Abscess of the septum refers to the accumulation of pus under the mucoperichondrium or mucoperiosteum of the nasal septum, which is a serious nasal infection. Delayed diagnosis and treatment can lead to severe consequences.

bubble_chart Etiology

1. Traumatic injury of the nose or secondary infection caused by untreated nasal septal hematoma after nasal septum surgery. This is the most common cause.

2. Infection of adjacent tissues spreading to the nasal septum, such as incisor root infection, nasal columella or nasal vestibule furuncle, etc.

3. Occasionally, it may be secondary to certain acute pestilence diseases, such as epidemic common cold, scarlet fever, etc.

bubble_chart Clinical Manifestations

1. Local symptoms Similar to a nasal septum hematoma, the patient experiences bilateral stuffy nose, with no relief from Ephedrine saline drops. There is redness, swelling, and pain over the nasal bridge and tip, accompanied by tenderness. The nasal septum shows bilateral symmetrical swelling, soft in texture, with fluctuation and marked tenderness. If the abscess ruptures spontaneously, purulent blood may discharge.

2. Systemic symptoms Shivering, fever, general malaise, and headache.

If a nasal septum abscess is inadequately managed, pressure on the septal cartilage can impair blood supply, leading to cartilage necrosis, manifested as a saddle nose or septal perforation. The infection may also spread intracranially, causing intracranial complications.

bubble_chart Diagnosis

In cases of symmetrical swelling of the nasal septum with significant local pain, accompanied by redness, swelling, and pain in the nasal bridge and tip, a thorough examination should be conducted. Diagnosis is confirmed by aspirating pus from the swollen area through puncture.

Once diagnosed, an abscess incision and drainage should be performed under topical anesthesia. The necrotic tissue and granulation within the abscess cavity must be thoroughly cleaned, followed by irrigation with an antibiotic solution. An iodoform gauze drain should be placed for 2–3 days. If a rubber strip drain is used, it should be replaced daily until the pus is completely drained. Concurrently, systemic antibiotics should be administered in sufficient doses. If nasal deformity remains, corrective surgery can be performed after 3 months.