Unmasking Nasal Septal Hematoma/Abscess: A Systematic Review and Meta-analysis.

Autor: Nanu DP; 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., Adelsberg D; Department of Otolaryngology Jacobs School of Medicine and Biomedical Sciences at the University of Buffalo Buffalo New York USA., Nguyen SA; Department of Otolaryngology-Head and Neck Surgery Charleston Medical University of South Carolina Charleston Washington USA., Radulovich NP; Elson S. Floyd College of Medicine at Washington State University Spokane Washington USA., Carr MM; Department of Otolaryngology University at Buffalo Buffalo New York USA.
Jazyk: angličtina
Zdroj: OTO open [OTO Open] 2024 Oct 08; Vol. 8 (4), pp. e174. Date of Electronic Publication: 2024 Oct 08 (Print Publication: 2024).
DOI: 10.1002/oto2.174
Abstrakt: Objective: We aim to discuss the demographics, symptoms, bacteriology, treatment, and sequelae associated with nasal septal hematoma/nasal septal abscess (NSH/NSA).
Data Sources: CINAHL, PubMed, and Scopus were searched from inception until October 15, 2023.
Review Methods: 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.
Results: 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 Staphylococcus   aureus at 56.5% (49.0-63.8), Streptococcus species at 8.9% (5.2-14.0), and Klebsiella pneumoniae 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).
Conclusion: 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.
Competing Interests: All authors (Douglas P. Nanu, Daniel Adelsberg, Shaun A. Nguyen, Nicholas P. Radulovich, Michele M. Carr) report no financial support or funding.
(© 2024 The Author(s). OTO Open published by Wiley Periodicals LLC on behalf of American Academy of Otolaryngology–Head and Neck Surgery Foundation.)
Databáze: MEDLINE
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