Introduction

In maxillofacial trauma, the most commonly injured structure is the nose due to its prominent location on the face. Nasal fractures often coincide with nasal trauma, comprising a significant 48%-50% of all facial fractures [1]. These fractures can result from various mechanisms, such as motor vehicle collisions involving cyclists or pedestrians, sports-related injuries, including weightlifting, or accidents at home. Nasal trauma can lead to bony fractures, soft tissue injuries, or, less frequently, hematomas. Typically, nasal hematomas are located in the nasal septum. However, there have been a few cases documented in the alar cartilage.

Nasal hematomas occur when blood vessels within the perichondrium are torn. The collection of blood between the cartilage and the overlying intact perichondrium gives rise to a sub-perichondrial hematoma. This hematoma disrupts the blood supply to the cartilage and may lead to nasal cartilage necrosis and perforation. The hematoma can also evolve into an abscess that can spread further intracranially via the skull base [2]. A rare site of the hematoma is the alar cartilage, which seems to primarily affect children, with six of the already reported cases being in the pediatric population. The alar cartilage is C-shaped and closely approximated to the septum. It is composed of medial and lateral crura that join to form the nostril and nasal entrance [1]. When undiagnosed, nasal hematomas can lead to complications ranging from scarring and cartilage destruction to intracranial infections.

Hence, it is crucial to promptly detect and surgically drain the hematoma, in addition to providing antimicrobial coverage. In other words, timely diagnosis and management are essential to potentially avoid both aesthetic and functional complications associated with alar cartilage hematomas. In this report, we present a rare case of alar cartilage hematoma in a three-year-old female.