Download Free Medical Nasal Disease PowerPoint Presentation

Nasal Disease PowerPoint Presentation

DOWNLOAD MEDICAL POWERPOINT PRESENTATION

About This Presentation

Description : Check out this medical presentation on Ear, Nose, and Throat Facts, which is titled "Nasal Disease", to know about the anatomy and physiology of the nose, and the disease of the nasal septum.

Tags : Ear, Nose, Throat Facts, Nasal Disease, anatomy, physiology, nasal septum

Published on : Jul 10, 2021 | Views : 3344 | Downloads : 21

Shareable Url :

Embed Code :

Comment

Transcript

Slide 1-

NASAL DISEASE PR. Issam Al-amine DAMASCUS UNIVERSITY
Slide 2-

Anatomy And Physiology Of The Nose External nose: Pyramid in shape Consist Of osteocartilaginous framework Bony part:( upper 1/3) - 2 nasal bones -frontal process of maxilla 2. Cartilginous part :( 2/3 lower) -lateral cartilage - alar cartilage -lesser alar cartilage
Slide 3-

ppt slide no 3 content not found
Slide 4-

Anatomy And Physiology Of The Nose B. Internal nose : Divided Into Right &left nasal cavity by nasal septum Each nasal cavity communicate with the exterier through naris or nostril and with nasopharynx through choana Each nasal cavity consist of :a skin-lined portion –the vestibule and a mucosa- lined portion ,the nasal cavity proper
Slide 5-

Naris Nasal septum
Slide 6-

Anatomy And Physiology Of The Nose Lateral wall: - 3 turbinates - 3meatus : Inf meatus :nasolacrimal duct open in the anterior part middle meatus : opening of anterior sinus group (frontal sinus – maxillary sinus – anterior ethmoid cells) Superior meatus :opening of post ethmoidal cells
Slide 7-

ppt slide no 7 content not found
Slide 8-

Anatomy And Physiology Of The Nose Function of the nose : Respiration Air conditioning of inspired air Filtration &Purification Temperature control Humidification Protection of lower airway Mucocilliary mechanism Enzymes and immunoglobulins Sneezing Vocal Resonance Olfaction
Slide 9-

Disease of the nasal septum 1-Deviated nasal septum Aetiology : occur following previous nasal trauma Result from asymmetric septal development possibly following birth trauma Clinical features : Present as unilateral nasal obstruction and less commonly epistaxis The inf and middle turbinates on the side opposite the septal deflection often undergo compensatory hypertrophy Management: If the symptom warrant, the septum can be positioned in the midline in the operation of septoplasty and submucosal resection
Slide 10-

Deviated
Slide 11-

Disease of the nasal septum 2- septal haematoma :( a collection of the blood beneath the mucoperichondrium and posteriorly the mucoperiosteum of the nasal septum ) Aetiology : Usually complication of nasal trauma (accidental or iatrogenic) Rarely a spontaneous haematoma can occur in a bleeding diathesis Clinical features : Nasal obstruction with widening of the septum on inspection Management : In the acute stage treat by incision and drainage After 48 h ; organization of haematoma occurs and evacuation of the clot is difficult Antibiotics are given to prevent secondary infection
Slide 12-

ppt slide no 12 content not found
Slide 13-

Diseases of External nose and nasal vestibule Diseases of external nose : Cellulitis : Streptococcus or staphylococcus nasal skin infection Red & swollen , tender nose Treatment Systemic ATB Analgesic Nasal deformities: Saddle nose Hump nose Crooked or deviated nose Cellulitis
Slide 14-

Crooked or deviated nose Hump nose Saddle nose
Slide 15-

Encephalocele & meningoencephalocele
Slide 16-

Diseases of External nose and nasal vestibule 3. tumors: a) Benign: Dermoid cyst : midline swelling under the skin ,in front of nasal bones . Encephalocele & meningoencephalocele: herniation of brain tissue with meninges through a congenital bony defect present as subcutaneous pulsatile swelling in the midline aat the root of the nose (naso frontal) or side of the nose (nasoethmoidal). treatment:neuro surgery. skin wart
Slide 17-

Nasal Skin wart Dermoide cyst
Slide 18-

Diseases of External nose and nasal vestibule Haemangiomas Rhinophyma: slow growing benign tumour ,due to hypertrophy of sebaceous glands of the tip of the nose. often seen in long standing Acne Rosacea. treatment :surgery ,carbon dioxide Laser
Slide 19-

