A septal hematoma associated with nasal trauma requires which management?

• A. Packing only
• B. Antibiotics only
• C. Drainage
• D. Observation

Answer: (C)

A septal hematoma after nasal trauma is an urgent condition because the blood collection sits between the mucoperichondrium and the septal cartilage, pressing on the cartilage’s blood supply. That pressure can lead to cartilage necrosis and a lasting saddle nose deformity if not relieved. The essential step is to evacuate the hematoma with drainage or incision and suction to remove the clot and decompress the septum. After drainage, packing is often used to prevent reaccumulation and antibiotics may be given to reduce infection risk, but removing the collected blood to relieve pressure is the critical move. Packing alone won’t resolve the hematoma, and antibiotics or observation alone don’t address the underlying pressure and risk of necrosis.