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Hematoma and abscess of the nasal septum

in children.
Canty PA1, Berkowitz RG.

Author information
Abstract
OBJECTIVE:
To evaluate the clinical characteristics and treatment outcome of hematoma and abscess of
the nasal septum (HANS) in children.
DESIGN:
Retrospective case series.
SETTING:
Pediatric tertiary care facility.
PATIENTS:
Consecutive series of 20 children (age, 2 months to 15 years; mean age, 7 years) who were
admitted to the hospital for treatment of HANS after nasal trauma during an 18-year period.
INTERVENTIONS:
In addition to receiving antibiotics, all patients underwent general anesthetic for incision and
evacuation of the collection of blood and pus together with nasal packing.
RESULTS:
All patients had a history of nasal trauma. The HANS was a consequence of child abuse (2
patients younger than 2 years), minor nasal trauma (14 patients aged 1 to 10 years), and
sports injury (4 patients older than 10 years). The diagnosis was made 1 to 14 days (mean, 5.9
days) after the episode of trauma. Nasal obstruction was the most common symptom found
and was present in all but 1 patient. Pain, rhinorrhea, and fever occurred in 50%, 35%, and
25% of patients, respectively. Nasal fracture was present in 3 children. Abscess was found at
surgery in 12 patients and was universally associated with septal cartilage destruction.
Hematoma was present in 8 patients and associated with cartilage destruction in 2 patients.
Organisms cultured were Staphylococcus aureus, Streptococcus pneumoniae, and group A
beta-hemolytic streptococcus and were obtained from all 12 patients with septal abscess and
from 1 patient with septal hematoma. Corrective nasal surgery has been performed in 5
patients, 4 of whom had a history of septal abscess.
CONCLUSION:

Rapiejko P.gov/pubmed/18637425 . http://www. [Article in Polish] Zielnik-Jurkiewicz B1. makes good functional and cosmetic effect. Drainage of the nasal septal abscess with antibiotic prevent the early complications but it isn't enough functional and cosmetic effect in the future.nlm. Olszewska-Sosińska O. Nasal septal hematoma and abscess were diagnosed in 22 (0.nlm. MATERIAL AND METHODS: In 1998-2005 in Department of Otolaryngology Children's Hospital in Warsaw 2500 children after nasal injury were examined. They were reviewed retrospectively and some of them were examined 1-8 years after.9%).gov/pubmed/8956753 [Treatment of the nasal septal hematoma and abscess in children]. drainage of the hematoma with septoplasty and reduction of fracture of the nose.The diagnosis of HANS must be considered in all children who have acute onset of nasal obstruction and a history of recent nasal trauma to minimize the risk of nasal deformity and prevent the development of septic complications.nih. RESULTS: In 22 children with nasal septal hematoma and abscess no complication were observed during treatment. http://www. Author information Abstract OBJECTIVES: Estimation of the treatment of the nasal septal hematoma and abscess after injury was performed.nih. CONCLUSIONS: Complex treatment of nasal septal hematoma. In 12 children examined 1-8 year after treatment 1 child developed saddle nose deformity (qualified to observation) and 1 child developed nasal septum deformities with nasal obstruction (qualified to septoplasty).ncbi.ncbi.

SETTING: University hospital. DESIGN: Prospective nonrandomized case series. PATIENTS: Six patients (5 boys and 1 girl). mild. or severe. Auricular cartilage was used in 5 children. columellar retraction.Nasal septal abscess in children: reconstruction with autologous cartilage grafts on polydioxanone plate. MAIN OUTCOME MEASURES: Nasal outgrowth was measured by the length of the nose and by the amount of nasal tip projection and was compared with standardized growth curves. Menger DJ1. INTERVENTION: The nasal septa of 6 children with a history of nasal septal abscess and partial or complete destruction of nasal septal cartilage were reconstructed with autologous cartilage grafts of the auricle or rib fixed on polydioxanone plate. aged 3 to 11 years. Aesthetic outcome variables included nasolabial angle. costal cartilage was needed in 1 child. Four children had complete loss of the cartilaginous septum. Compared with standardized growth curves. 38 months). RESULTS: The duration of follow-up ranged from 10 to 68 months (mean follow-up. Author information Abstract OBJECTIVE: To assess outgrowth and aesthetics of the nose in children after reconstruction of the cartilaginous nasal septum with autologous cartilage grafts on polydioxanone plate. with nasal septal abscess. Areas 1 and 2 (caudal parts) had been destroyed in 2 children. Trenité GJ. Tabink IC. None of the children . and development of saddle nose deformity and were classified as normal. the length of the nose and the amount of nasal tip projection were within 1 SD in all children.

