بررسي باليني موارد هماتوم و آبسه تيغه بيني

A clinical evaluation of nasal septal hematoma and abscess

Objective: Septal hematoma is one of the most sever and early complications of nasal trauma that lead to septal cartilage necrosis. A nasal septal abscess usually results from an infected hematoma of the septum. While the necrosis of septal cartilage can lead to nasal deformity and sever impairment of nasal patency. The purpose of this study was to evaluate the clinical characteristics, causes and treatments undertaken for patients suffering from hematoma and abscess of the nasal septum. Subjects and Methods: In this cross-sectional study we preformed a retrospective evaluation seventy-four (74) patients who were admitted for treatment of hematoma and abscess of the nasal septum during years 2000 to 2007 at Ahvaz Jundishapur University, Imam Khomeini Hospital. Clinically important diagnostic features, etiology, delay of referral, bacteriological results and type of treatment undertaken as well as age and sex of all the patients were recorded. Results: The mean age of the patients was 9 years (range 11 months to 53 years). All of 74 (55 males and 19 females) patients underwent surgical treatment, 67 of whom had a history of nasal trauma (91%). Hematoma was present in 53 patients (72%) and septal abscess was observed in 21 cases (28%). Nasal obstruction was the most common symptom which was found in all the patients. Pain, rhinorhea and fever occurred in a few cases. The average delay of treatment was 3.5 days for patients with hematoma and 8 days for patients with abscesses. All these lesions were incised under general anesthesia and treated with drainage and nasal packing. The commonest pathogenic organism isolated from the pus of nasal septal abscess was Staphylococcus aureus. Conclusion: The diagnosis of hematoma and abscess of the nasal septum must be considered in all patients who have acute onset of nasal obstruction and history of recent nasal trauma to minimize the risk of nasal deformity and prevent the development of septic complications. Early diagnosis and immediate therapy is mandatory to avoid cosmetic nasal deformity or intracranial infection.