Place the patient on broad-spectrum antibiotic therapy. If no recurrence of hematoma is seen, remove the drain and repack the nasal passage for final removal 24 hours later. Antibiotics may be stopped when the packing is discontinued. Bilateral hematomas are handled in a similar manner, but ensure that the incisions are staggered over the septum so that no cartilage is underperfused on both sides. Palpate dorsum of nose for deformity, instability, crepitus, and tenderness after any blunt injury causing bleeding from the nose.
Diagnosis is confirmed by radiographs.
Initial bleeding should be controlled and septal hematoma ruled out. Early reduction is possible if the injury is acute and swelling insignificant. Closed reduction should occur within 3 to 7 days for children and 5 to 10 days for adults. All rights reserved.