Nasal Vestibulitis and Vestibular Furunculosis: a systematic review about two common nasal infections and considerations about correct diagnosis and management

BACKGROUND

Nasal vestibulitis (NV) and nasal vestibular furunculosis (NVF) are two infectious processes of the nasal vestibule, sharing common etiology, the same risk of complications, and similar treatment while remaining two different pathological entities.

METHODS

We performed a comprehensive literature research on NV and NVF in PubMed, Cochrane, and Google Scholar databases, with the aim to review the evidence on these two conditions and discuss the therapeutic approaches.

RESULTS

We identified a total of 248 records; according to our inclusion/exclusion criteria, 27 of them, published over a period of 59 years (1962-2021), were included in this review.

CONCLUSION

NV and NVF are reported to be common conditions, with well-known etiological agents and risk factors. The diagnosis is clinical and topical antibiotics are the mainstay of treatment. Complications appear to be infrequent. Further studies are necessary to clarify the pathogenetic mechanisms and the exact prevalence of both conditions.

The therapeutic effects of basic fibroblast growth factor in nasal vestibulitis

OBJECTIVE

To observe the effect of topical application of recombinant human basic fibroblast growth factor (bFGF) in patients with nasal vestibulitis.

METHODS

One hundred patients with nasal vestibulitis were randomly divided into two groups. Local application of bFGF + conventional medication was administered in the treatment group, while conventional medication was conducted in the control group. The healing of the nasal vestibular mucosa was observed.

RESULTS

The mucosal healing time was 18.3 ± 4.8 days in the treatment group and 36.2 ± 6.2 days in the control group. The data comparison revealed that the difference between groups was statistically significant (P < 0.01). The total effective rate was 98.0% in the treatment group and 90.0% in the control group, and the difference was not statistically significant between the two groups (P > 0.05).

CONCLUSION

Topical application of bFGF in patients with nasal vestibulitis could promote the growth of nasal mucosa, shorten the healing time of mucosal erosion, enhance the clinical treatment effect, and save a lot of treatment time for patients.

Natural history of nasal vestibulitis associated with paclitaxel, docetaxel, and other chemotherapy agents: a Minnesota Cancer Clinical Trials Network (MNCCTN) study

PURPOSE

To describe the natural history of nasal vestibulitis in patients receiving taxane chemotherapy, including incidence, severity, and associated symptoms.

METHODS

Eligible patients with minimal or no baseline nasal symptoms were enrolled in this natural history study at initiation of a new chemotherapy regimen. Patients completed nasal symptom logs each time they received a chemotherapy dose. This manuscript reports upon the patients who received paclitaxel, docetaxel, or non-taxane non-bevacizumab chemotherapy. The proportions of patients within each cohort reporting any treatment-emergent nasal symptoms were estimated, with corresponding exact 95% confidence intervals. A cumulative incidence function was estimated within the chemotherapy cohorts to calculate the cumulative incidence rate of treatment-emergent nasal vestibulitis, treating death and disease progression as competing risks.

RESULTS

Of the 81 evaluable patients, nasal symptoms were reported by 76.5% (58.8%, 89.3%) receiving paclitaxel, 54.2% (32.8%, 74.5%) receiving docetaxel, and 47.8% (26.8%, 69.4%) receiving non-taxane and non-bevacizumab chemotherapy. Of the three pairwise chemotherapy group comparisons, both the tests comparing the cumulative incidence function between the paclitaxel and non-taxane non-bevacizumab chemotherapy cohorts and between the paclitaxel and docetaxel cohorts achieved statistical significance at the 5% level with a higher incidence of treatment-emergent nasal vestibulitis in the paclitaxel cohort in both comparisons (P = 0.026 and P = 0.035, respectively). These significant differences were retained in the cumulative incidence function regression analysis controlling for age, smoking history, allergies, and asthma. Most patients in the paclitaxel cohort reported nasal symptoms as moderate or severe (56%).

CONCLUSION

Patients receiving paclitaxel chemotherapy experience a high incidence of nasal symptoms.

Nasal vestibulitis: etiology, risk factors, and clinical characteristics: A retrospective study of 118 cases

BACKGROUND

Nasal vestibulitis (NV) is a common infection; however, scant data is available in the literature as it pertains to NV. We aim to describe the clinical characteristics of NV in respect to its potential complications.

METHODS

A retrospective chart review of 118 NV cases admitted to a tertiary medical center between 2008 and 2015.

RESULTS

Identified risk factors for NV included nasal hair plucking (n=15, 14.41%), nose blowing (n=10, 9.32%), nose picking (n=9, 8.47%) and nose piercing (n=5, 3.39%). Twelve patients (10.17%) were diabetic, and 3 patients were immunosuppressed. Mid-facial cellulitis was observed in the majority of patients (78.81%), and abscess of the nasal vestibule was observed in almost half (48.30%). Cultures were taken from 33.33% of patients demonstrated MSSA as the most common isolate (81.25%). No complications were observed.

CONCLUSION

Even in complicated cases of NV requiring admission, the risk of major complications is extremely low.