of which 81 articles were identified to be relevant to this review. Epub 2011 Apr 14. trauma.ncbi. management options. rhinoplasty. abscess. No randomized controlled trials or systematic reviews were found in the Cochrane Collaboration database. It is a collection of pus in the space between the nasal septum and its overlying mucoperichondrium and/or mucoperiosteum. EMBASE and the Cochrane Collaboration databases (Cochrane Central Register of Controlled Trials. METHOD: A structured review of the PubMed. Lo S. Nasal trauma and untreated septal hematoma are the leading cause. CONCLUSION: Total reconstruction of abscess-induced destruction of nasal septal cartilage with autologous cartilage grafts fixed on polydioxanone plate has. doi: 10.010. facial deformity.75(6):737-44. presentation. RESULTS: A total of 159 citations from 1920 to date were reviewed regarding nasal septal abscess.nih. resulted in normal development of the nose during follow-up. 2011 Jun. reconstructive surgery.2011. . There is no universally agreed consensus on the treatment of this condition. NSA is more common in children and in male.developed saddle nose deformity. If left untreated. One child had mild columellar retraction.nlm.1016/j. Alshaikh N1. there are risks of intracranial complications. Cochrane Database of Systemic Reviews) was undertaken. investigation. without expected aesthetic problems. This study reviews evidence in the literature to determine its etiology. and children. Staphylococcus aureus is isolated in up 70% of the cases. Nasal septal abscess in children: from diagnosis to management and prevention. 3 children had mild overrotation of the nasal tip. using the MeSH terms: nasal septum. http://www. so far.ijporl. pediatric. PubMed or EMBASE. Author information Abstract BACKGROUND: Nasal septal abscess (NSA) is an uncommon condition.gov/pubmed/18711058 Int J Pediatr Otorhinolaryngol. nasal cartilage. hematoma.03. and outcome. and delayed facial growth.

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. Recent studies suggest early septal reconstruction in children in order to prevent immediate and late facial deformity and nasal dysfunction. with purulent discharge are mostly evident. http://www. Autologous cartilage is the implant material of choice.ncbi. The immediate management of NSA is incision and drainage and antibiotic therapy. early reconstruction of destructed septal cartilage is essential for normal development of the midface (nose and maxilla).Clinically.nih.gov/pubmed/21492944 . nasal septal swelling.nlm. pain and tenderness.

Rest of the pleural space and bony cage were normal. 1) lymphadenopathy with subtle sub pleural and peri bronchovascular nodules. sensitivity and fungal smear. well defined granuloma was seen (Fig.CASE REPORTS Tubercular Septal Abscess Meenakshi Singh*. Nevertheless. Case Report A 52 year old female presented to ENT/OPD with chief complaint of nasal blockage since one month. Introduction Granulomatous lesions within the nasal cavity may represent either local diseases or a manifestation of a systemic disorder. two months back.740. At the time of admission WBC count was 8. HRCT of chest was done at that time which showed mediastinal. mucopurulent rhinorrhoea. She had supraclavicular lymph node biopsy. 4). it can occur in all segments of our population and may present a confusing diagnostic problem. Nasal involvement of this condition was first described in Venice by Giovanni Morgagni in 17611 but it was not until 1876 that primary nasal disease was 2 described by Clarke in an address to the pathological society of London. acute ethmoiditis. Rohit Singh*. Fungal smear and culture sensitivity was negative. which was progressively increasing. . PAS and GMS stains were negative for fungal elements. neutrophils 79% and ESR was 90 mm/hr. In any of the situation differential diagnosis must include tuberculosis. sphenoiditis and dental infection have been mentioned as cause. Quadrangular cartilage was thinned out. bilateral hilar and left supraclavicular (Fig. Incision and drainage was done under local anaesthesia in view of medical condition. Patient was continued with AKT and discharged. The histopathology of lymph node was tubercular and she was on Anti tubercular therapy since then. anterior rhinoscopy showed bulge in the septum which was prominent on both the sides. epistaxis. 3). ANCA was also negative. ANCA the diagnosis as tubercular abscess. The mucoperichondrium was thickened with lots of granulation tissue. Spontaneous septal abscesses are rare. CT scan of paranasal sinuses revealed septal bulging with breach in continuity of anterior end of septum (Fig. On clinical examination there was swelling of the dorsum of the nose. There was no history of trauma. Discussion Nasal septal abscess is defined as a collection of purulent material between the cartilage or bony septum and its mucoperichondrium or mucoperiosteum. visual disturbance and pain over the face. Seropurulent discharge was sent for bacterial culture. 2). Smear and culture was positive for Acid Fast Bacilli which confirmed the diagnosis as tubercular abscess. Overlying muco perichondrium was normal. no ulcer/erosion seen and postnasal space was apparently normal. Histopathology showed inflamed granulation tissue with Langhan’s cell and necrosis. Fungal smear and culture sensitivity was negative. Anita P Sonsale** Tuberculosis of nose has become so infrequent that it is virtually a forgotten disease entity among younger practitioners in this country. I and D revealed minimal seropurulent discharge. Posterior part of septum was absolutely normal (Fig. A case is presented because of its rarity and more importantly as a reminder of the diagnosis since despite modern chemotherapy the incidence of this disease is once again increasing. Most patients have a history of trauma which may be accidental or iatrogenic. She was diagnosed diabetic and hypothyroid three months back. Continuous follow up was done upto one year and patient was completely cured with no recurrence. Granulation tissue alongwith the cartilage were removed and sent for histopathological examination. No definite vasculitis was seen.

