Subcutaneous Cysts in the Nasal Cavity: What to Do Next?

Subcutaneous cyst

Hello Doctor: I have a round mass in my right nasal cavity that I can feel but not see.
I consulted an ENT specialist, but the doctor couldn't feel or see it either.
The doctor mentioned it might be a follicular inflammation or a subcutaneous cyst and prescribed antibiotics and ointment.
I've been taking the medication for almost two days, but it hasn't decreased in size.
If it is a nasal cyst, will medication help reduce its size? Should I go to a larger hospital for a CT scan?

Niming, 40~49 year old female. Ask Date: 2022/08/04

Dr. Zheng Jueyi reply Otolaryngology

Hello, if there is no significant reduction or improvement, it is recommended to visit the ENT department of a hospital for further examination.
Wishing you safety and health.
Sincerely, Dr.
Cheng Jue-Yi, Director of the ENT Department, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2022/08/04

More Info

Subcutaneous cysts in the nasal cavity, such as the one you described, can be a source of concern, especially when they are palpable but not visible. These cysts can arise from various causes, including inflammation of hair follicles, sebaceous gland obstruction, or other benign processes. The fact that your ENT specialist could not see or palpate the cyst suggests that it may be located deeper within the nasal cavity or may not be a typical cyst.

When it comes to treatment, the initial approach often involves conservative management, which may include antibiotics and topical treatments if there is a suspicion of infection or inflammation. However, if you have been on antibiotics for two days without any noticeable reduction in size, it may indicate that the cyst is not responding to this treatment, or it may not be an infectious process.

Regarding your question about whether a subcutaneous cyst will shrink with medication, it largely depends on the nature of the cyst. If it is indeed an inflamed cyst or an abscess, antibiotics may help reduce inflammation and size. However, if it is a true cyst (like a sebaceous cyst), antibiotics alone typically will not cause it to shrink. Cysts often require surgical intervention for definitive treatment, especially if they are symptomatic or causing discomfort.

As for whether you should undergo a CT scan, this decision should be made in consultation with your healthcare provider. A CT scan can provide detailed imaging of the nasal cavity and surrounding structures, helping to clarify the nature of the cyst and rule out other potential issues, such as nasal polyps or more serious conditions. If your symptoms persist or worsen, or if the cyst continues to grow, a CT scan may be warranted to guide further management.

In summary, while antibiotics may help if there is an infection, they may not be effective for a true cyst. If the cyst does not improve, further imaging and possibly surgical evaluation may be necessary. It is essential to maintain open communication with your ENT specialist regarding your symptoms and any changes you observe. If you feel that your concerns are not being adequately addressed, seeking a second opinion from another ENT specialist or a larger medical center may also be beneficial.

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