Haemangiomas
Slide 20-

Rhinophyma:
Slide 21-

Diseases of External nose and nasal vestibule B) MALGNANT TUMOURS 1)BASAL CELL CARCINOMA (Rodent ulcer): 87%of malignancy of the skin of the nose. ♂=♀ age:40-60 very Slow growing nodal metastasis are extremely rare treatment: surgical excision with 5 m.m safe margin around the palpable borders of the tumour Rx therapy
Slide 22-

Diseases of External nose and nasal vestibule 2)Squamous cell carcinoma 11%of nasal skin malignancy LN metastasis 20% cases treatment: early lesions :Rx therapy advanced lesions :wide surgical excision LN enlargement require neck dissection
Slide 23-

Diseases of nasal vestibule 1)Furuncle or Boil acute infection of the hair follicle by staphylococcus aureus pain++++ may spread to nasal tip &dorsum which became red & swollen it may complicated into cellulitis of the upper lip or septal abscess treatment warm compress analgesics (topical +systemic )ATB do not squeeze the furuncle (dangerous triangle) : spread infection to cavernous sinus I/D if abscess formed
Slide 24-

Diseases of nasal vestibule 2)vestibulitis: diffuse dermatitis cause : staph aureus treatment: cleaning nasal vestibule by cotton applicator soaked in hydrogen peroxide. application of ( ATB+STEROID) ointment
Slide 25-

Diseases of nasal vestibule 3)stenosis& atresia of the nares: congenital or acquired (accidental or surgical trauma). treatment :plastic surgery
Slide 26-

ACUTE &Chronic RHINITIS A) Viral Rhinitis: 1)common cold (coryza): viral cause :(adenovirus ,picorna virus) incubation:1-2 days. clinical features: * burning sensation *nasal stuffiness *watery rhinorrhoea then become mucopurulent *sneezing& low grade fever
Slide 27-

ACUTE &Chronic RHINITIS Treatment: bed rest fluids +++++ anti histamine +anti congestant analgesics ATB if secondary infection
Slide 28-

ACUTE &Chronic RHINITIS 2) Influenzal rhinitis: influenza virus :A,B,C symptoms & signs are similar to C.cold complications due to bacterial invasion are common. treatment: Rimantadine (X- flue) Oseltamivir (Tami flu)
Slide 29-

ACUTE &Chronic RHINITIS B)Bacterial Rhinitis: (pneumococcus ,streptococcus ,staph)+++ Diphtheric Rhinitis rare greyish membrane covering the inf turbinate + floor of the nose (removal of membrane cause bleeding). treatment: patient isolation systemic penicillin Diphtheria antitoxin
Slide 30-

diphtheria pseudomembrane
Slide 31-

ACUTE &Chronic RHINITIS C)ATROPHIC RHINITIS: primary or secondary Chronic inflammation of the nose characterized by atrophy of nasal mucosa and turbinate bones. female+++ foul smell+++ ansomia Crusting++++ Nasal obstruction in spite of wide nasal chamber Hearing loss may be noticed because of obstruction of E.T cause M.E effusion.
Slide 32-

ACUTE &Chronic RHINITIS Aetiology: unknown cause Various theories advocated: Hereditary Endocrinal disturbance Race :(white & yellow) +++ Nutrition deficiency (Vit A+D ,Iron) Infective Autoimmune process
Slide 33-

ACUTE &Chronic RHINITIS Treatment: 1)medical Nasal irrigation &removal of crust: Warm nasal saline Alkaline solution: -1teaspoon of soda bicarbonate -1teaspoon of sodium biborate -2 part Nacl/280ml water 25%glucose in glycerin :painting the nose after crust removal local ATB
Slide 34-

ACUTE &Chronic RHINITIS 2)surgical: Young operation: close both nostrils for 6 month. nnarrowing the nasal cavities: sub mucosal injection of Teflon. insertion of fat ,cartilage under the mucoperiosteum medial displacement of lateral wall of the nose
Slide 35-

ACUTE &Chronic RHINITIS Secondary Atrophic Rhinitis: Causes: specific infections : Syphilis ,Leprosy Rhinoscleroma Rx therapy Excessive surgical removal of Turbinate treatment :same as before Leprosy
Slide 36-

