SynthesisEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2026
Systematic review of non-surgical etiologies of nasal necrosis: evidence from case reports and case series.
Synthesis in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeNasal necrosis is a rare but potentially devastating manifestation of diverse conditions, including fulminant infection, immune-mediated vasculopathy, drug toxicity, neoplasia and device-related pressure injury. Surgical intervention is often prioritized; however, a subset of patients is managed non-surgically and evidence-based guidance remains limited. The objective is to systematically synthesize non-surgical etiologies, clinical patterns, diagnostic workup, and management strategies reported in cases of nasal necrosis.
methodsA systematic search of PubMed, Scopus and ScienceDirect from inception to December 7, 2025 identified case reports and case series involving human patients with nasal skin or soft-tissue necrosis not primarily attributable to surgery or cosmetic procedures. Non-human studies, systematic reviews and non english records were excluded. Data on demographics, etiology, presentation, investigations, management and outcomes were extracted. Methodological quality was appraised using Joanna Briggs Institute (JBI) tools.
resultsThirty-nine publications comprising 45 cases were included. Infectious etiologies were most frequent (44.4%), followed by mechanical or traumatic (20.0%), immune-mediated (13.3%), drug-induced (13.3%), neoplastic (6.7%), and congenital causes (2.2%). Isolated nasal involvement occurred in 57.8% of cases. Non-surgical management included antimicrobials, corticosteroids, immunosuppressive agents, anticoagulation, wound care, and adjunctive hyperbaric oxygen therapy, with better outcomes in cases where the underlying cause was identified early.
conclusionNasal necrosis represents a heterogeneous clinicopathologic endpoint in which prompt etiologic diagnosis is critical for effective, organ-preserving dermatologic management.
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