2 : CT of PNS showing anterior septal bulging Fig. rhinorrhoea. indeed any nasal involvement is uncommon but in over 75 per cent of 3 4 cases represents a manifestation of generalized disease. Smoking and low socio economic status were also reported as risk factors. epistaxis and snoring are known symptoms of nasal tuberculosis. Nasal obstruction. These lesions tend to occur on the lateral nasal wall. Pulmonary koch’s should be excluded by chest X-ray. Some times patients may be totally asymptomatic when associated with nodal disease and only diagnosed by histological diagnosis. 1 : HRCT chest showing bilateral hilar and peribronchovascular nodules Fig. septal involvement is rare.Fig. Primary nasal disease is not thought to be particularly contagious. Tuberculosis of the upper respiratory tract and nasopharyngeal region has been observed mainly in patients with active pulmonary tuberculosis. . 3 : CT of PNS showing normal posterior part of septum Primary nasal tuberculosis is extremely rare. It is predominantly seen in females and usually in elderly.

Buchanan D. Robinson D. 2. The changing pattern of granulomas in the upper respiratory tract. BMJ. Sebek B. 3.in/journal/2004_4602_april/html/tubercular_243. X-ray chest of the patient was normal but repeat HRCT chest showed hilar lymphnode enlargement. 27 : 240-9. 109 : 326-7. 1761. Delayed management of septal abscess can result in compromise of the vascular supply to septal cartilage resulting in its ischaemic necrosis and saddle shaped deformity of the nose. This is especially relevant as 5 the rate of drug resistant mycobacteria is rising. Hellyer T. Soames JV. Ormerodo L. References 1. On the seats and causes of death investigated by anatomy. however left supra clavicular node had resolved following AKT. Fig. Other complications of septal abscess documented include sepsis. PREVENTING FALLS MAKES HOSPITAL STAY SAFER A multiple intervention programme to prevent falls can make in-hospital stay safer for patients. The Journal of Laryngology and Otology 1995. Tucker H. Waldman S. Tuberculosis in the 1990s. Mycobacterial infection in patients infected with the human immunodeficiency virus. McCarthy M. Johnson IJM. Parker W. 4 : Histopathology of granulation tissue from nasal septal cartilage showing granuloma with Langhan’s cell The drug therapy for nasal tuberculosis is the same as for generalized condition and should be undertaken by or at least in conjunction with a chest physician. bacteraemia. Helbert M. Tuberculous lupus of the tongue palate and gums. 91 : 11-6. Transactions of the Pathological Society (London) 1876. Initially the rise was blamed on the emerging problem relating to human immuno deficiency virus infection. 85 : 631-77. Morgagni G. meningitis and maxillary hypoplasia. 5.htm . 2004.an increasing problem. but it is now recognised to be multifactorial in origin including socio economic deprivation. Hence. the only positive examination finding was broadening of the dorsum of nose and bulging septum with no signs of active infection. http://bhj. Friedmann I. 328 : 676. Clarke W.In our case. HIV must be considered in all cases of tuberculosis as between five to ten per cent of immuno 7 compromised patients are infected by mycobacteria species. 45 : 45-8. 20 : 363-8. Marshall HF. Journal of Laryngology and Otology 1971. which can be fatal to the patient.org. immigration and previous under 6 reporting. Nasal tuberculosis . Nasal tuberculosis: a forgotten entity: Laryngoscope 1981. 6. The surgical debridement is essential for diagnosis and clearance. Levine H. Thorax 1990. 4. Hospital Update 1761. 7. in order to avoid unnecessary complications. Venice. diagnosis should be accurate and treatment prompt. 1 : 50-5. Reducing falls in elderly patients admitted to hospital will benefit the patients and reduce additional costs.

