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April 1989

Picture of the Month

Author Affiliations

Contributed from the Department of Otolaryngology and Maxillofacial Surgery, University of Cincinnati (Ohio).

Am J Dis Child. 1989;143(4):501-502. doi:10.1001/archpedi.1989.02150160131026

The statements listed below are best associated with which of the above figures:

(a) Following nasal trauma, this lesion is associated with progressive nasal obstruction.

(b) This mass is a cause of nasal obstruction in patients with allergic rhinitis or chronic sinusitis.

(c) This condition should be considered in the differential diagnosis of any newborn or infant with nasal obstruction.

Denouement and Discussion  A nasal septal abscess should be considered in patients presenting with progressive nasal obstruction following nasal trauma. The abscess usually presents as an erythematous, tender nasal mass that may completely obstruct the airway either unilaterally or bilaterally (Fig 1). The treatment of choice is incision and drainage with the placement of a drain and nasal packing. Septal hematomas may progress to suppuration and ultimately dissolution of the septal cartilage. This may occur as early as 48 hours, resulting in a long-term cosmetic deformity.

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