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Yang SW, Luo CM, Cheng TC. Fungal Abscess of Anterior Nasal Septum Complicating Maxillary Sinus Fungal Ball Rhinosinusitis Caused by Aspergillus flavus: Case Report and Review of Literature. J Fungi (Basel) 2024; 10:497. [PMID: 39057382 PMCID: PMC11278497 DOI: 10.3390/jof10070497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2024] [Revised: 07/03/2024] [Accepted: 07/15/2024] [Indexed: 07/28/2024] Open
Abstract
Anterior nasal septum abscess is not a rare clinical disease entity. In terms of the etiologies of the disease, bacteria are obviously more common than fungi. Fungal culture and pathological examination are essential for diagnosis of a fungal abscess of the anterior nasal septum and the basis of prescription of antifungal agents. We report a 57-year-old male patient who came to our outpatient clinic due to refractory nasal congestion for 3 weeks despite receiving treatments by a local medical doctor. Radical surgery with postoperative adjuvant radiotherapy for the right buccal cancer was carried out 14 years ago. The patient has diabetes mellitus and the blood sugar level has been well controlled by oral hypoglycemic agents over the past several years. Computed tomography revealed an abscess in the anterior septum along with rhinosinusitis. Incision and drainage of the nasal septum abscess and functional endoscopic sinus surgery were carried out. Fungal culture and pathological examination confirmed a fungal abscess in the anterior nasal septum and fungal ball rhinosinusitis. Antibiotics and an antifungal agent were given, and the postoperative course was uneventful. A dialectical argument was made regarding the causal relationship between the fungal abscess of the anterior nasal septum and maxillary fungal ball sinusitis. A literature review of the previous case reports was carried out to elucidate the immune status of patients of this disease. In order to reach a rapid establishment of a fungal abscess of the anterior nasal septum, clinicians should keep this disease in mind and remain vigilant. An immuno-compromised status is more commonly found in patients with fungal abscess of the anterior nasal septum and is another important characteristic of this disease. Prompt diagnosis and effective treatment are equally important in patients with lower immune status of this kind, and the latter is based on the former.
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Affiliation(s)
- Shih-Wei Yang
- Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung 204, Taiwan;
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Cheng-Ming Luo
- Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung 204, Taiwan;
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Tzu-Chien Cheng
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Department of Pathology, Chang Gung Memorial Hospital, Keelung 204, Taiwan;
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Marin Acevedo P, Wise T, Mayer J, Lin S. Point-of-Care Ultrasound of a Nasal Septal Abscess. Pediatr Emerg Care 2024; 40:326-328. [PMID: 38355135 DOI: 10.1097/pec.0000000000003128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/16/2024]
Abstract
ABSTRACT Although nasal septal abscesses (NSA) are rare, complications can be significant and devastating. Thus, timely diagnosis of NSA is critical. In this case report, we describe the use of point-of-care ultrasound in diagnosing NSA in a healthy boy presenting with viral upper respiratory infection symptoms and fever. Point-of-care ultrasound findings resulted in expediting this patient's treatment and transfer to a quaternary care center for definitive treatment.
