How To Treat A Septual Nasal Cavity Hematoma

The nose is a complex series of honeycombed chambers that allows air to be filtered before returning to the lungs. To supply these chambers there are many tiny blood vessels, however, if one of these gets ruptured it can cause a hematoma to grow which may need to get drained to heal up properly.

Let's start by defining the Septum. The Septum is the part of the nose that separates the two nostrils and is made up of cartilage. The rest of the nose is a complex series of honeycombed chambers that filter the air before it gets back into the lungs. These chambers are supplied fresh blood and oxygen from many tiny blood vessels. Now that you have some basic understanding of how the nose works we'll need to define what a hematoma is.

A hematoma is a collection of blood or clotted blood that has leaked out from the blood vessel and made its way into the surrounding tissue creating pressure, pain, and bruising. The escaped blood will start off as fluid but over time it will become hard if it is not treated.

Now that we have defined the septum and hematoma we can therefore deduce that a septual hematoma is a collection of blood or clot that has formed in the space between the nostrils, the septum. You may find that bad cases of hematoma can extend up into the honeycombed chambers but you should seek medical advice well before that happens.

What causes a septual hematoma?

The most common cause is head trauma causing a fracture to the nasal cavity or causing the cartilage to break and in doing so shearing the blood vessels allowing blood to escape into the tissue.

A lot of contact sports such as hockey, football and martial arts will list this as a common injury to it's participants. Wherever possible you should take the appropriate methods to prevent facial injuries.

Another common way of getting a septual hematoma is through vehicle accidents. Quite often if you are not wearing a seat belt or if you're in the back you'll find that your face will smash into something before you can reflexively extend your arms to protect your face. In most cases you'll either go through the windscreen or hit the front passengers head rest/seat; another reason to wear your safety belt.

Quite often these types of facial injuries will involve a broken nose so the symptoms will be very straight forwards and normally very bloody. Here are the main symptoms that you should be looking out for:

• Difficulty breathing
• Painful area
• Swelling
• Bruising
• Congestion

And occasionally

• Vomiting
• Nausea
• Fainting
• Headache

If you or someone you've come across has any of these symptoms then seek out medical attention immediately.

It is very important to get any facial or nasal trauma checked out by a doctor as they will need to check for any internal bleeding or clotting and to assess the right course of treatment for your condition.

If you have developed a septual hematoma it will need to be drained. Depending on the size of the swelling or clot will depend on which procedure your doctor will use. If caught quickly it can be drained by making a small incision and allowing the blood to flow out. If left to develop then a draining mechanism may need to be inserted to fully remove the blood from the area.

After the drain has been successful the doctor will the pack your nasal cavity with gauze and to start you on a series of oral antibiotics to fight off any infection. You will need to have a return trip in a few days (timescales dependent on your own healing) to have the gauze removed and to check the healing process.

As you can see by the video that bruising can be quite an issue. I've found that applying topical Arnica to the area helps to speed up the process. However, there are lots of other treatments available to you.

In the video you will also see the aftermath of an accident, if this has happened to you, you may find that you have some scarring too. If you are worried about scarring then there are plenty of over-the-counter medications designed to reduce scarring as you are healing but the best advise can be given by your health care provider.

If the hematoma is left to grow thinking that it will just go away on its own then you can run into some serious trouble. Because the septum's natural blood supply is cut off due to the swelling the cartilage between the two nostrils can die (called necrosis) leading to what is known as saddle nose.

Other complications include

• Fever
• Abscess
• Infection
• Nasal congestion

However, if treated immediately after the injury occurs the nose will heal just fine as long as there are no other complications during or after treatment.

This is for informational use only and you should always see a doctor if you have suffered any type of injury.