Overview
Injuries to the nose are the most common form of facial trauma. Nasal septal haematomas are an important complication of nasal trauma that should be looked for, as they can lead to septal necrosis and subsequent deformity and infection.
Epidemiology
- Nasal trauma is more common in young men (15-30 years)
- In the elderly, nasal trauma often occurs secondary to falls
Presentation
The classic presentation is a patient complaining of a blocked nose after trauma to the nose with bilateral red swellings seen from the nasal septum:
- Palpation can distinguish this from a deviated septum. A normal nasal septum is firm, whereas nasal septal haematomas are boggy.
- The nose may be runny and painful
Management
All patients
- 1st-line: immediate referral to on-call ENT for surgical drainage + IV antibiotics
- Diagnosis is clinical
Complications
- Septal necrosis – can develop “saddle-shaped” nose deformity
- Infection and abscess formation
