- 期刊
鼻中隔膿瘍併齒外傷－病例報告
Nasal Septal Abscess Associated with Dental Injury - Case Report
摘要
鼻中隔膿瘍可能在鼻部外傷或手術後出現，若處理不當可導致鼻部變形及顱內併發症。因牙齒感染併發鼻中隔膿瘍則相當罕見，在英文文獻中只有兩篇病例報告。本文提出1名48歲女性病例，主訴一個月前因跌倒造成左上中央門齒斷裂及持續齒痛，約2星期前開始出現鼻部疼痛、鼻塞。她先至牙科診所接受左上中央門齒開腔術、根管治療及口服抗生素cephalexin治療後雖然牙齦腫脹消失，但鼻部症狀並未改善，且出現發燒。詳細檢查確定診斷為鼻中隔膿瘍。經靜脈注射抗生素及切開引流並清除壞死軟骨，術後照會牙科完成後續根管治療後病情穩定出院。一年後追蹤鼻孔通暢且無鼻部變形。上中央門齒齒痛患者若出現鼻部疼痛及鼻塞應予以高度警覺，及早治療能避免併發症發生。
並列摘要
Abscesses of the nasal septum are a rare complication following nasal trauma or septal surgery, and occur even less commonly as a result of dental injury. In this paper a 48-year-old woman is described who suffered from a septal abscess one month after a fall in which her left upper central incisor was fractured. She presented with a two week history of progressive nasal stuffiness and pain as well as a one week history of intermittent fever. A toothache had persisted despite open-chamber endodontic treatment and antibiotic therapy with cephalexin given for apicits and gingivitis. Septal swelling with central fluctuation and edema of the surrounding structures including the nostrils were noted on examination and a abscess seemed likely. A radiological study identified a periapical abcess of the fractured tooth, with the septal abscess being ascribed to extension of the periapical infection. Under intravenous penicillin G and ceftriaxone cover, she underwent incision, debridement and drainage from the right side of the nasal septum. The swelling soon subsided and the patient was discharged four days later. She was followed up for several weeks and then reviewed one year later, at whick time there were no sequelae. Otolaryngologists should note that nasal septal abscesses can be a rare complication of incisor injury.