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Affiliation(s)
| | - Tyler Wise
- From the New York-Presbyterian Hospital Emergency Medicine Residency, New York, NY
| | - Jeffrey Mayer
- Department of Emergency Medicine, Weill Cornell Medicine, New York, NY
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Berlucchi M, Tomasoni M, Bosio R, Rampinelli V. Spontaneous Abscess of the Posterior Nasal Septum: An Unusual Cause of Nasal Obstruction in Children. Ann Otol Rhinol Laryngol 2021; 130:966-969. [PMID: 33423503 DOI: 10.1177/0003489420987974] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Nasal septal abscess is a rare disorder in pediatric patients and is mostly diagnosed as a complication of trauma or secondary to dental or sinonasal infection. CASE PRESENTATION A 10-year-old girl presented with acute nasal obstruction, otalgia, and headache. Medical history was negative; physical examination and anterior rhinoscopy did not reveal signs of acute rhinosinusitis or septal abscess. MANAGEMENT AND OUTCOME A thorough nasal endoscopy was performed to rule out a posterior nasal infection, revealing a bilateral posterior septal bulging, in the absence of purulent discharge. CT scan and contrast-enhanced MRI were performed, confirming the diagnosis of a spontaneous posterior septal abscess. Trans-nasal endoscopic-assisted drainage was conducted under general anesthesia. Haemophilus influenzae was detected on culture. DISCUSSION Although rare, nasal septal abscess in the pediatric age is typically anterior and secondary to local trauma or infection. Accurate medical history and anterior rhinoscopy are usually sufficient to make the diagnosis. In cases where the clinical presentation is consistent with a nasal septal abscess, with no history of recent local trauma or infection, or signs of anterior septal bulging, nasal endoscopy should be performed to rule out spontaneous posterior septal abscess. Delay in diagnosis and treatment could potentially cause the rapid onset of life-threatening complications, including intracranial abscess, meningitis, and cavernous sinus thrombosis.
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Affiliation(s)
- Marco Berlucchi
- Unit of Pediatric Otorhinolaryngology, Spedali Civili, Brescia, Italy
| | - Michele Tomasoni
- Unit of Otorhinolaryngology-Head and Neck Surgery, University of Brescia, Brescia, Italy
| | - Roberta Bosio
- Unit of Pediatric Otorhinolaryngology, Spedali Civili, Brescia, Italy
| | - Vittorio Rampinelli
- Unit of Otorhinolaryngology-Head and Neck Surgery, University of Brescia, Brescia, Italy
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AKYİĞİT A, KELEŞ E, KARLIDAĞ T, KAYGUSUZ İ, YAĞMAHAN MS, YALÇIN Ş. ANALYSIS OF PATIENTS WITH SEPTAL ABSCESS CAUSED BY ELECTROCAUTERISATION OF THE NASAL SEPTUM. ENT UPDATES 2020. [DOI: 10.32448/entupdates.828992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Orman G, Kralik SF, Desai N, Meoded A, Vallejo JG, Huisman TAGM, Tran BH. Imaging of Paranasal Sinus Infections in Children: A Review. J Neuroimaging 2020; 30:572-586. [PMID: 32472739 DOI: 10.1111/jon.12737] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 05/13/2020] [Indexed: 12/17/2022] Open
Abstract
Paranasal sinuses (PNS) infections are common in children. They may cause common and well-known complications, but also, unusual and potentially devastating complications. Diagnosing PNS infections and complications in children requires knowledge of the unique anatomy of the nasal cavity and the PNS. In fetal life, nasal mucosa evaginations into the lateral nasal walls initiate the development of the PNS. The PNS continue to develop after birth and complete their maturation and pneumatization at different ages during childhood which makes the pattern of PNS infections determined by patient age. Complications are caused by direct spread of the infection to the orbit, face, intracranial or osseous structures or hematogenous spread of the infection to the intracranial structures. Emergent imaging studies are often necessary in the evaluation of the complications in pediatric patients when the symptoms persist for 10 days and/or if there is evidence of intracranial or orbital complications. In addition, immunocompromised children are especially vulnerable to developing unusual complications. Computed tomography (CT) is excellent for determining whether there is intraorbital extension of PNS disease. However, when the infection approaches the orbital apex, a magnetic resonance imaging (MRI) study with contrast is necessary to assess spread into the cavernous sinus and the intracranial compartment. The goal of this manuscript is to review and characterize imaging findings of PNS infections using CT and MRI allowing determination of the extent of PNS infections and their common and unusual complications in children. In addition, a summary of the development of the normal PNS is provided.
