Nasal septal abscess: a 10-year retrospective study

Area of Science:

• Otolaryngology
• Infectious Diseases
• Plastic Surgery

Background:

• Nasal septal abscess is rare but can lead to serious intracranial complications and facial disfigurement.
• Understanding optimal diagnostic and therapeutic strategies is essential for patient outcomes.

Purpose of the Study:

• To analyze a decade of nasal septal abscess cases to identify optimal diagnostic and therapeutic modalities.
• To evaluate the role of uncontrolled diabetes mellitus as an etiology and the impact of bacterial pathogens, including MRSA.

Main Methods:

• Retrospective review of six nasal septal abscess cases treated between 2007 and 2017.
• Analysis of clinical symptoms, etiology, diagnostic methods, bacteriology, and treatment outcomes.

Main Results:

• Common symptoms include nasal pain and obstruction; trauma, sinusitis, and uncontrolled diabetes mellitus were key etiologies.
• Staphylococcus aureus and Klebsiella pneumoniae were identified pathogens; MRSA was also detected.
• All patients received antibiotics and surgical drainage, achieving resolution, but two developed saddle nose deformity.

Conclusions:

• Uncontrolled diabetes mellitus is an emerging important etiology for nasal septal abscess.
• Prompt treatment with broad-spectrum antibiotics, including MRSA coverage when indicated, and surgical drainage is vital.
• Immediate septal cartilage reconstruction with autologous grafts is recommended to prevent intracranial complications and cosmetic deformities.