You have been treated for a nasal septal hematoma — a collection of blood between the cartilage and lining of the dividing wall inside your nose
A small incision was made to drain this blood and prevent serious complications
Nasal packing or a small drain was placed and must not be removed at home
Wound and packing care
Do not remove nasal packing or drain — this is removed at your follow-up appointment
Breathe through your mouth until packing is removed
Gentle saline nasal spray may be used to keep nasal passages moist around packing
Keep head elevated — sleep with head of bed elevated on pillows
No nose blowing for at least one week after the procedure
No heavy lifting or straining for one week
Medications
Take prescribed antibiotics for the full course — do not stop early even if feeling better
Pain relief: acetaminophen as directed for pain; avoid NSAIDs unless prescribed
Do not take blood thinning medications unless directed by your physician
Diet and activity
Soft diet is comfortable while nasal packing is in place
Avoid hot liquids and foods in the first 48-72 hours to reduce re-bleeding risk
Avoid contact sports or any nasal trauma until cleared by your ENT specialist
Follow-up appointment
Mandatory ENT follow-up within 24-48 hours — this is critical
Packing or drain will be removed and the nose re-examined for re-accumulation
Additional follow-up will be arranged at that appointment
Return to emergency department immediately for
Worsening nasal obstruction or swelling
New-onset fever or chills
Purulent (green or yellow) nasal discharge
Increasing facial pain or facial swelling
Headache, especially if severe or worsening
Vision changes, eye pain, or swelling around the eyes
Confusion, altered mental status, or difficulty waking up
Neck stiffness
References
Guidelines and key sources
Primary clinical evidence
Guchlerner L et al. Nasal Septal Hematoma Is a Rare and Self-Recognizable Complication of Nasal Bone Fracture. American Journal of Otolaryngology 2025. PMID 41135290
Ali HM et al. Nasal Septal Hematoma in Children: Time to Diagnosis and Resulting Complications. International Journal of Pediatric Otorhinolaryngology 2021. PMID 33930759
Kass JI, Ferguson BJ. Treatment of Hematoma of the Nasal Septum. New England Journal of Medicine 2015
Alshaikh N, Lo S. Nasal Septal Abscess in Children: From Diagnosis to Management and Prevention. International Journal of Pediatric Otorhinolaryngology 2011. PMID 21492944
Marston AP, O'Brien EK, Hamilton GS. Nasal Injuries in Sports. Clinics in Sports Medicine 2017. PMID 28314421
Sayin I et al. Nasal Septal Hematoma and Abscess in Children: An Uncommon Otorhinolaryngology Emergency Revisited. Journal of Craniofacial Surgery 2021. PMID 33705048
Shaari AL et al. Nasal Septal Abscesses: A Systematic Review. Journal of Craniofacial Surgery 2025. PMID 39750551
Jackson R, Jia W, Edafe O. Evaluation of the Management of Nasal Septal Haematoma and Abscess: A Systematic Review. Journal of Laryngology and Otology 2025. PMID 39434415
Imaging guidance
Radiology society guidelines
Expert Panel on Neurological Imaging. ACR Appropriateness Criteria Sinonasal Disease: 2021 Update. Journal of the American College of Radiology 2022
Berlucchi M et al. Spontaneous Abscess of the Posterior Nasal Septum. Annals of Otology Rhinology and Laryngology 2021. PMID 33423503
MRI head with contrast reported 97% diagnostic accuracy vs 87% for CT for intracranial complications of septal abscess
ENT epistaxis guideline
AAO-HNS epistaxis guideline
Tunkel DE et al. Clinical Practice Guideline: Nosebleed (Epistaxis). Otolaryngology Head and Neck Surgery 2020
Provides guidance on concurrent epistaxis management in nasal trauma patients
SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.