S. Flu.net: Radiology Teaching Files > Case 48507567 NASAL SEPTAL ABSCESS Contributed by: Jonah Moon. cavernous sinus thrombosis. S. Less common bacterial organisms include S. saddle nose deformity and . Infiltration of the soft tissues of the nose Fig. viridans. Infection can then occur.� The most common organisms include Streptococcus aureus. Ohio. 1: Rim enhancing hypodense fluid collection (abscess) involving the anterior nasal septum. Northeastern Ohio Universities College of MedicineCanton Affiliated Hospitals. and dental infections. concern for abscess Images: [small] larger Fig. sepsis. pneumoniae. there is rim enhancing hypodense fluid collection which measures about 2 cm in size Diagnosis: Nasal Septal Abscess Discussion: Nasal septal abscesses can arise as a complication of trauma. sinonasal. Complications include bacteremia. and H. or otherwise) and then mucoperichondrium is separated by the cartilage. epidermidis. Resident. USA. pain. meningitis. Usually there is some form of trauma (micro. cellulitis. History: Fever. 2: Sagittal image demonstrating AP extention of the rim enhancing hypodense fluid collection Findings: � Involving the anterior nasal septum.MyPACS.

http://www. References: StatDx "Nasal Septal Abscess" � Nasal Septal Abscess in Patients with Immunosuppression. Systemic symtoms include generalized malaise. Debnam J M. pain and tenderness. The Journal of Laryngology & Otology July 2002. and� headache. fever.mypacs. AJNR 28 NovDec 2007. 543�545. 116. Presenting symptoms include nasal occlusion.extension of the abscess to the brain. pp.html .net/cases/NASAL-SEPTAL-ABSCESS-48507567. Nasal septal abscess: an unusual complication of acute spheno-ethmoiditis. Vol.

Case Report .5The rupture of the small vessels that supply the nasal septum forms a hematoma that separates the mucoperichondrium from the septal cartilage. it can be cured with little residual deformity of problems. if diagnosed and attended to promptly. 2005 Volume 3 Number 2. The static blood and the necrotic cartilage form an adequate medium for the growth of the bacteria which normally colonize the nasal mucosa.1.3.3 NSA is a rare entity. Abstract Nasal septal abscesses caused by dental infection are rare. We report a case of a nasal abscess caused by dental infection. nasal septal abscess Citation F Özan. S Polat. (1. possible complications. and treatment are discussed. The Internet Journal of Dental Science. and how to manage it. H Yeler Keywords dental infection. Three cases were found in the English literature.6 This pathology is often the result of an infected septal hematoma which can be a serious complication of trauma or surgery. Introduction Nasal septal abscesses caused by dental infection were rare.5. possible complications. Nasal Septal Abscess Caused by Dental Infection: A Case Report. and treatment are discussed. In this manuscript development of the condition.Nasal Septal Abscess Caused by Dental Infection: A Case Report F Özan.4 On the other hand. but.4. H Yeler. its life threatening complications. Cartilage destruction follows as a result of ischemic and pressure necrosis. In this manuscript development of the condition.2) We report a case of a nasal abscess caused by dental infection. A nasal septal abscess (NSA) is defined as a collection of pus between the cartilage or bony septum and its normally applied mucoperichondrium or mucoperiostium. neglect can lead to nasal collapse and even cavernous sinus thrombosis. S Polat.5.3.7 The aim of this manuscript was presentation this rare condition.

