Bacteria may form papules and boils in every nostril opening (nasal vestibule), known as vestibulitis and nasal vestibular furuncle.
Nasal vestibulitis: a slight infection at the opening of the nose causes papules (folliculitis) at the base of the nasal hair and sometimes forms the hard skin around the nostrils. It is usually caused by bacteria Staphylococcus aureus. Infection may be caused by scratching, overventilation or an excessive blowup of the nose, and will cause annoying hard skin and bleed when the hard skin falls off. Bacilli ointment and Mupirocin Ointment are usually capable of treating these infections by using 2 times a day. The ointment may take several weeks.
Nasal vestibular furuncle: a more serious infection can form a boil in the nasal vestibule, usually caused by staphylococcal infection, and can develop into cellulitis at the tip of the nose. Infection in this area requires great attention because this place is venous and intracranial traffic. If bacteria pass through these veins to the brain, they may develop into life-threatening cavernous sinus thrombophlebitis (cavernous sinus thrombosis). It is necessary to use antistaphylococcal antibiotics (such as cephalosporin 500mg, 4 times a day), combined with topical hot compress and mupirocin. If necessary, incision and drainage should be performed to prevent local thrombophlebitis and further develop cavernous sinus thrombosis.
Deviations of nasal septum are mostly caused by development or trauma, but in most cases, there are no symptoms, therefore, no treatment is required. Symptomatic deviation of nasal septum leads to nasal congestion (especially when a nasal obstruction is obstructed by a deviated structure). Other symptoms include facial pain, headache, and sleepless snoring. Although only the anterior nasal examination is not enough, it is easy to diagnose through physical examination. Septoplasty can be used for treatment.
Eschar skin and bleeding will appear in the lesion's septum. Small perforations have a whistle when breathing. Anterior nasal endoscopy or fiberoptic endoscopy can clearly detect perforation of the septum. Local use of bacilli or mupirocin ointment or saline can reduce scab. Symptomatic septal perforation can sometimes be repaired with buccal or septal mucosal flap; silicone septum button can also be used to repair perforation.
Photo by Marvin P. Fried, MD, Professor and University Chairman, Department of Otorhinolaryngology