Collection of pus between the mucoperichondrium and the cartilage of the nasal septum ; anterior location and that can occur unilaterally or bilaterally.
Causes
The most frequent causes are regional trauma and secondary infection of the septal hematoma; However, its origin can be traumatic, or by the spread of neighboring infections, such as the furuncle of the upper lip of the columella. It can also behave as a metastatic abscess from general conditions ( erysipelas , scarlet fever , diabetes ).
Clinical picture
This entity is characterized by a nasal obstructive syndrome, with a marked ventilation deficit and accompanied by lancinating pain located in the nasal pyramid with radiation to the neighboring paranasal areas. Photophobia and tearing may occur ; capture of the general state is marked and the high fever , presented by the patient with a toxic impregnation fascia.
On examination, obstructive masses are found that may not be very different from the hematoma, although in the abscess the coloration is paler and the fluctuation greater.
Diagnosis
The traumatic or hematoma history and the clinical picture make up the diagnosis; the puncture allows making the differential diagnosis with the hematoma.
Evolution
More torpid than the hematoma, well treated it will be satisfactory; the perforative and deforming sequela will always be present if the treatment is not carried out according to the condition.
Forecast
The prognosis depends on the treatment and the possible intracranial complications that the abscess can cause.
Treatment
An incision and drainage are made, with the removal of the necrotic cartilage. Rest, antibiotic therapy and analgesic are oriented. Nasal packing is optional.