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Nasal Septal Hematomas, Sports Medicine

Brandon M. Bockewitz, MD, CAQSM Reviewed 04/2019
 


BASICS

  • Nasal bone fractures are the third most common fracture in the human skeleton, 90% of which involve septal injury.

  • Nasal bone fractures are the most common facial bone fracture in sports injurie...

DIAGNOSIS

HISTORY

Trauma to the nose, most often an inferior blow, because the supportive structure of the lower 2/3 of the nose is composed entirely of cartilage 

PHYSICAL EXAM

  • Signs and symptoms:

    • Epista...

TREATMENT

Prompt intervention: 
  • Needle aspiration or sharp incision and drainage under local or general anesthesia followed by suction of the clot, if needed, and irrigation 1,2,3:

    • Mucosal incision shou...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Patients and parents should be instructed on signs and symptoms of nasal septal hematoma because formation may be delayed up to 14 days after the initial trauma 3...

REFERENCES

1
Menger DJ, Tabink I, Nolst Trenité GJ. Treatment of septal hematomas and abscesses in children. Facial Plast Surg.  2007;23(4):239–243.
2
Lopez MA, Liu JH, Hartley BE, et al. Septal hem...

ADDITIONAL READING

  • Kaufman BR, Heckler FR. Sports-related facial injuries. Clin Sports Med.  1997;16(3):543–562.

  • Puricelli MD, Zitsch RPIII. Septal hematoma following nasal trauma. J Emerg Med. &#...

CLINICAL PEARLS

  • Special populations: children 4[C]:

    • Increased incidence of septal hematoma secondary to highly cartilaginous nasal skeleton

    • Minor trauma can lead to hematoma formation, even without sign...

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