Causes of pathology
The causes of the pathological process are:
- Vascular injury due to septum surgery (septoplasty). At the postoperative stage, blood from the vessels affected during the surgical intervention accumulates under the mucous membrane from one or both sides.
- Nose contusions.
- Fractures of the nose.
Development mechanism
Hematoma of the nasal septum can be observed in both an adult and a child. There are two forms of pathology: unilateral and bilateral.
The first is characterized by unilateral accumulation of blood and a mild course of the pathological process. It is also easier to treat. The bilateral form involves the accumulation of blood on both sides and often transforms into an abscess.
In many situations, the bruise only covers the cartilaginous part of the septum. In the presence of a unilateral nasal hematoma, breathing will not undergo changes. The painful syndrome will be mild or absent altogether. Directly because of this, many patients are late in discovering the disease.... At this time, the hematoma begins to fester and transforms into an abscess, which is dangerous due to the curvature of the nasal septum and complications inside the cranium.
Clinical picture
Symptoms often depend on how badly the septum is damaged. In certain situations, at the stage of bruising, any signs are not observed or they are distorted. The most common ones are:
- Difficulty unilateral or bilateral breathing;
- painful sensations;
- deterioration of smell;
- increased temperature (observed during suppuration and abscess formation);
- with an abscess with the spread of the inflammatory process to the cartilage, the curvature of the external nose is likely.
Complications
The adverse consequences of this pathological process are often manifested in connection with untimely therapy or infection. The most common complications are:
- nose bleed;
- suppuration and abscess;
- purulent consequences of an abscess: an inflammatory process in the soft tissues of the face, the eye socket (leads to the formation of abscesses), inside the cranium. In addition, sometimes there is thrombosis of the cavernous sinus, which is accompanied by intense pain in the head, convulsive and coma and other disorders of the central nervous system;
- curvature of the outer nose;
- perforation of the nasal septum.
Diagnostics
To identify pathology, the following diagnostic methods are used:
- Physical examination. In the process of performing anterior rhinoscopy, a unilateral or bilateral thickening of the reddish nasal septum is determined. The nasal cavity in such situations is poorly or completely inaccessible for examination. Sometimes a bulge is found during lifting of the tip of the nose.
- Clinical research. When diagnosing peripheral blood in patients with an abscess of the nasal septum, neutrophilic leukocytosis is found.
- Instrumental diagnostics. Sometimes, in order to detect a hematoma, it is required to remove blood from the nasal cavity by means of an electric aspirator and use a bulbous probe when probing the protrusion.
- Indications for consultation of narrow-profile doctors. The complex course of the pathological process, the presence of pathogenetically interrelated diseases in the patient, which require appropriate therapy (diabetes mellitus), is considered an indication for consulting specialized doctors.
Comprehensive and thorough diagnostics allows you to choose the appropriate therapy for pathology.
Treatment activities
Treatment is carried out on an outpatient or inpatient basis. It depends on the patient's well-being and the intensity of the hemorrhage. Therapeutic measures involve:
- Aspiration of blood. The hematoma cavity is subject to puncture, then aspiration is carried out with a syringe. It is used for mild pathology.
- Drainage. It is used if the puncture is ineffective. Surgery is performed under local anesthesia. To remove a blood clot, an incision is made in the mucous membrane over the hematoma. Then the caked blood is pumped out and drainage is installed into the formed cavity.
- Antibacterial treatment. Used only for surgical therapy. The drugs of choice in this case are antimicrobial agents of the 2-3 generation cephalosporin subgroup and aminopenicillins. In many situations, they are used in a course of up to one week.
After removing the clotted blood and treating the affected area with antibiotics, special tubes are installed and tamponation is performed. Subsequent therapy involves the injection of broad-spectrum antimicrobial agents.
They are used in accordance with the scheme throughout the week. Means from the subgroup of cephalosporins are effective against various pathogenic microorganisms, which often cause the appearance of pathology.
Remedies for bruising and swelling
Even after the removal of the internal hematoma, traces of trauma will remain on the face. The swelling will remain, there will be bruising, often extending to the area under the eyes. The drugs that can eliminate the bruise include creams and gels, which are highly effective. Therapy begins with medications of light consistency, since they are quickly absorbed.
The use of external products should be started as soon as possible. An exception may be heparin ointment, it is used only on the second day. The drugs are applied to the bruise four to five times a day. Creams and gels are used only in a situation where there are no scratches, abrasions and other minor injuries on the skin.
Medicines
It is possible to eliminate the manifestations of pathology by means of medications, which include troxerutin and heparin. They are classified as a subgroup of anticoagulants that thin the blood. The most common drugs are:
- troxevasin;
- troxerutin;
- heparin ointment;
- hepatrombin.
In order to eliminate the bruise, medicines containing vitamin K are also used. It helps to improve the penetration of active elements into the cells of the skin, and normalizes blood coagulation.
Folk remedies
Folk remedies for getting rid of bruises should have a good absorbing effect. They are considered an additional element to traditional therapy, and their use requires prior agreement with a specialist. Arnica and comfrey are natural remedies for reducing unpleasant symptoms. Leech extract is often included in the composition of medicines that are intended for the treatment of hematoma.
Often, in order to eliminate the pathological process, a badyag is used. This freshwater alga has a beneficial effect on the affected area and gives a positive result in the shortest possible time.There are a large number of different pharmacy products, which are based on badyaga.
It is possible to make a compress based on it on your own at home. It is necessary to purchase dried plant raw materials. The powdery mass is diluted with hot water, 1 hour of algae is taken for 2 hours of liquid.
Forecast and prevention
One of the main preventive measures is the prevention of nose injuries. If such a nuisance occurs, then it is required to fulfill the following prescriptions as soon as possible:
- after a blow, bruise or fracture, you should immediately consult a specialist;
- on the way to the hospital, ice is required near the nose (it helps to curb the formation of hematoma);
- it is necessary to ensure that during transportation the patient is in a semi-sitting position.
Timely therapy of diseases of the upper respiratory tract is of great importance in preventing adverse consequences.
Prevention plays a key role for patients at risk. These include:
- children;
- patients with diabetes mellitus;
- people with arterial hypertension.
If there is any injury to the nose, they need to find out the advice of a doctor. If surgery is performed on time, the opening of the hematoma and the elimination of clotted blood or pus, then the prognosis will be positive. When a secondary infection is added or a nasal abscess is formed, involvement of the quadrangular cartilage is not excluded. As a result, the outer nose is deformed. If suppuration spreads further against the background of other diseases, then the prognosis will depend on the effectiveness of therapy.
