Nasal Septal Abscess Complicating Acute Sinusitis in an 8-Year-Old Child: A Case Report

Introduction: Nasal septal abscess (NSA) in the pediatric population is an uncommon condition, but it can cause devastating complications (such as potentially life-threatening intracranial infections and cosmetic nasal deformity). The objective of this study is to report a case of an pediatric patient presenting with NSA in association with frontal-ethmoid acute sinusitis and intracranial abscess. Method and Results: In this study, we report a case of an 8-year-old patient who progressed from spontaneous nasal septal abscess to sinusitis (maxillary, frontal and ethmoidal), cosmetic nasal deformity (destruction of septal cartilage) and intracranial complication. The purulent collection necessitated urgent surgical drainage and adequate medical treatment. Conclusion: Nasal septal abscess in children is a rare condition that necessitates early appropriate drainage in order to prevent severe life-threatening complications. Furthermore, in the growing child, in case of total destruction of the cartilaginous septum, immediate reconstruction with autologous cartilage graft is essential for normal development of the nose and maxilla.

Application of the Konno procedure for infective endocarditis in native bicuspid aortic valve with annular abscess extending into the interventricular septum

Annular abscess is a serious complication of infective endocarditis, which often requires complex surgery and has a very high post-operative mortality rate. The Konno procedure involves valve annuloplasty for a narrow aortic annulus or left ventricular outflow tract stenosis in children; it is also performed for various cardiac conditions in adults. Here, we report a case of the Konno procedure performed in a patient with aortic valve infective endocarditis, with an annular abscess extending into the interventricular septum (IVS). A 58-year-old man who presented to our hospital with fever was diagnosed with aortic valve infective endocarditis caused by Streptococcus saccharolyticus. On echocardiography, an annular abscess in the direction of the IVS was detected, and surgery was planned. The Konno procedure was performed to secure an adequate surgical field and to debride and reconstruct the cavity created by the interventricular septal abscess. The patient was discharged uneventfully 29 days after surgery.

Comparison of Efficacy of Nasal Septal Splints with Clip versus Nasal Packing after Septoplasty

Introduction It has always been a concern of ENT surgeon to prevent post operative complications like nasal bleeding, septal hematoma and septal abscess after septoplasty. Traditionally nasal packing has been done to avoid these complications. Although the nasal pack itself has been a concern for several reasons, packing apart from causing breathing distress, has resulted in epiphora, dysphagia, sleep disturbance, post-operative pain, headache, septal infection, septal abscess and even toxic shock syndrome. Materials and Methods This study has compared the efficacy of a newly designed septal splint with clip with nasal packs. This study was done on 60 patients, nasal packing was done in 30 patients and septal splints with clip were applied in 30 patients. Results Post-operative pain, epiphora, dysphagia, dryness of mouth and sleep disturbance was found to be significantly less in patients with septal splints with clip as compared to those with nasal packing. Conclusion Septal splints with clip is more efficacious alternative to nasal packing in patients undergoing septoplasty.

AYURVEDIC MANAGEMENT OF DEVIATED NASAL SEPTUM – A CASE STUDY

Nasa Pratinaha is one among the 31 Nasa Roga in which nasal obstruction is the main symptom. It is a commonly encountered disease in clinical practice. This disease occurs due to aggravation of Udan Vata, enveloped with Kapha, thereby causing obstruction in nose. In contemporary science this disease can be co-related with many disorders like turbinate hypertrophy, deviated nasal septum, nasal polyp, tumours, allergic rhinitis and others; among which deviated nasal septum is a common cause. Deviated Nasal Septum can be treated with surgical and medical methods. The medical and surgical managements have their own limitations, merits, and demerits like synechiae formation, rhinitis sicca, severe bleeding, septal perforation, septal heamatoma, septal abscess etc. In Ayurvedic classics the treatment for Nasa Pratinaha is Snehapana, Nasya, Dhoompana etc. The best prescribed in Nasya Pratinaha for Nasya is Bala Taila, the same oil is also recommended for Nasa Pichu. Thus, this study was carried out with the objective of to evaluate the effectiveness of Bala Taila Nasya and Nasa Pichu in the management of Deviated Nasal Septum Nasal Septum. A case report of 43-year-old female who presented with complaints of frequent nasal obstruction, nasal discharge, discomfort in nose, and headache; was diagnosed with Deviated Nasal Septum. The patient was treated with Bala Taila nasya and Nasa Pichu with the same oil. Hence Bala Taila administered as Nasya and Nasa Pichu was significant in controlling the symptoms of Nasa Pratinaha (Deviated Nasal septum) without recurrence in the follow up period.

A Case Report of Spontaneous Nasal Septal Abscess in a Child

We describe a case of spontaneous nasal septal abscess (NSA) in a 9-year-old child. We also reviewed the literatures in recent years and summarized the characteristics of NSA, such as gender, age, inducement, pathogenic bacteria, treatment, and prognosis. We found that this boy reported by us has the most extensive abscess. May be the delay of treatment was related to the recent fluctuation of COVID-19 epidemic in China. Fortunately, with the help of surgery and anti-infection treatment, the boy was discharged from the hospital without septal perforation or saddle nose.

Spontaneous Abscess of the Posterior Nasal Septum: An Unusual Cause of Nasal Obstruction in Children

Introduction: 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. Case Presentation: 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. Management and Outcome: 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. Haemophilus influenzae was detected on culture. Discussion: 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.