Allergic Rhinitis IGE mediated Immunologic response of nasal mucosa to air-borne allergen. Clinical types: 1)seasonal 2)Perennial aeotiology: -Inhalant allergen (Pollen ,Dust,….) -Food :rare
Slide 37-

ppt slide no 37 content not found
Slide 38-

Allergic Rhinitis Clinical features: a) NOSE: -sneezing++++++ -itching+++ -watery nasal discharge++ -nasal obstruction++→↓ smell
Slide 39-

Allergic Rhinitis B) ocular symptoms: - itching - oedema of lids - conjunctivitis - dark circles under the eyes C) otologic sign - ear itching - retracted TM → ↓ hearing
Slide 40-

Allergic Rhinitis Exanimation Post nasal drip Pale , oedematous mucosa Turbinate swollen with thin watery or muciod discharge
Slide 41-

Allergic Rhinitis Investigation : ↑ Eosinophils ( WBC) Nasal smear: eosinophils+++ Skin test: identify the specific allergen RAST (Radioallergosorbent test ): - measure the specific IgE concentration
Slide 42-

Allergic Rhinitis Complications A) recurrent sinusitis B) nasal polypi C) otitis media with effusion D) bronchial asthma
Slide 43-

Allergic Rhinitis Treatment : A) avoidance of allergen B) antihistaminics C) corticosteroids : local or oral D) sodium chromoglycate : stabilises the mast cell B) immunotherapy : desensitization
Slide 44-

Non – Allergic Rhinitis Vasomotor Rhinitis (VMR) : same symptoms as seen in All rhinitis with predominance of nasal obstruction which is alternate from side to side Skin test (-) Same treatment, as in nasal allergy
Slide 45-

Non – Allergic Rhinitis Other Form of Non- allergic Rhinitis : Drug-induced rhinitis: Anti- hypertensive drug ( propranolol , methyl dopa,reserpine) Neostigmine Contraceptive Rhinitis medicamentosa Excessive use of topical decongestant ++++ Rhinitis of pregnancy : Hormonal factors Care should be taken while prescribing drugs :oral antihistamine must be avoided
Slide 46-

Non – Allergic Rhinitis 4. Emotional rhinitis Anxiety, Tension , hostility , humiliation Psychological treatment Imipramine (antidepressant and anticholinergic ) found useful 5. Rhinitis due to hypothyroidism : ↓Sympathetic system → ↑ parasympathetic system → nasal obstruction Treatment: thyroid hormone 6. Non air –flow rhinitis : Seen in Patients of laryngectomy and tracheostomy ,choanal atresia
Slide 47-

Epistaxis
Slide 48-

ppt slide no 48 content not found
Slide 49-

Epistaxis Bleeding from inside the nose ENT emergency Epistaxis is a sign and not a disease Blood supply of nose Internal carotid system : Anterior ethmoidial artery Posterior ethmoidial artery Braches of opthalmic Artery
Slide 50-

Epistaxis Difference between anterior and posterior epistaxis Anterior epistaxis Posterior epistaxis Incidence More common Less common Site Mostly from little’s area or anterior part of lateral wall. Posterosuperior part of nasal cavity; often difficult to localise the bleeding point. Age Mostly occurs in children or young adults. after 40 years of age. Cause Mostly trauma Spontaneous; often due to hypertension or arteriosclerosis. Bleeding Usually mild, can be easily controlled by local pressure or anterior pack. Bleeding is severe, requires hospitalitisation ; postnasal pack often required.
Slide 51-

Epistaxis External carotid system: Sphenopalatine artery branch of maxillary artery . Branch of facial artery to nasal vestibule Little area Situated in the ant – inf part of nasal septum Most causes of epistaxis originate from this area There is rich vascular anastomosis In this area “kiesselbach’s plexus ”
Slide 52-

Epistaxis A) Causes of epistaxis : Traumas Infection F.B Tumor Benign Haemangiomas Papiloma Juvenile angiofibroma
Slide 53-

Epistaxis Malignancy :(nose, sinus , nasopharynx) 5. General causes: Hypertension Blood diseases Aplastic anemia Leukemia Thrombocytopenic Hemophilia Rendu- osler disease (hereditary haemorrhagic telangectasia
Slide 54-

