In the management of acute septal hematoma following nasal trauma, which complication is most feared if the hematoma is left untreated?

• A Nasal polyposis from mucosal irritation
• B Saddle nose deformity due to cartilage necrosis from ischemia ✓
• C Ozena (atrophic rhinitis) from scarring
• D Septal perforation due to pressure necrosis only at the posterior septum

Explanation

Septal hematoma is a collection of blood between the septal cartilage and its overlying perichondrium, which provides the cartilage's blood supply. Untreated, it leads to avascular necrosis of the cartilaginous septum, followed by infection (septal abscess), and ultimately collapse of the nasal bridge producing the classic saddle nose deformity. Treatment is prompt incision and drainage with quilting sutures and nasal packing to prevent reaccumulation. This is an ENT emergency.

Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.