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Affiliation(s)
- Gunes Orman
- Edward B. Singleton Department of Radiology, Texas Children's Hospital, Houston, TX
| | - Stephen F Kralik
- Edward B. Singleton Department of Radiology, Texas Children's Hospital, Houston, TX
| | - Nilesh Desai
- Edward B. Singleton Department of Radiology, Texas Children's Hospital, Houston, TX
| | - Avner Meoded
- Edward B. Singleton Department of Radiology, Texas Children's Hospital, Houston, TX
| | - Jesus G Vallejo
- Department of Pediatrics, Section of Infectious Diseases, Texas Children's Hospital and Baylor College of Medicine, Houston, TX
| | | | - Brandon H Tran
- Edward B. Singleton Department of Radiology, Texas Children's Hospital, Houston, TX
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Nasal septal abscess: a 10-year retrospective study. Eur Arch Otorhinolaryngol 2018; 276:417-420. [PMID: 30506184 DOI: 10.1007/s00405-018-5212-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Accepted: 11/16/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVE Nasal septal abscess is an uncommon condition but it can cause potentially life-threatening intracranial complications and cosmetic nasal deformity. METHODS We analyzed ten years of cases to determine the optimal diagnostic and therapeutic modalities. A retrospective review of case notes from Tri-Service General Hospital archives was performed. Records of six patients diagnosed with nasal septal abscess, who were treated from September 2007 to August 2017 were retrospectively reviewed. Patients' clinical symptoms, etiology, diagnostic methods, bacteriology, antibiotic and surgical treatment were recorded and analyzed. RESULTS Out of six patients diagnosed with nasal septal abscess, three were male and three were female. Ages ranged from 19 to 75 years (mean 51 years). The most common symptoms at presentation were nasal pain and nasal obstruction. Typical etiologies were trauma or acute sinusitis, but uncontrolled diabetes mellitus was also an important etiology. In the series of six patients, four of them had positive findings of abscess and in drainage, had the following bacterial cultures: Staphylococcus aureus (two cases), methicillin-resistant S. aureus (one case), and Klebsiella pneumoniae (one case). In addition to antibiotic treatment, all patients underwent surgical drainage and had complete resolution of disease without intracranial complications during at least 1 year of follow-up. However, two out of the six patients developed saddle nose deformity. CONCLUSIONS This study highlights that: 1. In view of the rapidly increasing number of diabetes mellitus cases, uncontrolled diabetes mellitus is an important etiology of nasal septal abscess. 2. Although S. aureus is the most common pathogen, we must pay attention to methicillin-resistant S. aureus (MRSA) to prevent severe complications and patients who are at increased risk for MRSA colonization should be administrated antibiotics against MRSA initially. 3. Nasal septal abscess should be managed with parenteral broad spectrum antibiotics, appropriate drainage and immediate reconstruction of the destructed septal cartilage with autologous cartilage graft, to prevent serious intracranial complications and cosmetic nasal deformity.
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Fatima SN, Sarwar F, Khan MS. Nasal septal abscess as a sequela of orbital cellulitis: An uncommon presentation. SAGE Open Med Case Rep 2018; 6:2050313X18778726. [PMID: 29899988 PMCID: PMC5985605 DOI: 10.1177/2050313x18778726] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Accepted: 04/30/2018] [Indexed: 12/02/2022] Open
Abstract
Nasal septal abscess is a rather unusual condition encountered in the Otorhinolaryngology outpatient department, let alone it being a complication of orbital cellulitis! The condition usually occurs due to trauma which is significant enough to cause a septal haematoma. The haematoma then eventually results in formation of a localised abscess. Orbital cellulitis as a sequela of nasal septal abscess is an established complication but vice versa, septal abscess as a sequela of orbital cellulitis is an extremely rare presentation. To emphasise the possibility of anterograde as well as retrograde passage of infection via valveless veins in the face, we report a unique case of a 2-month-old infant who developed nasal septal abscess as a complication of orbital cellulitis.
