Nasal Septal Abscesses: A Systematic Review.

Background: Nasal septal abscesses (NSA) necessitate prompt recognition and management to prevent morbidity and long-term sequelae. To date, no comprehensive review of NSA alone has been conducted.

Objective: To conduct a systematic review of the presentation and management of NSA and determine patients at risk of sequelae.

Methods: Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines were followed. PubMed, Web of Science, Cochrane, and reference lists were searched. Patient demographic information, etiology, presentation, management, and outcomes were recorded and analyzed.

Results: A total of 79 articles (90 cases) were included. The mean age was 32.86 years old with a slight male predominance. The most common signs were nasal pain (44.86%, N=48), trouble breathing (23.36%, N=25), and headache (15.89%, N=17). All cases were treated with intranasal drainage. Most patients (66.67%, N=60) were asymptomatic at last follow-up. Most abscesses (73.07%) were located in the anterior septum. Of those patients who experienced complications, common complications were saddle nose deformity (70.59%, N=24), nasal obstruction (5.88%, N=2), and septal perforation (5.88%, N=2). No significant association between age (P = 0.23), sex (P = 0.99), history of diabetes (P = 0.11), history of nasal trauma (P = 0.91), history of nasal/dental surgery (P = 0.14), location (P = 0.18), or postoperative nasal packing (P = 0.65) and NSA outcomes was found.

Conclusion: Patients with or without a history of immunodeficiency, trauma, or nasal surgery are at risk of developing NSA. Without adequate treatment, NSA can be associated with functional and aesthetic sequelae.