elevated while lying down.
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Common Medical Abbreviations & Terms
Doctors, pharmacists, and other health-care professionals use abbreviations, acronyms, and other terminology for instructions and information in regard to a patient's health condition, prescription drugs they are to take, or medical procedures that have been ordered. There is no approved this list of common medical abbreviations, acronyms, and terminology used by doctors and other health- care professionals. You can use this list of medical abbreviations and acronyms written by our doctors the next time you can't understand what is on your prescription package, blood test results, or medical procedure orders. Examples include:
- ANED: Alive no evidence of disease. The patient arrived in the ER alive with no evidence of disease.
- ARF: Acute renal (kidney) failure
- cap: Capsule.
- CPAP: Continuous positive airway pressure. A treatment for sleep apnea.
- DJD: Degenerative joint disease. Another term for osteoarthritis.
- DM: Diabetes mellitus. Type 1 and type 2 diabetes
- HA: Headache
- IBD: Inflammatory bowel disease. A name for two disorders of the gastrointestinal (BI) tract, Crohn's disease and ulcerative colitis
- JT: Joint
- N/V: Nausea or vomiting.
- p.o.: By mouth. From the Latin terminology per os.
- q.i.d.: Four times daily. As in taking a medicine four times daily.
- RA: Rheumatoid arthritis
- SOB: Shortness of breath.
- T: Temperature. Temperature is recorded as part of the physical examination. It is one of the "vital signs."
Deviated Septum
A deviate septum is a condition that may require surgery. With a deviated septum, the bone and cartilage that divide the nasal cavity of the nose in half (nasal septum) is significantly off-center or crooked. The causes of a deviated septum can be congenital, or develop after a trauma or injury to the nose. Symptoms of a deviated septum include nasal congestion, recurrent sinus infections, nosebleeds, headache, facial pain, postnasal drip, snoring, and loud breathing. A deviated septum can be relieved with medications and, if necessary, a surgery called septoplasty.
Hematoma
A hematoma is a collection of blood that is outside a blood vessel. There are different areas where hematomas occur including; inside the skull, on the scalp, ears, septum, bones, finger nails, toenails, and intra-abdominal.
How Long Does It Take for a Hematoma to Go Away?
A hematoma is not a bruise. Learn what causes a hematoma and what you can do to treat one. What is the difference between a contusion and a hematoma? See the differences and similarities between these two types of bruises.
Is a Hematoma Worse Than a Contusion?
A hematoma is very similar to a bruise, but when the blood vessels break, the blood gets stuck and pools in one place. No single hematoma is guaranteed to be worse than a contusion.
Nasal Irrigation
Clogged sinuses and congestion bothering you? Nasal irrigation can relieve sinus symptoms associated with colds and allergies. Learn how to do nasal irrigation with this visual guide from WebMD.Why Is a Hematoma Worse Than a Bruise?
A hematoma is like a bruise but more serious. A hematoma is worse than a bruise because it's usually a sign of an injury deeper in the skin.