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Affiliation(s)
- Syeda Nidaa Fatima
- Department of ENT-Head and Neck Surgery, KRL Hospital, Islamabad, Pakistan
| | - Fatima Sarwar
- Department of Pediatrics, KRL Hospital, Islamabad, Pakistan
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Kishimoto I, Shinohara S, Ueda T, Tani S, Yoshimura H, Imai Y. Orbital apex syndrome secondary to a fungal nasal septal abscess caused by Scedosporium apiospermum in a patient with uncontrolled diabetes: a case report. BMC Infect Dis 2017; 17:649. [PMID: 28950832 PMCID: PMC5615809 DOI: 10.1186/s12879-017-2753-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2017] [Accepted: 09/21/2017] [Indexed: 11/20/2022] Open
Abstract
Background Orbital apex syndrome is a localized type of orbital cellulitis, where mass lesions occur at the apex of the cranial nerves. Although nasal septal abscess is uncommon, the organism most likely to cause nasal septal abscess is Staphylococcus aureus, and fungal septal abscesses are rare. Here we present an extremely rare and serious case of orbital apex syndrome secondary to fungal nasal septal abscess caused by Scedosporium apiospermum in a patient with uncontrolled diabetes. Case presentation A 59-year-old man with a 1-month history of headache underwent consultation in an otolaryngological clinic of a general hospital. He was diagnosed with nasal septal abscess and was treated with incisional drainage and 1 month of an antibiotic drip; however, his symptoms persisted. The patient later complained of diplopia due to bilateral abducens nerve palsy, and was then referred to the department of Otolaryngology – Head and Neck Surgery, Kobe City Medical Center General Hospital. The septal lesion was biopsied under general anesthesia, and S. apiospermum was detected using polymerase chain reaction. The patient was treated with an antifungal drug and surgical resection of the lesion was performed. Although the patient survived, he lost his eyesight. Conclusions This patient represents the second reported case of nasal septal abscess and orbital apex syndrome caused by S. apiospermum. If not treated properly, septal abscess can be life-threatening and cause severe complications, such as ablepsia.
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Affiliation(s)
- Ippei Kishimoto
- Department of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Shogo Shinohara
- Department of Otolaryngology - Head and Neck Surgery, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-Minamimachi, Chuo-ku, Kobe, 650-0047, Japan.
| | - Tetsuhiro Ueda
- Department of Neurology, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-Minamimachi, Chuo-ku, Kobe, 650-0047, Japan
| | - Shoichi Tani
- Department of Neurosurgery, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-Minamimachi, Chuo-ku, Kobe, 650-0047, Japan
| | - Hajime Yoshimura
- Department of Neurology, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-Minamimachi, Chuo-ku, Kobe, 650-0047, Japan
| | - Yukihiro Imai
- Department of Clinical Pathology, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-Minamimachi, Chuo-ku, Kobe, 650-0047, Japan
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Cai Y, Saqi A, Haddad J. Spontaneous Nasal Septal Abscess Presenting as a Soft Tissue Mass in a Child. J Emerg Med 2016; 52:e129-e132. [PMID: 27988261 DOI: 10.1016/j.jemermed.2016.10.049] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Revised: 09/25/2016] [Accepted: 10/03/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Nasal septal abscess (NSA) is a rare condition most commonly seen as a complication of nasal trauma. The diagnosis of NSA requires emergent treatment, because delayed management can result in significant morbidity. Typically, NSA presents as a purulent collection that can be managed with drainage, either surgically or at bedside. CASE REPORT We report an unusual presentation of a spontaneous NSA in a 7-year-old boy as a solid nasal mass eroding the nasal septum. The solid, tumor-like nature of the mass necessitated intervention beyond drainage and was ultimately excised. Imaging initiated in the emergency department revealed a partially cystic mass and erosion of the septum, which was key to the diagnosis. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Given the ease with which a diagnosis of NSA may be missed and the need for urgent management upon diagnosis of a NSA, we aim to highlight the clinical, radiologic, and histopathologic aspects that aid in diagnosis of NSA. Imaging, obtaining culture results, and initiation of antibiotics are paramount in management. In addition, NSAs may also necessitate bedside drainage given their emergent nature.
