Definition: Pus collection between mucoperichondrium & cartilage of the nasal septum. It is uncommon medical condition but serious.
Etiology (causes):
- Infected hematoma
- Vestibulitis
- Recent nasal surgery
- Nasal furuncles
- Chronic dental infections
Symptoms:
- Fever, headache, and malaise.
- Throbbing pain.
- Bilateral Nasal obstruction.
- Purulent discharge, if ruptured.
Signs:
- Bilateral fluctuant, tender swelling on both sides of septum.
- Tenderness and edema of nasal tip.
Differential Diagnosis (DDx):
- Neoplastic: Lymphoma, metastasis, nasal glioma, esthesioneuroblastoma, sarcoma, chloroma.
- Infectious: Typical infections (S. aureus, S. pneumonia), atypical (tuberculosis, fungal).
- Inflammatory: Wegener granulomatosis.
Complications:
- Septal perforation
- External deformity.
- Cavernous sinus thrombosis.
Treatment:
As in Septal hematoma.
- Aspiration, if the patient visits the doctor early.
- As newborn babies are obligatory nose breathers, they may need additional care including the placement of a tube to help them breathe while the hematoma heals.
- Incision & evacuation: Drainage under local anathesia usually, but some cases (particularly babies and very young children) may need general anesthesia.Transverse incision, to avoid disturbance of mucociliary transport. Put a nasal pack for 24hours.
- Broad spectrum antibiotics.