Endoscopic Surgery for Facial Subcutaneous and Nasal Submucosal Abscesses in a Child

Endoscopic Surgery for Facial Subcutaneous and Nasal Submucosal Abscesses in a Child

Tomotaka Hemmi,¹ Shuji Chiba¹ and Kazuhiro Nomura²

¹Department of Otolaryngology, Japanese Red Cross Ishinomaki Hospital, Ishinomaki, Miyagi, Japan
²Department of Otolaryngology, Tohoku Kosai Hospital, Sendai, Miyagi, Japan

We herein report a case of abscess formation from the subcutaneous area of the face to the submucosa of the nasal cavity. To our knowledge, this case was unprecedented, but we were able to cure the patient by applying endoscopic sinus surgery techniques. A 13-year-old boy visited a local clinic because of right facial swelling. Contrast-enhanced computed tomography (CT) showed abscess formation from the subcutaneous region of the face to the submucosa of the nasal cavity, and endoscopic surgery was performed. In surgery, endoscopic modified medial maxillectomy (EMMM) and a direct approach to the anterior and lateral parts of the maxillary sinus with an endoscope (DALMA) were applied to perform radical drainage. The patient was discharged from the hospital on postoperative day 7 after completion of antimicrobial therapy because of good progress. Two months postoperatively, healing of the incision and maintenance of openness of the maxillary sinus were confirmed, and the follow-up was terminated. Endoscopic surgery is the first-choice treatment because of its superior therapeutic efficacy and functional preservation.

Key words —— child; endoscopic surgery; facial subcutaneous abscess; nasal submucosal abscess; Parvimonas micra

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Tohoku J. Exp. Med., 2025 May, 266(3), 273-277.

Correspondence: Tomotaka Hemmi, Department of Otolaryngology, Japanese Red Cross Ishinomaki Hospital, 71 Nishimichishita, Hebita, Ishinomaki, Miyagi 986-8522, Japan.

e-mail: hemmi@orl.med.tohoku.ac.jp