Granulation tissue was curetted and root tip excised. upper lip swollen and nasal obstruction occurred. Than she was started on 625mg amoxicillin + clavulanic acid twice a day (Bioment Ko-Amoksiklav BID. general malaise. {image:2} Under topical anesthesia aspiration was attended. After 1 month the patient showed no evidence of infection. A few days later after root canal therapy had been her complaint of pain. The size of the swelling depends on the stage at which the patient is examined. Two weeks prior to presentation at our institution. nasal airway obstruction and swollen upper lip. Postoperatively patient was continued on previous medication regimen for a week. Periapical radiograph was taken and it was observed that there was large periapical lesion associated with upper left second incisor that had been root canal filling (Figure 2). Lesion was extended to floor of the nasal cavity. More infrequently. Istanbul. nasal septal abscess occurs following nasal surgery. Pus that was small amount was drained from operation area. headache. Fako. fever. but we did not get enough pus on aspiration for microbiologic evaluation. Turkey) and 550 mg naproxen sodium twice a day (Synax Fort. sinusitis or surgical trauma. Biofarma. sinusitis. The physical examination at presentation was remarkable for an anterior round purplish mass in the nose which projected bilaterally form the nasal septum (Figure 1). we encountered greyish nasal mucosa. {image:3} Discussion Abscess of the nasal septum are uncommon. There are several proposed mechanisms for the development of a NSA: (1) direct extension along the tissue .. and tenderness over the perinasal area. the patient had had root canal filling in dental office to upper left second incisor.5 Nasal obstruction is the most common presenting symptom seen with NSA. Three days after started on antibiotic regimen apical resection was made. Turkey). furunculosis of the nasal vestibule. pain.5. Istanbul. Examination of the nose usually reveals bilateral swelling of the anterior septum that can range in color from gray to reddish purple. and dental infections. 3 The pathophysiology of a NSA depends on the aetiology of the abscess.3. influenza.A 21-year-old woman presented with complaints of having something in her nose. There is no history of trauma. The most common cause is infection of an untreated nasal septal hematoma following nasal trauma.8 The presenting symptoms depend on the etiology of the NSA and the earliest symptoms are usually those of a mild upper respiratory infection. Apical resection operation was planned when her acute symptoms were resolved. At the time of suture removal nasal airway obstruction and upper lip swollen were totally resolved (Figure 3). {image:1} Her upper lip and perinasal areas were swelled and tender to palpation. At the operation we encountered larger apical lesion than seen on radiography. Other associated symptoms include throbbing nose pain.

communicating from the danger area defined by a triangle formed from the glabella to the corners of the mouth. Nasal septal abscess of dental origin. incision. Drainage is provided by Penrose drain sutured in the incision.1. It prevents reaccumulation of blood and pus. reported a case of nasal septum abscess. extraoral drainage found unnecessary. The packing serves both as a stent for the nasal skeleton and septum. it may be Streptococcus pneumonia or β-hemolytic Streptococcus. the mass in the nose reduced significantly just after operation.6 The ophthalmic and angular veins are valveless. (2) infection of a septal hematoma. Chopra S.1. The septal cartilage may undergo necrosis secondary to interference with its blood supply by thrombotic vasculititis the pus separates the mucoperichondrium from the cartilage.5 Piotrowski at al. perforation. followed by further lysis by the bacteria.3.5 Mostly treatment protocol depends on infection's source. Desai NT. 3 As mentioned above a NSA can be followed by infection of the orbit or cavernous sinus by way of the ethmoidal and ophthalmic veins. Helman J.3. References 1.3.4. drainage and packing. which will occur on manipulation of a mature abscess.5 Necrosis of the septal cartilage leads to septal deformity. There was no reaccumulation at the follow examinations.108:380-1.1.1 An incision across the swelling is made as near as possible to the floor of the nose to prevent pocketing of the pus. Nasal septal abscess due to infection from upper incisors.1.5. Eliachar I. (3) infections of dental aetiology.4.5 Prevention of serious complications can be achieved only by prompt and effective surgical treatment.5 Less often. Evaluation of aspiration samples reveals factor pathogenic organism which is usually Staphylococcus. da Silva M.3. as well antibiotic coverage.4. A secondary septal abscess may be the result of infections extending from any of the neighboring tissues.year-old child.3. J Indian Dent Assoc . Most often choice of antibiotic is Penicillin. However.planes as seen with sinusitis. and saddle nose deformity. Joachims HZ. complicated with cavernous sinus thrombophlebitis in a four.5 A nasal septal abscess is usually the result of an infected hematoma of the septum. 2. Necrotic tissue and cartilage. Different authorities advocate almost same treatment methods. Since little amount of pus was observed and granulation tissues were curetted totally. The lack of valves and the intracranial communication via the cavernous sinus predisposes this area to the spread of infection. granulations. Our treatment protocol is different from others. Arch Otolaryngol 1982. and blood clots are removed.1. The lost cartilage is replaced with fibrous tissue that may scar and later lead to unorganized asymmetric contractions that will result in obstructive nasal symptoms.1. The close relationship of the incisor teeth to the nasal floor explains the fact that an abscess arising from the central upper incisors may extend and bulge into the nasal floor. and (4) venous spread from the orbits or cavernous sinus. causing ischemic necrosis. Dental infections can reach to the septum by direct extension.9 Antibiotic treatment has to be given immediately to prevent bacteriemia. In our case usage of antibiotic and remove of source of infection seemed to be enough for treatment protocol because of uneventful healing. Septic embolism through the bloodstream is highly improbable but cannot be excluded.1 Delayed diagnosis and treatment may lead to extensive destruction of the nasal skeleton.

