Pediatric Septal Hematoma: Outcomes of Management with Splints versus Quilting Technique

Monday, October 13, 2025

10:18 AM - 10:24 AM EDT

Location: 233-234

Disclosure(s):

Shirley Xiaosu Liu, MS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Allison B. Tobey, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Amanda L. Stapleton, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Rachel L. Whelan, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Nasal septal hematoma is a rare condition that can lead to long-term complications if untreated. The purpose of this study is to investigate factors influencing outcomes in nasal septal hematoma, focusing on surgical technique. We evaluated the placement of Doyle nasal splints versus septal quilting sutures and their impact on clinical outcomes.

Methods: A retrospective chart review identified 37 pediatric patients treated for nasal septal hematoma at a tertiary care children’s hospital between 2013 and 2024. The independent variables include the splinting method and time from trauma to treatment. Outcomes measured include complications such as abscess formation, nasal deformity, and cartilage destruction, recurrence, and the need for return to the operating room (RTOR). Fisher’s exact test and receiver operating characteristic (ROC) curve analysis was performed to evaluate the associations of days from trauma to treatment with outcomes. The area under the curve (AUC) and Youden's J statistic determined an optimal cutoff for increased risk of RTOR.

Results: Among 23 patients with Doyle splints and 14 with quilting sutures, no significant difference in complications, recurrence, or RTOR was observed. Similarly, gender and race were not associated with these outcomes. Septal abscess at diagnosis was significantly associated with post-op complications, including cartilage destruction, septal perforation, and saddle nose deformity (p < 0.01). ROC analysis revealed that the number of days from trauma to treatment did not predict recurrence (AUC = 0.47), but moderately predicted RTOR (AUC = 0.68). A delay of more than 4 days from trauma to treatment significantly increases RTOR risk.

Conclusions: Doyle splints versus quilting sutures did not impact outcomes in pediatric nasal septal hematoma. Delays >4 days from trauma to treatment and septal abscess at diagnosis are associated with higher RTOR risk and complications. Early detection and treatment, rather than placement of splints, are key for optimizing outcomes in pediatric septal hematoma.

Presenting Author(s)

Shirley Xiaosu Liu, MS

Medical Student
University of Pittsburgh
Pittsburgh, PA, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

Shivam D. Patel, MD

Resident Physician
Department of Otolaryngology, University of Pittsburgh Medical Center
Pittsburgh, PA, United States

Disclosure information not submitted.
Amber D. Shaffer, PhD

Research Assistant Professor
UPMC Children's Hospital of Pittsburgh
Pittsburgh, PA, United States

Disclosure information not submitted.
AT

Allison B. Tobey, MD

Assistant Professor
University of Pittsburgh Medical Center, Department of Otolaryngology - Head and Neck Surgery
Pittsburgh, PA, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
AS

Amanda L. Stapleton, MD

Associate Professor Of Otolaryngology
Childrens Hospital of Pittsburgh of UPMC
Pittsburgh, PA, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Senior Author(s)

Rachel L. Whelan, MD

Assistant Professor of Otolaryngology
Childrens Hospital of Pittsburgh
PGH, Pennsylvania, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.