Nanu Douglas P, Adelsberg Daniel, Nguyen Shaun A, Radulovich Nicholas P, Carr Michele M
Department of Otolaryngology-Head and Neck Surgery Charleston Medical University of South Carolina Charleston Washington USA.
Elson S. Floyd College of Medicine at Washington State University Spokane Washington USA.
OTO Open. 2024 Oct 8;8(4):e174. doi: 10.1002/oto2.174. eCollection 2024 Oct-Dec.
We aim to discuss the demographics, symptoms, bacteriology, treatment, and sequelae associated with nasal septal hematoma/nasal septal abscess (NSH/NSA).
CINAHL, PubMed, and Scopus were searched from inception until October 15, 2023.
Preferred Reporting Items for Systematic Reviews and Meta-analysis 2020 guidelines were followed. Inclusion criteria included patients who were diagnosed with a traumatic NSH/NSA. NSH/NSA due to surgical procedures was excluded. Demographics included N of patients, patient age, and gender. Symptoms, antibiotics given, bacteriology, and sequelae were analyzed. Meta-analysis of continuous measures (mean, median), and proportions (%) with a 95% confidence interval (CI) was conducted.
Thirty studies (N = 598) were included. In total, 72.1% were males (95% CI: 67-78). The total mean age was 21.6 years (range: 0.2-85, 95% CI: 17.2-26.1). The mean time from trauma to diagnosis was 8.2 days. Common symptoms at presentation included nasal obstruction/congestion at 60.3% (95% CI: 37.1-81.4), nasal pain at 30.0% (17.2-44.6), swelling at 20.4% (8.7-35.5), headache at 15.5% (7.3-26.0), and fever at 13.9% (7.3-22.2). The most common pathogens isolated included at 56.5% (49.0-63.8), species at 8.9% (5.2-14.0), and at 6.3% (3.2-10.8). Antibiotics given included amoxicillin-clavulanate at 10.3% (4.5-18.2), metronidazole at 9.5% (1.1-24.9), ampicillin-sulbactam at 8.9% (0.4-26.5), and unspecified antibiotics at 39.7% (13.8-69.2). The most common sequelae were nasal septal deformity/cartilage destruction at 14.3% (7.7-22.6).
NSA/NSH has an 8-day delay in diagnosis from the time of trauma. First-line practitioners should be made aware of the signs and symptoms of this condition to minimize the risk of morbidity.
我们旨在探讨与鼻中隔血肿/鼻中隔脓肿（NSH/NSA）相关的人口统计学特征、症状、细菌学、治疗及后遗症。
检索CINAHL、PubMed和Scopus数据库，检索时间从建库至2023年10月15日。
遵循系统评价和Meta分析的首选报告项目2020指南。纳入标准包括诊断为创伤性NSH/NSA的患者。排除手术所致的NSH/NSA。人口统计学特征包括患者数量、患者年龄和性别。分析症状、使用的抗生素、细菌学及后遗症。对连续指标（均值、中位数）和比例（%）进行Meta分析，并计算95%置信区间（CI）。
纳入30项研究（N = 598）。总体而言，72.1%为男性（95%CI：67 - 78）。总平均年龄为21.6岁（范围：0.2 - 85岁，95%CI：17.2 - 26.1）。从创伤到诊断的平均时间为8.2天。就诊时的常见症状包括鼻塞/鼻充血，占60.3%（95%CI：37.1 - 81.4）；鼻痛，占30.0%（17.2 - 44.6）；肿胀，占20.4%（8.7 - 35.5）；头痛，占15.5%（7.3 - 26.0）；发热，占13.9%（7.3 - 22.2）。分离出的最常见病原体包括[具体病原体1]，占56.5%（49.0 - 63.8）；[具体病原体2]种，占8.9%（5.2 - 14.0）；[具体病原体3]，占6.3%（3.2 - 10.8）。使用的抗生素包括阿莫西林 - 克拉维酸，占10.3%（4.5 - 18.2）；甲硝唑，占9.5%（1.1 - 24.9）；氨苄西林 - 舒巴坦，占8.9%（0.4 - 26.5）；未明确的抗生素，占39.7%（13.8 - 69.2）。最常见的后遗症是鼻中隔畸形/软骨破坏，占14.3%（7.7 - 22.6）。
NSA/NSH从创伤时起诊断延迟8天。一线从业者应了解这种疾病的体征和症状，以尽量降低发病风险。
