5 - ENT - Rhinology - Nasal obstruction Flashcards
7 causes of this
rhinosinusitis nasal polps FB's nasal septum abnormalities turbinate hypertrophy adenoid hypertrophy neoplasm
Nasal polyps - typically which parts of nasal area
middle turbinates, middle meatus, ethmoid sinus
usually bilateral
describe a nasal polyp
grey/pale, slightly translucent, mobile and insensitive to palpation
when would a biopsy of a nasal polyp be needed
if unilateral, bleeding or painful
Antrochoanal polyps - in who? originate and extend to where?
most frequently in young men
maxillary sinus > through ostium to nasal cavity
may extend to nasopharynx and mouth - valve causing unilateral obstruction on expiration
nasal polyps - associations
allergic rhinosinusitis non-allergic rhinosinusitis chronic rhinosinusitis Cystic fibrosis TRIAD - polyps, asthma, aspirin sensitivity
Sx of nasal polyps
watery rhinorrhoea, nasal obstruction, anosmia, mouth breathing, snoring, rhinosinusitis
mgmt of nasal polyps
steroid drops - then maintenance with steroid spray
endoscopic polypectomy - follow with steroid drops
Nasal septum abnormalities - 3 types
septal deviation
septal perforation
septal haematoma
septal deviation - cause? deviation site?
trauma later in life or decent down birth canal
may be at columella or further back into nose
septal deviation - nasal reduction - when assessed? when performed?
assess immediately following trauma or 5-10 days after when swelling subsides
performed within 2 weeks as bone sets by 3 weeks
Septal perforation - traumatic causes
surgical, nose picking, piercings
septal perf - avascular necrosis causes
cocaine, sickle cell disease, 2 to haematoma/abscess
septal perf - granulomatous inflammation causes
+other type of cause
TB, sarcoid, syphilis, Wegeners granulomatosis (type of vasculitis)
malignancy - eg skin BCC
Septal haematoma - from what? what happens?
following nasal surgery, or trauma
blood accumulates between cartilage and perichondrium
