diseases of the nose

Question 1

causative organism in nasal furunculosis

Answer 1

S. aereus

Question 2

predisposing factors in NF

Answer 2

Trauma from nose picking 
Nose piercing
Diabetes mellitus
Immunodeficiency state
Prolong use of nasal  steroids

Question 3

complications of NF

Answer 3

Rhinosinusitis
Septal abscess
Cavernous sinus thrombosis
Cellulitis of upper lip
Nasal cellulitis

Question 4

mode of entry of foreign bodies

Answer 4

1. Through the Anterior nares .
2. Through the Posterior nares , ie. During vomiting. cough or regurgitation .
3. Penetrating wounds and nasal surgery .
4. Palatal perforation as in cleft palate .

Question 5

symptoms of FB in nose

Answer 5

1. Unilateral offensive nasal discharge. Mucoid - Mucopurulent - Haemorrhagic mucopurulent .
2. Halitosis -
3. Nasal irritation and sneezing .
4. Unilateral nasal obstruction .
5. Painful nose .

Question 6

complications of FB in nose

Answer 6

rhinitis
rhinolith
epistaxis
airway obstruction

Question 7

management of FB

Answer 7

1. Removal - using a hooked nasal probe, Freer’s elevator, Rounded probe, Tilley’s nasal forceps, etc.
2. Animate FB. -

Instillation of liquid paraffin into the nose

Question 8

when do we remove FBs under GA

Answer 8

Impacted FBs
Difficulty in visualizing FB
Non - cooperating child

Question 9

what trauma to the nose can lead to

Answer 9

Septal hematoma
deviation of nasal septum
fracture of nasal bone
epistaxis

Question 10

four main causes of nasal trauma

Answer 10

1. Personal assault -
2. Sports injuries - eg . Boxing , Judo / Karate, Football, Rugby etc.
3. Personal accidents -
4. Road traffic accident ( RTA ) -

Question 11

definition of septal hematoma

Answer 11

This is an accumulation of blood in between the mucoperichondrium and the septal cartilage , often as a result of trauma.

Question 12

in which direction of trauma of the tip on nose usually cause septal hematoma

Answer 12

anterior - posterior direction

Question 13

management of septal hematoma

Answer 13

Incision / Drianage . ( Freer’s incision ) Long hemi- transfixation incision .

• Packing of the nose with a BIPP gauze.
• Prophylactic Antibiotic . - Systemic - Topical
• Analgesic -

Question 14

Complications of septal hematoma

Answer 14

1. Septal cartilage necrosis - Saddle nose deformity.
2. Cavernous sinus thrombosis .
3. Septicaemia .
4. Septal abscess - sopra-infection after 48 Hrs. of trauma . This presents with : Fever, Painful nose, Nasal obstruction ,Headache .

Question 15

management of nasal septum deviation

Answer 15

Submucosal resection

this is a procedure of elevating a septal mucosal flap and then straightening / repositioning of the nasal septum.

Question 16

management of nasal fracture

Answer 16

1. Reduction - with the Walsham forceps
2. Nasal packing - with a BIPP gauze
3. Fixation - with a POP cast – with Nasal pins – with Nasal splint

Question 17

In which of the meatus does the nasolacrimal duct lie

Answer 17

inferior meatus

Question 18

in which meatus does the maxillary, frontal and anterior ethmoid sinuses drain

Answer 18

middle meatus

Question 19

what sinus drain into the posterior ethmoid sinuses

Answer 19

superior meatus

Question 20

which arteries supply skin of external nose

Answer 20

ophthalmic and maxillary artery

Question 21

which artery supplies the ala and lower part of the septum

Answer 21

facial artery

Question 22

what is choanal atresia

Answer 22

complete lack of opening of the posterior nares. occurs when the buccopharyngeal membrane fails to be absorbed during the embryogenic development

Question 23

in which week is the bp membrane usually absorbed

Answer 23

6th

Question 24

management of choanal atresia

Answer 24

1. Primary ( Emergency )- treatment within 24 hours ie. With the insertion of a standard neonatal Water’s airway, taping it securely in position.
2. Secondary ( Definitive ) surgery- Transnasal – under GA – Perforation of the atretic lamina with Tilley’s hypoon, then insertion of Portex or Silastic tube.