Analysis of patients with septal abscess caused by electrocauterization of the nasal septum

Year 2020, , 418 - 423, 30.12.2020

Abdulvahap Akyiğit , Erol Keleş Turgut Karlıdağ , İrfan Kaygusuz , Mehmet Salih Yağmahan , Şinasi Yalçın

https://doi.org/10.32448/entupdates.828992

Abstract

Objective: Although nasal septal abscesses are mostly caused by trauma, they may occur due to non-traumatic causes. In the present study, we aimed to review patients who underwent electrocauterization of the nasal mucosa for epistaxis and subsequently developed a nasal septal abscess.
Methods: The study included 11 patients who underwent nasal electrocauterization for epistaxis and were subsequently admitted to our clinic with a pre-diagnosis of septal abscess for drainage of the abscess. The medical records of the patients, including details such as age, sex, duration of follow-up, symptoms, chronic diseases, microbiological cultures, radiological investigations and complications were retrospectively evaluated.
Results: Of the 11 patients included, seven were male and four were female with a mean age of 66.18±3.7 years. The mean duration of follow-up was 29.09±17.5 months; five patients had both hypertension and diabetes mellitus, three patients had only diabetes mellitus and three patients had only hypertension. Microbiological culture of the purulent material collected during septal abscess drainage revealed no bacterial growth in six patients, growth of Staphylococcus aureus in two patients and growth of Corynebacterium amycolatum in one patient. Four patients underwent preoperative computed tomography (CT) of the paranasal sinuses and five patients developed a saddle nose deformity in the long-term follow-up.
Conclusion: All surgical interventions to the nose or cauterization procedures should be performed under sterile conditions, especially in patients with chronic diseases, and such patients should be followed up after the procedure.

Keywords

Septal abscess, epistaxis, electrocauterization

References

• 1. Ambrus PS, Eavey RD, Baker AS, Wilson WR, Kelly JH. Management of nasal septal abscess. Laryngoscope 1981;91:575-82.
• 2. Adnane C, Adouly T, Taali L, et al. Unusual spontaneous nasal septal abscess. J Case Rep Stud 2015;3:302.
• 3. Kryger H, Dommerby H. Haematoma and abscess of the nasal septum. Clin Otolaryngol Allied Sci 1987;12:125-9.
• 4. da Silva M, Helman J, Eliachar I, Joachims HZ. Nasal septal abscess of dental origin. Arch Otolaryngol 1982;108:380-1.
• 5. Dispenza C, Saraniti C, Dispenza F, Caramanna C, Salzano FA. Management of nasal septal abscess in childhood: our experience. Int J Pediatr Otorhinolaryngol 2004;68:1417-21.
• 6. Shah SB, Murr AH, Lee KC. Nontraumatic nasal septal abscesses in the immunocompromised: etiology, recognition, treatment, and sequelae. Am J Rhinol 2000;14:39-43.
• 7. Walker R, Gardner L, Sindwani R. Fungal nasal septal abscess in the immunocompromised patient. Otolaryngol Head Neck Surg 2007;136:506-7.
• 8. Nemer AK, Motassim AR. Evaluation of conservative measures in the treatment of epistaxis. Khartoum Medical Journal 2008;1:15-7.
• 9. Bailie N, Hanna B, Watterson J, Gallagher G. A model of airflow in the nasal cavities: Implications for nasal air conditioning and epistaxis. Am J Rhinol Allergy 2009;23:244-9.
• 10. Davies K, Batra K, Mehanna R, Keogh I. Pediatric epistaxis: epidemiology, management & impact on quality of life. Int J Pediatr Otorhinolaryngol 2014;78:1294-7.
• 11. Damrose JF, Maddalozzo J. Pediatric epistaxis. Laryngoscope 2006;116:387-93.
• 12. Patel N, Maddalozzo J, Billings KR. An update on management of pediatric epistaxis. Int J Pediatr Otorhinolaryngol 2014;78:1400-4.
• 13. Elden L, Reinders M, Witmer C. Predictors of bleeding disorders in children with epistaxis: value of preoperative tests and clinical screening. Int J Pediatr Otorhinolaryngol 2012;76:767-71.
• 14. Pang KP, Sethi DS. Nasal septal abscess: an unusual complication of acute spheno-ethmoiditis. J Laryngol Otol 2002;116:543-5.
• 15. Ginsburg CM, Leach JL. Infected nasal septal hematoma. Pediatr Infect Dis J 1995;14:1012-3.
• 16. Dinesh R, Avatar S, Haron A, Suhana, Azwarizan. Nasal septal abscess with uncontrolled diabetes mellitus: case reports. Med J Malaysia 2011;66:253-4.
• 17. Tien DA, Krakovitz P, Anne S. Nasal septal abscess in association with pediatric acute rhinosinusitis. Int J Pediatr Otorhinolaryngol 2016;91:27-9.
• 18. Cain J, Roy S. Nasal septal abscess. Ear Nose Throat J 2011;90:144-7.
• 19. Huang PH, Chiang YC, Yang TH, Chao PZ, Lee FP. Nasal septal abscess. Otolaryngol Head Neck Surg 2006;135:335-6.
• 20. Cheng LH, Wu PC, Shih CP, et al. Nasal septal abscess: a 10-year retrospective study. Eur Arch Otorhinolaryngol 2019;276:417-20.
• 21. Kim T, Kim JS, Heo SJ. Nasal Septal Abscess Developed After Radiofrequency Cauterization for Epistaxis. J Craniofac Surg 2019;30:713-4.
• 22. In SM, Kim JY. A case of saddle nose deformity caused by electrocautery of nasal septum. [Article in Korean] Korean J Otorhinolaryngol Head Neck Surg 2018;61:532-5.
• 23. Wallenborn WM, Fitz-Hugh GS. Abscess of the posterior nasal septum. Report of a case. Arch Otolaryngol 1963;77:3-5.
• 24. George A, Smith WK, Kumar S, Pfleiderer AG. Posterior nasal septal abscess in a healthy adult patient. J Laryngol Otol 2008;122:1386-8.
• 25. Canty PA, Berkowitz RG. Hematoma and abscess of the nasal septum in children. Arch Otolaryngol Head Neck Surg 1996;122:1373-6.
• 26. Jalaludin MA. Nasal septal abscess--retrospective analysis of 14 cases from University Hospital, Kuala Lumpur. Singapore Med J 1993;34:435-7.