Nasal Septal Abscess: A Case Report. 3. Piotrowski S. and Sequelae. Thawley SE. Cuddihy PJ. Dispenza F. An unusual presentation of a nasal septal abscess.59:78 5. 1998. Ambrus PS. Bennett J. Saraniti C.14:34.  Nose Surgeries « first‹ previous…101112131415161718next ›last » . Int J Pediatr Otorhinolaryngol.91:575-82  {full_citation} https://ispub. Maggioni A. Caramanna C. Srinivasan V. Ann Plast Surg 1986. Wisd Lek. 2004 68:1417-21 8. Complications. Nasal septal abscess in a healthy. Hospital Medicine January 1998. Eavey RD. Management of nasal septal abscess. Management of nasal septal abscess in childhood: our experience. Wilson WR. Baker AS.47:155-7 7.14:229-31 4. Bojarska D. Matsuba H. 1994. non-immuno compromised patient.112:775-6 9. Nasal Septal Abscess: Unusual Causes.16:161-6 6. Treatment. Rafael Santiao. Villalonga P.41:249-50.com/IJDS/3/2/5293 SEPTAL ABSCESS Submitted by cj on Sun. Cavernous sinus thrombosis-complicaton of nasal septum abscess in children. J Laryngol Otol. Mielniczak K. Salzano FA. Dispenza C. Laryngoscope 1981. Rapado F. 1999. Int Pediatr. Augustyniak M. 10/05/2008 .1969. Kelly JH.

fever. A history of trauma can usually be elicited. Nasal septal abscess usually occurs secondary to a nasal hematoma. (3) infections of dental etiology. Haemophilus influenzae are found occationally. and tenderness over the nose. and (4) venous spread from the orbits or cavernous sinus. to less traumatic and forgotten events such as falling off a bicycle or bumping heads during play. Nasal obstruction is the most common presenting symptom seen with septal abscess. Others include nose pain. Streptococcus pneumoniae. Staphylococcus aureus is the most common organism. The presenting symptoms depend on the cause. There are several proposed mechanisms for the development of a septal abscess. (1) direct extension along the tissue planes as seen with sinusitis.This picture depicts a nose with a swelling of the middle partition or septum due to an abscess. ranging from major trauma. including child abuse and nasal septoplasty. general malaise. (2) infection of a septal hematoma. Cartilage destruction follows as a result of ischemic and pressure necrosis. Streptococcus milleri. headache. . The rupture of the small vessels that supply the nasal septum form a hematoma that separates the mucoperichondrium from the septal cartilage. There is usually an inciting traumatic event. Staphylococcus epidermis. Streptococcus viridans.

The hematoma or abscess should be evacuated to relieve the pressure and restore blood flow. vancomycin can be used. Intravenous antibiotics should be continued for 3 to 5 days and if the patient exhibits a favorable response then it is reasonableto switch to oral antibiotics. In patients who are allergic to penicillin. culture and sensitivity. the next step in management is incision and drainage. . and bacteremia can result from vascular. saddle nose deformities. and in younger patients maxillary hypoplasia. Intra venous antibiotic should be started. sepsis.The most common pathogen involved is S aureus. Oral antibiotics should be continued for 7 to 10 days.The initial treatment usually consists of fine needle aspiration of the hematoma or abscess under topical anesthesia. bacteremia. The aspirate is sent for gram stain.Blood forms a medium for bacterial growth and subsequent abscess formation. Meningitis. or direct spread through tissue planes. lymphatic. After antibiotics have been started. The complications of a septal abscess include meningitis. thus a semisynthetic penicillin is a reasonable choice. sepsis.

Symptoms of ABSCESS OF NASAL SEPTUM View symptom groups below that present with ABSCESS OF NASAL SEPTUM Nose painful red lump just within the nose lump may spontaneously drain pus Nose nasal pain pain over cheeks behind or above eyes nasal discharge headache sore throat .