American Society of Plastic Surgeons
For Medical Professionals
June Evan
6 months ago

Septal Hematoma

I had septoplasty 6 weeks ago. I had septal hematoma after surgery. Everythg is ok inside my nose now. It looks airway is totally open. For all that i cant breath well from one side ( which i had hematoma) . Airway is always less than other Side. Is it related with hematoma i had? Hematomas can causes permanent breathing problems like this?

Procedure: Rhinoplasty
Location: californian, AB

Replies 4

Peter Taub
ASPS Surgeon

The persistent airway issue could be from any number of causes, including normal persistent swelling that should eventually resolve, scarring, a persistent hematoma as well as obstructions deeper in the nose.

Baris Yigit
ASPS Int. Surgeon

Septal hematoma is the accumulation of blood between the membrane that lines the cartilage and the septum. If there was no breathing problem before the hematoma and it occurred together with or after the hematoma, the hematoma may have probably settled and organized there. Hematomas have two forms; one is liquid and the other is organized. Sinonasal organizing hematomas (SOH); means there is clotting and may be difficult to remove. Your best option is to consult with the doctor who performed your surgery ASAP in order to have it examined via nasal endoscopy if possible.

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Samir Shureih

I believe you got a sound advise from the plastic surgeons.

It sounds that your surgeon is an ENT surgeon. We do not know how the septal hematoma was treated?

Now you have problem breathing from the nose. Your ENT should also do functional tests of air flow: Rhinomanometry. Also a simple Cottle test to test for the nasal valve. The nasal endoscopy looking at the septum cartilage (including thickness) and boney, the Turbinate. Foreign body (though remote).

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Ellis Tavin
ASPS Surgeon
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In addition to everything my colleagues have said, another possibility is that you may have nasal valve collapse. I see a number of patients who are referred for persistent nasal obstruction in spite of septoplasty (without hematoma), who have this problem. This condition can be diagnosed on examination by your doctor.

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