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This may end up in septal necro sis, with subsequent perforation due to both a lack of nutrition from the perichondrium or a secondary an infection of the hematoma, generally with Staphylococcus aureus. Differential Diagnosis G Oral and pharyngeal infections such as pharyngitis or stomatitis G Chancre G Benign oral or odontogenic lesions G Denture sores G Aphthous ulcers or herpetic sores G Lesion because of cheek biting G Oral manifestations of systemic ailments G Necrotizing sialometaplasia N Evaluation History Evaluation begins with an in depth history inquiring about tobacco and alcohol usage, oral pain, referred otalgia, dysphagia, articulation adjustments, and weight loss. 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