A 58-year-old man was referred to our hospital with a 2-week history of nasal obstruction, pain, and intermittent fever. He had visited two other hospitals, where oral antibiotics and local treatment of the nose had been given. He had no recent history of nasal trauma, surgery, sinusitis, or dental infections. Physical examination revealed bulging septal mucosa occupied his bilateral nasal cavity (Figure 1A and 1B). Maxillofacial computed tomography with contrast showed a hypodense lesion with ring enhancement measuring approximately 2.9 × 2.4 cm at the anterior septum (Figure 1D–1F). An emergent incision and drainage was performed under general anesthesia. Approximately 6 mL pus was drained via an incision placed just about 5 mm above the caudal border of the septal cartilage, known as Killian's incision (Video 1). Operative findings showed absence of cartilaginous septum. A septal mucosa suture with Penrose drain was placed. A bacterial culture of the purulent fluid grew Viridans streptococcus. The nasal septum recovered with visible bilateral inferior turbinate and nasal cavity (Figure 1C). Unfortunately, the patient finally complicated with a depressed nasal tip.
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Published online: June 27, 2019
Accepted: May 6, 2019
Received in revised form: April 11, 2019
Received: February 28, 2019
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