There was no significant difference between the two groups in tip cellulitis, and no patient in either group experienced a septal hematoma.
The traditional rationale for routine nasal packing following septal surgery is that it results in good flap apposition and minimizes the risks of postoperative bleeding, septal hematoma, and adhesion formation.
A diagnosis of nasal septal hematoma and abscess was made, and the patient was taken urgently to the operating room for surgery.
Even minor trauma may injure the nasal septum, which can lead to the development of a nasal septal hematoma or nasal septal abscess, defined as a collection of pus between the cartilaginous or bony nasal septum and its normally coapted mucoperichondrium or mucoperiosteum.
The classic NSA results from infection of a septal hematoma
following nasal trauma.
The once-common practice of packing the nose after septoplasty was based on a desire to prevent postoperative complications such as bleeding, septal hematoma, and adhesion formation.
This practice was based on the assumption that packing would result in good flap apposition and minimize the risk of complications such as bleeding, septal hematoma, and adhesion formation, although there were no published studies at the time to support these assumptions.
Prior to treatment, six patients developed a septal hematoma and one developed an abscess of the nasal septum; all seven of these patients underwent incision, drainage, and treatment with oral antibiotics.
Three of these patients had a fracture of the nasal septum and two had a septal hematoma.
I have done hundreds of them with one complication of a septal hematoma
in a teenager requiring septoplasty for drainage.
A septal hematoma can occur after nasal trauma if the force of the trauma ruptures the blood vessels that supply the septal perichondrium.
Early diagnosis and treatment are key to avoiding the dire complications of a septal hematoma.