The need for septal control to exclude septal hematoma after nasal skeletal fracture

Introduction:

Due to its exposed position, the nose is predisposed to injuries and the fractures of the nasal skeleton (FNS) is the most common fracture in the cranial region. One of the dreaded complications of FNS is the septal hematoma (SH).

Therefore, in our clinic, 24 hours after the first contact between the patient and the doctor, another check of the nasal septum, to exclude an SH, is carried out.

This leads to an increased workload for the treating physicians and a lack of patient compliance. That's why we wondered if this control was really needed.

Method:

In the period from 01.10.2016 – 01.10.2017, 63 patients presented to our clinic who had the diagnosis of an isolated FNS. In this abstract patients were included, who presented themselves, after the first contact with the doctor, for control. These controls were not all after 24h. However, it can be assumed that in the interval up to the control no SH could have occurred, which was then already regressive in the case of a delayed contact.

Results:

24 patients from the above 63, appeared to the control. 17 of these patients received imaging confirming the fracture. All patients received a nasal framework posture. None of the patients had a SH during first contact or during the control. One patient developed a SH 4 days after the event, despite checking after 24 hours.

Conclusion:

Clinical control of the septum after isolated fracture of the nasal Skeleton is probably not indicated in our view.

Publication History

Publication Date:
18 April 2018 (online)