Nasal septal haematoma — MCCQE Part 1 MCQ

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ModerateTraumaNasal septal haematomaMCCQE Part 1

A 13-year-old boy is hit in the nose during basketball and has nasal obstruction with a fluctuant bluish bilateral septal swelling. Which of the following is the most appropriate next step?

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Correct answer: E — Urgent drainage of septal haematoma

Urgent drainage of septal haematoma is the single best answer because the age, timing, examination findings and investigations in the vignette fit Nasal septal haematoma better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to Canadian otolaryngology guidance, with attention to acuity, safety-netting and local provincial pathways.

Reference: Canadian otolaryngology guidance