Five cases of hematoma in the nasal cavity and sinuses.

Five patients with hematoma in the nasal cavity and sinuses who had complained of unilateral nasal obstruction or nasal bleeding were examined. One of them had exophthalmus, and CT scan showed destruction of the wall of the maxillary sinus, deviation of the right pterygoid process, and invasion of tumor into the right orbit and right nasal cavity. Our first diagnosis was maxillary cancer, but a biopsy of the nasal cavity lesion showed necrosis, as did repeated biopsies of the maxillary sinus obtained after exploratory antrotomy. The final diagnosis was hematoma in a maxillary sinus.There are no specific symptoms or signs of hematoma in the nasal cavity and sinuses. Therefore a definitive diagnosis must be based on histologi.cal evidence of hemangioma, polyp, etc. In some cases, biopsy reveals necrosis. It is very difficult to distinguish this from maxillary malignant tumors. In those cases which we can not diagnose definitely by endonasal biopsy, exploratory antrotomy is advisable, with biopsy for accurate histological diagnosis.