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Affiliation(s)
- Yi Cai
- Columbia University College of Physicians and Surgeons, New York, New York
| | - Anjali Saqi
- Department of Pathology and Cell Biology, Columbia University Medical Center, New York, New York
| | - Joseph Haddad
- Department of Otolaryngology/Head and Neck Surgery, Columbia University Medical Center, New York, New York
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Nasal septal abscess in association with pediatric acute rhinosinusitis. Int J Pediatr Otorhinolaryngol 2016; 91:27-29. [PMID: 27863637 DOI: 10.1016/j.ijporl.2016.10.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 08/18/2016] [Accepted: 10/06/2016] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Nasal septal abscess (NSA) in the pediatric population is rare and can result in devastating complications. Objective of this study is to review a case series of pediatric patients presenting with NSA in association with acute rhinosinusitis (ARS) for possible risk factors and predisposing conditions. METHOD This is a retrospective review of pediatric patients that presented to a tertiary care hospital with nasal septal abscess associated with ARS. Patient demographics, presence of ARS, sinuses involved, and other potential risk factors were recorded. In addition, a literature review was conducted to evaluate other reported cases of NSA in association with ARS. Cases of NSA associated with trauma or other causes were excluded from analysis. RESULTS Five patients with NSA were treated by the pediatric otolaryngology department of a tertiary care center from 2003 to 2014. Three of these cases were associated with ARS. Of these cases, the average age at diagnosis was 9.7 years. Two were male and one was female. In these cases, the bilateral frontal, maxillary and ethmoid sinuses were involved. Sphenoid involvement occurred in two patients. One case was associated with ipsilateral middle turbinate concha bullosa. The cartilaginous septum was compromised in all three cases. All patients were treated with incision and drainage. CONCLUSION This is the largest case series of NSA described in the pediatric population. NSA is exceedingly rare but may be associated with ARS. While the etiology of NSA is not always clear, identifying and treating nasal septal abscesses early is imperative to reduce potentially devastating complications.
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Maeda M, Matsunobu T, Kurioka T, Kurita A, Shiotani A. A case of nasal septal abscess caused by medication related osteonecrosis in breast cancer patient. Auris Nasus Larynx 2016; 43:93-6. [PMID: 26775849 DOI: 10.1016/j.anl.2015.04.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Revised: 04/23/2015] [Accepted: 04/27/2015] [Indexed: 11/26/2022]
Abstract
Antiresorptive drugs have been widely used to treat patients with hypercalcemia caused by malignancy, bone metastasis, multiple myeloma, and osteoporosis. However, it is well known that antiresorptive drugs can cause osteonecrosis of the jaw (ONJ). Herein, we report a rare case of nasal septal abscess caused by medication related osteonecrosis of the jaw (MRONJ) in a breast cancer patient. A 69-year-old woman was referred to our clinic for evaluation of nasal obstruction. Physical examination revealed a cherry-like swelling of the nasal mucosa emanating from the septum that obstructed both nasal cavities and a fistulous tract showing pus discharge after extraction of the bilateral maxillary central incisors (MCI) and the right maxillary lateral incisor (MLI). Computed tomography and panoramic radiography revealed extensive osteonecrosis of the maxilla and swelling of the nasal mucosa. The clinical diagnosis was nasal septal abscess caused by osteonecrosis of the maxilla. Surgical procedure was undertaken for this case. An indwelling drain was placed in the oral cavity, and sequestrectomy was performed with incision and drainage of the anterior portion of left nasal septum. The patient was doing well at the 7-month follow-up. The patient had a medical history of breast cancer with bone, lung, liver metastases, and had received intravenous bisphosphonate, which is one of the antiresorptive medicines, over the past 4 years. We suspect that this history played an important role in MRONJ induced nasal septal abscess.