Epistaxis Liver disease cirrhosis Kidney disease chronic nephritis Drugs anticoagulant therapy 6. Idiopathic : 90% causes B) Classification of epistaxis: 1.Antirior epistaxis 2.Post epistaxis
Slide 55-

Epistaxis Management: in any cause of epistaxis I is important to know 1)Mode of onset 2)Duration and frequency of bleeding 3)Amount of blood loss 4)Side of epistaxis 5)Whether Ant or post epistaxis 6)Any known bleeding tendency in the pt on his family 7)History of drugs intake (analgesics , anticoagulant etc.. ) 8)Medical illness history ( HTN, cirrhosis, leukemia )
Slide 56-

Epistaxis Intiales measure to stop bleeding consist of: pinching the nose with thumb& index for 5 minute If bleeding vessel seen : cautery AgNO3 ant nasal packing for ant epistaxis Removal after 2-3 days Systemic ATB to prevent infection Post nasal packing for post epistaxis
Slide 57-

Anterior nasal packing
Slide 58-

Posterior nasal packing
Slide 59-


Slide 60-

Epistaxis Nasal balloons endoscopic cautery Vessel ligation external carotid Int maxillary artery embolization Laser :in case of hereditary haemorrhagic telangectasia :
Slide 61-

ppt slide no 61 content not found
Slide 62-

Epistaxis General Measures in Epistaxis: Make the Pt sit up with a back rest and record any blood loss taking place through spitting or vomiting Reassure the Pt .mild sedation should be given Keep check on pulse , BP and respiratory rate Maintain hemodynamic. Blood transfusion may be required Antibiotic may be given to prevent sinusitis , if pack is to be kept beyond 24 hours
Slide 63-

Epistaxis 6. Intermittent oxygen may be required in Pt with bilateral packs because of increased pulmonary resistance from nasopulmonary reflex 7. Investigate and treat the Pt for any underlying local or general cause
Slide 64-

Miscellaneous Disorders of Nasal Cavity 1)Foreign bodies (FB) children+++ any child presents with unilateral foul smelling nasal discharge FB must be excluded X-rays is useful to confirm the diagnosis only in radio-opaque objects treatment :removal
Slide 65-

treatment :removal X-rays for F.B
Slide 66-

Miscellaneous Disorders of Nasal Cavity 2)Rhinolith: stone formation in the nasal cavity treatment: removal under GA 3)Nasal Myiasis (Maggots in Nose ): maggots are larval forms of flies They infest nose, nasopharynx and paranasal sinuses causing extensive destruction Clinical feature : First 3-4 days : nasal irritation , blood – stained discharge, ooze from the nose After 4 days : maggots crawl out of the nose , foul smell Maggot cause extensive destruction of the nose ,sinuses soft tissue of face
Slide 67-

The fly responsible for maggots The maggot
Slide 68-

Miscellaneous Disorders of Nasal Cavity Treatment: removal by forceps after instillation of oil 4 . Nasal synaechia : Adhesion formation between the nasal septum and turbinates Causes : Nasal surgery Nasal trauma Rhinoscleroma Treatment : Removal of synaechia Placing thin silastic sheet to prevent recurrences
Slide 69-

Miscellaneous Disorders of Nasal Cavity 5. Choanal Atresia: Congenital anomalies due to persistence of bucconasal membrane Bony 90%+++++ Membranous 10% Unilateral : ++++++ may remain undiagnosed until adult life Bilateral :++ complete or incomplete Complete& bilateral ( emergency +++++++( life threatening ) Diagnosis Presence of mucoid discharge in the nose Absence of air bubbles in the nasal discharge Failure to pass catheter from nose to pharynx Putting a few drops of dye ( methylen – blue ) into the nose and seeing it is passage into the pharynx Installing radio opaque dye into the nose and taking lateral film CT
Slide 70-

ppt slide no 70 content not found
Slide 71-

Miscellaneous Disorders of Nasal Cavity Treatment: Bilateral choanal atresia Emergency opening of the atresia Feeding nipple with a large whole provide a good oral air way ( MC Govern’s< technique) Definitive treatment consist of transnasal or transpalatal approach > 1 ½ y 6. CSF RHINORRHOEA:
Slide 72-

Different between CSF and nasal secretion
Slide 73-

ppt slide no 73 content not found