When there is minimal obstruction, it is often possible to visualize the nasopharynx.Identifying the Nasal Septal Hematoma
If lateral bulging of the septum and fluctuance persist after the nasal administration of a vasoconstrictive agent, such as oxymetazoline, it is a strong indicator of a nasal septal hematoma. A septal hematoma is highly likely in patients who have had trauma or a sudden onset of nasal blockage that does not resolve with the removal of blood clots and the administration of a vasoconstrictive agent.Diagnosis can be made by a medical professional after performing an anterior rhinoscopy examination, by using an otoscope or a nasal speculum and overhead light source.Sometimes palpitation is used to diagnose the hematoma. Treatment
A septal hematoma requires urgent treatment from a doctor in order to stop any further complications arising.Prompt treatment of septal hematomas can prevent complications such as ischemia of the septal cartilage, which can lead to permanent necrosis and a saddle-nose deformity. Such complication can occur rapidly, within as few as 3 days.There are two different procedures used to achieve this and will be selected upon the size of the swelling or clot. If the condition is being treated promptly and is still relatively small, then a small incision can be made to allow the blood to flow out. If the septal hematoma has been left untreated, then a doctor may need to insert a mechanism in order to fully remove the blood from the area.If left untreated, the hematoma can cause bacterial colonization that leads to infection.
Nasal septal hematoma is a condition affecting the nasal septum. It can be associated with trauma.A septal hematoma is blood that collects in the space between the septal cartilage and the overlying perichondrium (a cross section of the cartilaginous portion of the nasal septum). A hematoma may deprive the septal cartilage of its blood supply from the overlying mucosa and can lead to permanent sequelae.The septal cartilage has no blood supply of its own and will receives all of its nutrients and oxygen from the perichondrium. An untreated septal hematoma may lead to the destruction of the septum and immediate drainage is necessary. Timely diagnosis and/or treatment of septal hematomas can cause what is called a saddle nose deformity.This condition is more common in children because the septum is thicker and the lining more flexible. Signs and symptoms
A normal nasal septum is rigid and thin. If you have a septal hematoma, your doctor will be able to press it down with a swab as the area will be soft. A quick check in the nose will show any swelling between the nostrils.Symptoms can include:

blockage in breathing
change in nose shape
painful swelling of nasal septum
nasal congestion.On occasion, it is possible for people with a septal hematoma to experience headache, nausea, vomiting, and fainting. Causes
The most common causes of nasal septal hematomas include:

broken nose (nasal fracture)
medication
surgery or injury to the soft tissue area.In adults, nasal septal hematoma typically occur with significant facial trauma and/or nasal fracture.