Alshaikh Nada, Lo Stephen
ENT Department, Tan Tock Seng Hospital, Singapore.
Int J Pediatr Otorhinolaryngol. 2011 Jun;75(6):737-44. doi: 10.1016/j.ijporl.2011.03.010. Epub 2011 Apr 14.
Nasal septal abscess (NSA) is an uncommon condition. It is a collection of pus in the space between the nasal septum and its overlying mucoperichondrium and/or mucoperiosteum. If left untreated, there are risks of intracranial complications, facial deformity, and delayed facial growth. There is no universally agreed consensus on the treatment of this condition. This study reviews evidence in the literature to determine its etiology, presentation, investigation, management options, and outcome.
A structured review of the PubMed, EMBASE and the Cochrane Collaboration databases (Cochrane Central Register of Controlled Trials, Cochrane Database of Systemic Reviews) was undertaken, using the MeSH terms: nasal septum, nasal cartilage, trauma, hematoma, abscess, reconstructive surgery, rhinoplasty, pediatric, and children.
A total of 159 citations from 1920 to date were reviewed regarding nasal septal abscess, of which 81 articles were identified to be relevant to this review. No randomized controlled trials or systematic reviews were found in the Cochrane Collaboration database, PubMed or EMBASE. NSA is more common in children and in male. Nasal trauma and untreated septal hematoma are the leading cause. Staphylococcus aureus is isolated in up 70% of the cases. Clinically, nasal septal swelling, pain and tenderness, with purulent discharge are mostly evident. The immediate management of NSA is incision and drainage and antibiotic therapy. Recent studies suggest early septal reconstruction in children in order to prevent immediate and late facial deformity and nasal dysfunction. Autologous cartilage is the implant material of choice.
Nasal septal abscess is a serious condition that necessitates urgent surgical management in order to prevent potential life threatening complications. In the growing child, early reconstruction of destructed septal cartilage is essential for normal development of the midface (nose and maxilla).
鼻中隔脓肿（NSA）是一种罕见病症。它是鼻中隔与其上方的鼻软骨膜和/或鼻骨膜之间的脓性积液。若不治疗，存在颅内并发症、面部畸形及面部发育迟缓的风险。对于该病症的治疗尚无普遍认可的共识。本研究回顾文献证据以确定其病因、表现、检查、治疗选择及预后。
使用医学主题词：鼻中隔、鼻软骨、创伤、血肿、脓肿、重建手术、隆鼻术、儿科、儿童，对PubMed、EMBASE和Cochrane协作网数据库（Cochrane对照试验中心注册库、Cochrane系统评价数据库）进行结构化回顾。
共回顾了1920年至今关于鼻中隔脓肿的159篇文献，其中81篇文章被确定与本综述相关。在Cochrane协作网数据库、PubMed或EMBASE中未发现随机对照试验或系统评价。NSA在儿童及男性中更常见。鼻外伤和未治疗的鼻中隔血肿是主要病因。高达70%的病例中分离出金黄色葡萄球菌。临床上，鼻中隔肿胀、疼痛和压痛伴脓性分泌物最为明显。NSA的即刻治疗是切开引流及抗生素治疗。近期研究建议对儿童尽早进行鼻中隔重建以预防即刻和晚期面部畸形及鼻功能障碍。自体软骨是首选的植入材料。
鼻中隔脓肿是一种严重病症，需要紧急手术治疗以预防潜在的危及生命的并发症。在生长发育中的儿童，早期重建受损的鼻中隔软骨对中面部（鼻子和上颌骨）的正常发育至关重要。
