A Swollen Nose – Nasal Septal Hematoma
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A nasal septal hematoma occurs when blood collects in the space between the septal cartilage and the overlying mucoperichondrium [1, 2]. It is classically bilateral and follows nasal trauma, although bleeding disorders, violent sneezing and anticoagulant drugs like aspirin and warfarin are also attributed to its development. The buckling force strips the perichondrium off the cartilage, tearing the submucosal blood vessels, resulting in a hematoma [1, 2]. If not drained immediately, the cartilage may undergo necrosis as it is deprived of its nutrition, leading to saddle nose deformity, supra tip collapse and columellar retraction. Undue delay in diagnosis and treatment can also lead to septal abscess, septal perforation and direct spread of infection to cavernous sinus via emissary veins . Hence, all patients with nasal trauma should be evaluated for septal hematoma, and immediate surgical drainage along with nasal packing for 2–3 d (to prevent recurrence) is warranted to avoid complications.
AC, PS and CAS were involved in the clinical care of the patient, literature review, and manuscript preparation. All authors read and approved the final manuscript. CAS is the guarantor for this article.
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This case image complies with the ethical standards outlined in the journal. It involved the medical management of a child as per society guidelines and was in accordance with the ethical standards of the institution. This case was not formal research involving Human participants and/or Animals.
Informed written consent was obtained from the child father for publication of the clinical image.
Conflict of Interest