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Affiliation(s)
- Mayuka Maeda
- Department of Otolaryngology-Head and Neck Surgery, National Defense Medical Collage, Namiki 3-2, Tokorozawa, Saitama 359-8513, Japan
| | - Takeshi Matsunobu
- Department of Otolaryngology-Head and Neck Surgery, National Defense Medical Collage, Namiki 3-2, Tokorozawa, Saitama 359-8513, Japan; Department of Otolaryngology, New Tokyo Hospital, Wanagaya 1271, Matsudo, Chiba, Japan.
| | - Takaomi Kurioka
- Department of Otolaryngology-Head and Neck Surgery, National Defense Medical Collage, Namiki 3-2, Tokorozawa, Saitama 359-8513, Japan
| | - Akihiro Kurita
- Department of Otolaryngology, Nisseki Hospital, Kamiochiai 8-3-33, Chuoku, Saitamashi, Saitama, Japan
| | - Akihiro Shiotani
- Department of Otolaryngology-Head and Neck Surgery, National Defense Medical Collage, Namiki 3-2, Tokorozawa, Saitama 359-8513, Japan
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Anselmo-Lima WT, Sakano E, Tamashiro E, Nunes AAA, Fernandes AM, Pereira EA, Ortiz É, Pinna FDR, Romano FR, Padua FGDM, Mello Junior JF, Teles Junior J, Dolci JEL, Balsalobre Filho LL, Kosugi EM, Sampaio MH, Nakanishi M, Santos MCJD, Andrade NAD, Mion ODG, Piltcher OB, Fujita RR, Roithmann R, Voegels RL, Guimarães RES, Meirelles RC, Paula Santos R, Nakajima V, Valera FCP, Pignatari SSN. Rhinosinusitis: evidence and experience: October 18 and 19, 2013 - São Paulo. Braz J Otorhinolaryngol 2015; 81:S1-S49. [PMID: 25697512 PMCID: PMC10157818 DOI: 10.1016/j.bjorl.2015.01.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
- Wilma T Anselmo-Lima
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Eulália Sakano
- Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil
| | - Edwin Tamashiro
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | | | | | | | - Érica Ortiz
- Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil
| | - Fábio de Rezende Pinna
- Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Fabrizio Ricci Romano
- Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | | | | | - João Teles Junior
- Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
| | | | | | | | | | | | | | | | - Olavo de Godoy Mion
- Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | | | | | - Renato Roithmann
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Richard Louis Voegels
- Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | | | - Roberto Campos Meirelles
- Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
| | | | - Victor Nakajima
- Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (UNESP), São Paulo, SP, Brazil
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Muller L, Schlegel M. [Spontaneous swelling of the nasal septum with life-threatening complications]. HNO 2015; 62:590-2. [PMID: 25008273 DOI: 10.1007/s00106-014-2885-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- L Muller
- Klinik für Hals-Nasen-Ohren-Heilkunde und Hals-/Gesichtschirurgie, Kantonsspital Aarau, Tellstr., 5001, Aarau, Schweiz,
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Jones KA, Walsh RE, Tatum SA. The infusion drain: an approach to treatment of intranasal abscesses. Laryngoscope 2012; 122:440-1. [PMID: 22252999 DOI: 10.1002/lary.22433] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2011] [Accepted: 10/12/2011] [Indexed: 11/06/2022]
Affiliation(s)
- Kristin A Jones
- Department of Otolaryngology and Communication Sciences, SUNY Upstate Medical Center, Syracuse, New York, USA.
