We reported a case of an immunocompromised 59-year-old woman who presented to our ENT outpatient department with severe nasal obstruction for at least one week.Physical examination revealed bilateral congested septal mucosa and hypertrophy of the inferior turbinates which significantly blocking the nasal cavities. Initial conservative treatment with oral antibiotics and local nasal treatment failed to improve her symptoms,so surgical intervention option was arranged. Pre-operative sinus computed tomography showed bilateral soft tissue bulging from the nasal septum with a central hypodense content. The surgical procedure included submucosal resection of the septum, incision and drainage then proper nasal packing. Approximately 10 mL of pus was drained, and subsequent culture showed pseudomonas aeruginosa. Dental issues, including loose maxillary central incisors with periapical periodontitis and gingival atrophy, were also subsequently treated by a dentist. Post-surgery, there was a significant improvement in nasal obstruction and septal swelling. The NSA should be considered as a rare entity of nasal obstruction in an immunocompromised patient with existing dental problems. (J Taiwan Otolaryngol Head Neck Surg 2023; 58:210-214)
