Download MBBS (Bachelor of Medicine and Bachelor of Surgery) 4th Year (Final Year) ENT Miscellaneous Disorders of Nasal Cavity Handwritten Notes
GRANULOMAS OF
UNSUSPECTED AETIOLOGY
WEGENER'S GRANULAMATOSIS
AETIOLOGY
Systemic d/o of unknown etiology
Involves URT, Lungs, kidney, skin
CLINICAL FEATURES
Clear or blood stained nasal d/c
Later become purulent
Nasal findings: crusting
? Granulations
Septal perforations
Saddle nose
General symptoms : anaemia, fatigue,
night sweats, migratory arthralgia
Lung involvement
Renal failure
Biopsy done for dignosis
TREATMENT
Systemic steroids, cyotoxic drugs
Cyclophosohamide and azathioprine
T CELL LYMPHOMA
Destructive lesion ,starting on one side
Involves upper lip, oral cavity
,maxilla,orbit
Polymorphic lymphoid tissue with
angiocentric & angioinvasive features
No vasculitis
Rapidly destructive, no systemic
involvement
Diagnosis by biopsy
TREATMENT : radio and chemo therapy
SARCOIDOSIS
Unknown aetiology
Systemic d/o ;involvement of lungs, lymph
nodes ,eyes, skin
Present with submucosal nodulesinvolving
septum or inf. Turbinate with nasal
obstrn, pain & epitaxis
X ray show diffuse pulmo. Infiltrate with
hilar adenopathy
Serum &urinary Ca elevated
Diagnosis with biopsy
TRETMENT
Systemic steroids
Steroids in form of nasal spray
RHINOLITH
Stone formation of nasal cavity
Usually around nucleus of small exogenous
foreign body, blood clot, inspissated
depositions of Ca & Mg salts
Grows into large , irregular mass
Cause pressure necrosis of septum & lateral
wall
TREATMENT: removed under GA
Most of them removed via ante. Nares
Hard, irregular ones need late. rhinotomy
NASAL MYIASIS(Maggots in nose)
Maggots seen to infest nose ,
nasopharnyx, paranasal sinuses
Flies(genus: chrysomyia) attracted to foul
smelling d/c emanating from atropic
rhinitis, syphilis, leprosy infected wounds
CLINICAL FEATURES
First 3-4 days maggots cause irritation,
sneezing, lacrimation &headache
Thin bloodstained d/c
Eyelids & lips become puffy
3rd or 4th day maggots crawl out of nose
Foul smell around the patient
Cause dstrn. Of nose, sinuses, soft tissue
of face, palate, eyeball
Fistula in palate or around nose
Death occur from meningitis
TREATMENT
All visible maggots should be picked up
with forceps
Instillation of chloroform water& oil kills
them
Nasal douche with warm saline to remove
slough, crusts, dead maggots
Patient isolated with mosquito net
THANK
A
Y
NK OU
This post was last modified on 11 August 2021