Nasal Abscess in Danger Area of Face

Nasal furunculosis-Abscess-is a boil in the nasal vestibule as a result of infection of a hair follicle. This condition is very rare. Staphylococcus is the most common organism, rarely MRSA.

In this condition the tip of the nose becomes red and very painful-throbbing pain.

Systemic antibiotics should be given immediately, preferably by injection. Follow up the patient after 24hrs.

Drainage of the abscess may be necessary but should be deferred until the patient has had appropriate antibiotic treatment for 24 hours. It must be done with sterile precaution.

1. Complications Abscess formation

2. Chondritis of nasal cartilages

3. Cavernous Sinus thrombosis

The condition is serious because it carries a risk of the development of cavernous venous thrombosis.

Danger Area of Face

The danger triangle of the face consists of the area from the corners of the mouth to the bridge of the nose, including the nose and maxilla. Due to the special nature of the blood supply to the human nose and surrounding area, it is possible (although very rare) for retrograde infections from the nasal area to spread to the brain.

This is possible because of venous communication (via the ophthalmic veins) between the facial vein and the cavernous sinus. The cavernous sinus lies within the cranial cavity, between layers of the meninges and is a major conduit of venous drainage from the brain.

Unlike other veins of the circulatory system, veins of the head do not contain one way valves, therefore blood can flow away from the skull and exit the face inferiorly, or flow back into the skull to be drained via the internal jugular vein.

This is of concern as any infection within the “danger triangle,” if entered the blood stream, can pass into the brain, thus spreading infection. Infection, cellulitis in this triangle can be serious. This may cause a cavernous sinus thrombosis or clotting of the blood in that area. Stopping the blood flow in the cavernous sinus would then cut off the flow to other parts of the brain.

For this reason, particular caution should be taken to avoid cavernous sinus thrombosis.