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Alshaikh N, Lo S. Nasal septal abscess in children: from diagnosis to management and prevention. Int J Pediatr Otorhinolaryngol 2011; 75:737-44. [PMID: 21492944 DOI: 10.1016/j.ijporl.2011.03.010] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2011] [Revised: 03/09/2011] [Accepted: 03/10/2011] [Indexed: 10/18/2022]
Abstract
BACKGROUND Nasal septal abscess (NSA) is an uncommon condition. It is a collection of pus in the space between the nasal septum and its overlying mucoperichondrium and/or mucoperiosteum. If left untreated, there are risks of intracranial complications, facial deformity, and delayed facial growth. There is no universally agreed consensus on the treatment of this condition. This study reviews evidence in the literature to determine its etiology, presentation, investigation, management options, and outcome. METHOD A structured review of the PubMed, EMBASE and the Cochrane Collaboration databases (Cochrane Central Register of Controlled Trials, Cochrane Database of Systemic Reviews) was undertaken, using the MeSH terms: nasal septum, nasal cartilage, trauma, hematoma, abscess, reconstructive surgery, rhinoplasty, pediatric, and children. RESULTS A total of 159 citations from 1920 to date were reviewed regarding nasal septal abscess, of which 81 articles were identified to be relevant to this review. No randomized controlled trials or systematic reviews were found in the Cochrane Collaboration database, PubMed or EMBASE. NSA is more common in children and in male. Nasal trauma and untreated septal hematoma are the leading cause. Staphylococcus aureus is isolated in up 70% of the cases. Clinically, nasal septal swelling, pain and tenderness, with purulent discharge are mostly evident. The immediate management of NSA is incision and drainage and antibiotic therapy. Recent studies suggest early septal reconstruction in children in order to prevent immediate and late facial deformity and nasal dysfunction. Autologous cartilage is the implant material of choice. CONCLUSION Nasal septal abscess is a serious condition that necessitates urgent surgical management in order to prevent potential life threatening complications. In the growing child, early reconstruction of destructed septal cartilage is essential for normal development of the midface (nose and maxilla).
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Hassani R, Aderdour L, Maliki O, Boumed A, Elfakiri MM, Bouchoua F, Raji A. [Nasal septal abscess complicating acute sinusitis in a child]. Arch Pediatr 2010; 18:15-7. [PMID: 21067905 DOI: 10.1016/j.arcped.2010.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2009] [Revised: 02/21/2010] [Accepted: 10/03/2010] [Indexed: 10/18/2022]
Abstract
Nasal septal abscess is a rare complication of acute sinusitis in children. We report the case of a 9-year-old girl who presented at the emergency unit with a bilateral eyelid edema evolving over 2 days, associated with bilateral rhinorrhea and nasal obstruction. Clinical examination found a tumefied nasal septum and nasal obstruction. A computed tomography scan of the nose and paranasal sinuses showed pansinusitis with an abscess of the nasal septum. Treatment consisted in the evacuation of the abscess associated with a triple antibiotic therapy. Progression was favorable. Acute sinusitis is seldom complicated by an abscess of the nasal septum, and very few cases are reported in the literature. Early diagnosis and treatment can avoid complications, which engage not only the functional but also the vital prognosis.
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Affiliation(s)
- R Hassani
- Service d'otorhinolaryngologie, CHU Mohammed VI, Marrakech, Morocco.
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Nasal septal abscess and facial cellulitis caused by community-acquired methicillin-resistant Staphylococcus aureus. The Journal of Laryngology & Otology 2010; 124:1014-6. [PMID: 20056011 DOI: 10.1017/s0022215109992738] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Community-acquired methicillin-resistant Staphylococcus aureus is emerging as an important pathogen. However, methicillin-resistant Staphylococcus aureus rarely causes nasal septal abscess. CASE REPORT We present a case of severe, community-acquired, methicillin-resistant Staphylococcus aureus infection causing rapidly progressing sinusitis, nasal septal abscess and facial cellulitis. CONCLUSION This report serves to remind the clinician of the expanding spectrum of severe infections caused by methicillin-resistant Staphylococcus aureus, all requiring prompt diagnosis and appropriate medical and/or surgical management.
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Sandel HD, Davison SP. Three Spontaneous Occurrences of Nasal Septal Abscess in Patients with Chronic Asymptomatic HIV–the Need for Early Intervention and Reconstruction. EAR, NOSE & THROAT JOURNAL 2009. [DOI: 10.1177/014556130908800810] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
We identified 3 patients with chronic, asymptomatic HIV who presented between 2001 and 2005 with spontaneous nasal septal abscesses in the absence of previous trauma, nasal surgery, sinusitis, infection, or immunodeficiency. A MEDLINE search revealed no other cases of spontaneous isolated nasal septal abscesses. Each of our patients presented to the emergency department with complaints of fever and headaches; 2 of them also had nasal obstruction, nasal and lip swelling, and pain. Clinical examinations and imaging studies revealed isolated anterior nasal septal abscesses. In each case, incision and drainage was performed immediately, and antibiotics started. One patient had an early loss of septal cartilage and nasal support, which developed into a crooked and saddle-nose deformity requiring reconstruction 7 months later. Staphylococcus aureus was identified in all 3 cases. To the best of our knowledge, these are the only 3 cases of spontaneous isolated nasal septal abscess reported in the literature. We discuss the importance of early diagnosis and intervention, as well as reconstructive techniques.
