J Korean Assoc Oral Maxillofac Surg.  2021 Apr;47(2):135-140. 10.5125/jkaoms.2021.47.2.135.

Nasal septal abscess with a dental origin: a case report and a review of the literature

• Lee SM
• Leem DH

• KMID: 2515312
• DOI: http://doi.org/10.5125/jkaoms.2021.47.2.135

Abstract

Since the first report of a nasal septal abscess (NSA) from a dental origin (1920), six articles have been published in the English literature to date. The most common cause of NSA is an infection of the nasal septal hematoma after trauma. This is a report of an uncommon cause of NSA with a dental origin. A PubMed search performed regardless of year and country using the terms (“nasal septal abscess”) OR (“nasal septum abscess”) initially yielded 229 articles. After screening, seven articles (eight patients) were selected. Addition of two related articles produced a total of nine articles (10 patients) to be included. The age of the included patients ranged from 7 to 69 years (mean, 32.82 years; standard deviation, ±23.86 years). The sex composition was as followed: males (n=7; 63.6%), females (n=4; 36.4%). Dental histories were various: periapical lesions, caries, extraction, endodontic therapy, and cystic lesions. The maxillary incisor dominated as the tooth of origin. Early diagnosis and treatment of NSAs are important to avoid not only facial deformity, but also severe complications (e.g., intracranial infection). If NSA is suspected in patients without facial trauma, the possibility of a dental origin, especially from the maxillary incisor area, should be considered.

Keyword

Nasal septal abscess; Dental focal infection

Figure

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  Fig. 1 Clinical photograph at first visit. Reddish swelling on both sides were observed around the nasal septum.

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  Fig. 2 Enhance computed tomography (coronal view). The lesion size in the anterior portion of the nasal septum is 31 mm×27 mm× 39 mm.

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  Fig. 3 Panoramic view. Left maxillary central incisor was extracted.

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  Fig. 4 Cone-beam computed tomography. The partial bone destruction of the nasal floor was confirmed. The chronic inflammation and local osteomyelitis were observed above the maxillary left lateral incisor implant.

Reference

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