Unit of Pediatric Otorhinolaryngology, Spedali Civili, Brescia, Italy.
Unit of Otorhinolaryngology-Head and Neck Surgery, University of Brescia, Brescia, Italy.
Ann Otol Rhinol Laryngol. 2021 Aug;130(8):966-969. doi: 10.1177/0003489420987974. Epub 2021 Jan 9.
Nasal septal abscess is a rare disorder in pediatric patients and is mostly diagnosed as a complication of trauma or secondary to dental or sinonasal infection.
A 10-year-old girl presented with acute nasal obstruction, otalgia, and headache. Medical history was negative; physical examination and anterior rhinoscopy did not reveal signs of acute rhinosinusitis or septal abscess.
A thorough nasal endoscopy was performed to rule out a posterior nasal infection, revealing a bilateral posterior septal bulging, in the absence of purulent discharge. CT scan and contrast-enhanced MRI were performed, confirming the diagnosis of a spontaneous posterior septal abscess. Trans-nasal endoscopic-assisted drainage was conducted under general anesthesia. was detected on culture.
Although rare, nasal septal abscess in the pediatric age is typically anterior and secondary to local trauma or infection. Accurate medical history and anterior rhinoscopy are usually sufficient to make the diagnosis. In cases where the clinical presentation is consistent with a nasal septal abscess, with no history of recent local trauma or infection, or signs of anterior septal bulging, nasal endoscopy should be performed to rule out spontaneous posterior septal abscess. Delay in diagnosis and treatment could potentially cause the rapid onset of life-threatening complications, including intracranial abscess, meningitis, and cavernous sinus thrombosis.
鼻中隔脓肿在儿科患者中较为罕见，多诊断为创伤并发症，或继发于牙源性或鼻-鼻窦感染。
一名 10 岁女孩因急性鼻塞、耳痛和头痛就诊。无既往病史；体格检查和前鼻镜检查均未显示急性鼻-鼻窦炎或鼻中隔脓肿的迹象。
行彻底的鼻内镜检查以排除后鼻孔感染，结果显示双侧鼻中隔后凸，无脓性分泌物。行 CT 扫描和增强 MRI 检查，确诊为自发性鼻中隔后脓肿。在全身麻醉下经鼻内镜辅助引流。培养检测到 。
尽管罕见，但儿童鼻中隔脓肿通常为前位，继发于局部创伤或感染。准确的病史和前鼻镜检查通常足以做出诊断。如果临床表现符合鼻中隔脓肿，且无近期局部创伤或感染史，或无前鼻中隔膨隆的迹象，应行鼻内镜检查以排除自发性鼻中隔后脓肿。诊断和治疗的延迟可能导致危及生命的并发症迅速发生，包括颅内脓肿、脑膜炎和海绵窦血栓形成。
