SEPTAL HAEMATOMA special posting in surgery ENT.pptx

special posting in surgery ENT

1. SEPTAL HAEMATOMA DEFINITION : A collection of blood beneath the mucoperichondrium or mucoperiosteum of the septum CAUSES: 1. Trauma- Direct blows or falls on the nose especially in children. Blunt injuries – Boxers, sports, RTA, assault Iatrogenic –operation of the nose e.g SMR, septoplasty 2. Non- Traumatic Blood dyscrasias /bleeding/clotting disorders

2. CLINICAL FEATURES 1. Bilateral constant usually acute nasal obstruction following trauma 2. mouth breathing 3. pain 4. septum thickened and bulging to both sides completely obstructing the nasal cavity

3. INVESTIGATIONS 1. clotting profile Bleeding time, clotting, PT,PTTK 2. ESR 3. FBC 4. X-ray PNS

4. TREATMENT 1. simple aspiration may suffice using wide bore needle. It may have to be repeated 2. Incision and Drainage 3. Nasal packing to prevent re- accumulation 4. Antibiotics COMPLICATIONS Septal abscess and cartilage necrosis External deformity Permanent thickening of the septum – due to fibrosis