Septal hematoma

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Classification according to ICD-10
J34.8 Other specified diseases of the nose and sinuses
ICD-10 online (WHO version 2019)

A septal hematoma , nasal septal hematoma , or nasal septum hematoma is bleeding between the perichondrium and cartilage or between the periosteum and the bones of the nasal septum. There is a swelling of the nasal septum . Nasal breathing can come to a complete standstill due to the bulging of the septal mucosa. The septal hematoma is a relatively common complication of the nasal bone fracture (nasal bone fracture) and a rather rare complication after septoplasty . Nasal septal hematomas are more common in children than in adults.

Since the perichondrium, which supplies the cartilage through diffusion, is lifted off by the hematoma, the cartilage may no longer be adequately nourished. On the one hand, this can lead to the development of a septal necrosis and consequently to the development of a so-called saddle nose , and on the other hand, the risk of infection is increased. An infection of the Septumhämatoms leads to septum abscess , which hematogenous via the cribriform plate to the cavernous sinus spread and a dangerous sinus thrombosis as well as meningitis ( meningitis may result).

The septal hematoma is diagnosed by mirroring the nasal cavity ( rhinoscopy ). In the case of pronounced septal hematomas, treatment consists of surgical removal of the hematoma. With the help of a scalpel the mucous membrane of the nasal septum is incised ( incision ) and the hematoma is suctioned off. Drainage takes place through the insert of a silicone film strip . A firm nasal packing of both nostrils prevents a recurrence of the septal hematoma through compression . Antibiosis is indicated for septal abscesses.

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  • P. Nagel: Basics ear, nose and throat medicine . 1st edition. Urban & Fischer Verlag, 2005, ISBN 3-437-42176-X , p. 48.
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