A septal haematoma following nasal trauma, if left untreated, leads to which sequence of complications?

• A Infection → abscess formation → avascular necrosis of septal cartilage → saddle nose deformity ✓
• B Reabsorption spontaneously within 2 weeks with no cartilage damage
• C Calcification of haematoma → rhinolith → chronic nasal obstruction only
• D Organisation into fibrous tissue providing structural support to the septum

Explanation

Septal cartilage derives its nutrition entirely from the overlying perichondrium. A haematoma strips the perichondrium from the cartilage, devascularising it. Without drainage, the haematoma becomes infected (commonly Staphylococcus aureus), forming a septal abscess. Avascular necrosis of the cartilage follows, resulting in collapse of the nasal dorsum — the classic saddle-nose deformity. Emergency incision and drainage with bilateral quilting sutures or nasal packing to prevent re-accumulation is the mandatory treatment.

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

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Written and medically reviewed by the StethoPrep medical team.