Fibrosis of the Nasal Septum: Complication of a Nasal Trauma

Introduction: Typical complications of nasal trauma are as follows: nasal deformity, deviated nasal septum, nasal septal hematoma, and nasal septal abscess.

Objectives: This study aims to report a case of a late complication of a nasal trauma that, to the best of our knowledge, has never been reported. A very thick fibrosis tissue in the space between the nasal septum cartilage and its overlying mucoperichondrium simulating a nasal septum deviation. Clinical presentation, diagnosis, management, and pictures intraoperative are presented.

Resumed Report: A 38-year-old man presented to our clinic with unilateral nasal obstruction after a nasal trauma 1 year ago. Patient reported no nasal deviation after the trauma. The nasofibroscopy showed a severe deviated nasal septum, in the anterior region and left inferior turbinate hypertrophy. The patient underwent septoplasty and left inferior turbinoplasty. During the procedure, a fibrotic tissue was noted in the space between the nasal septum cartilage, and its overlying mucoperichondrium, with a dissection plane relatively avascular between the fibrosis and the mucosa, and avascular between the fibrosis and the cartilage. The majority of the fibrotic tissue was resected and removed (size, 20 × 10 mm; thickness, 3 mm). Follow-up at 6 months demonstrated a centralized septum, and the patient reported no more nasal obstruction.

Conclusion: Although the pathogenesis is unclear, the authors created one hypothesis that the nasal trauma resulted in a septal hematoma that was organized and then leaded to the fibrosis. The fibrosis of the nasal septum may be included in differential diagnosis of severe posttraumatic septal deviation without nasal deformity.