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Affiliation(s)
| | - Steven P. Davison
- Department of Plastic and Reconstructive Surgery, Georgetown University Hospital, Washington, DC
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Posterior nasal septal abscess in a healthy adult patient. The Journal of Laryngology & Otology 2007; 122:1386-8. [PMID: 17967206 DOI: 10.1017/s0022215107000886] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE We report an extremely rare case of bilateral posterior nasal septal abscess in an otherwise healthy adult patient. METHOD Case report and a review of the world literature concerning atraumatic nasal septal abscess and its management. RESULTS The development of an atraumatic nasal septal abscess is rare, but it has been reported in association with acute sinusitis, in patients with poor immunity and in children. The presentation, clinical course and treatment are discussed in the presented patient. CONCLUSION To our knowledge, this is the first report in the world literature of a bilateral posterior septal abscess associated with acute sinusitis in an otherwise healthy adult.
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Debnam JM, Gillenwater AM, Ginsberg LE. Nasal septal abscess in patients with immunosuppression. AJNR Am J Neuroradiol 2007; 28:1878-9. [PMID: 17905891 PMCID: PMC8134265 DOI: 10.3174/ajnr.a0708] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The purpose of this study was to review the imaging findings of nasal septal abscess in 2 patients with immunosuppression. MATERIALS AND METHODS Two patients with immunosuppression were identified as having a nasal septal abscess, and correlative CT imaging in both patients was evaluated. RESULTS The characteristic radiographic appearance of a nasal septal abscess included a fluid collection with thin rim enhancement, located within the cartilaginous nasal septum. After CT examination, incision and drainage was performed in both patients, and appropriate antibiotic coverage was initiated. Clinical and imaging follow-up demonstrated no signs of residual infection. CONCLUSION Nasal septal abscess has a characteristic appearance on CT examination. Prompt diagnosis and treatment, including incision and drainage and appropriate antibiotic coverage, are necessary to avoid serious complications.
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Affiliation(s)
- J M Debnam
- Department of Radiology, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, USA.
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Lin IH, Huang IS. Nasal septal abscess complicated with acute sinusitis and facial cellulitis in a child. Auris Nasus Larynx 2006; 34:241-3. [PMID: 17059875 DOI: 10.1016/j.anl.2006.07.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2006] [Revised: 07/14/2006] [Accepted: 07/21/2006] [Indexed: 10/24/2022]
Abstract
Non-traumatic nasal septal abscess is rare, commonly seen in patients with poor immunity, and presents as isolated nasal septal abscess. Further, nasal septal abscess complicated with acute sinusitis is rather rare. Very little literature has been generated for non-traumatic nasal septal abscess complicated with acute sinusitis in healthy patients. Prompt diagnosis and adequate treatment will help to prevent the complications associated with nasal septal abscess such as saddle nose and intracranial involvement. Herein, to our knowledge, we present the first case involving an otherwise healthy little girl with nasal septal abscess complicated with acute sinusitis and facial cellulitis.
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Affiliation(s)
- I-H Lin
- Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University College of Medicine, 123, Dapi Road, Niaosong, Kaohsiung 83301, Taiwan
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Huang PH, Chiang YC, Yang TH, Chao PZ, Lee FP. Nasal septal abscess. Otolaryngol Head Neck Surg 2006; 135:335-6. [PMID: 16890096 DOI: 10.1016/j.otohns.2005.09.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2005] [Indexed: 11/18/2022]
Affiliation(s)
- Pei-Hsuan Huang
- Department of Otolaryngology, Taipei Medical University, University Hospital, 252 Wu-Shing Street, Taipei 110, Taiwan
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