Diseases of the nose: polyps, nasal/septal deformity, sino-nasal cancer Flashcards
What is the name for the study of the nose, including sinuses?
Rhinology.
Name the 5 functions of the nose.
Airway Filtration Humidification Temperature Control Olfaction.
When we breathe in, we normally breathe through the ________.
Nose.
How does the nose filter?
it filters using:
- The hairs in the nose
- cilia to capture and move bacteria
There is an increased rate of secretion to…
Humidify the air.
By the time the air reaches the ________________ it will be 100% ________.
Nasopharynx
Humidified (aka. air saturated)
By the time the air reaches the nasophraynx, what temperature will it be?
5 degrees below body temperature.
What does olfaction mean?
Smell.
What sort of patients don’t use their nose like we use it?
Laryngectomy patients- air re-directed so they don’t breathe through nose, they breathe through stoma on neck.
What system replaces the filtration, humidification and temperature control of the nose?
HME- Heat and Moisture Exchange system
If there is a disease in the nose, what happens?
The function is disrupted.
What is a sign that the nose isn’t functioning properly?
Person has a really sore throat and dry mouth because they are breathing through the mouth all the time.
A group of bony boxes are referred to as…
Sinuses.
What is kept in the sinuses (normally)?
Air
How many paranasal sinuses are there?
8.
Name the paranasal sinuses.
2 maxillary
2 frontal
2 ethmoidal complexes
2 sphenoid.
Theres are _ pairs of paranasal sinuses.
4
What is a paranasal sinus?
a hollow, air-filled cavity in the skull that is connected to the nasal airway by a narrow hole in the bone.
Name where each sinus is situated: Frontal Maxillary Ethmoid sphenoid
Behind the brow ridges (forehead).
In the body of the maxilla (cheek area at front of face-below eyes.)
Near the bridge of the nose. (where you’d pinch)
Behind/round the back of eye.
What is the main paranasal sinus?
The maxillary sinus.
Give some more information about the maxillary sinus.
Pyramid shaped
Largest paranasal sinus.
What is sinusitis?
Inflammation of the sinuses.
What can sinusitis be a result of?
- sinusitis can be as a result of infection from a virus, bacteria or fungus.
- Allergic reactions eg. asthma
What is the most common type of sinusitis?
Acute infective sinusitis .
Acute infective sinusitis is usually ________.
Viral.
If sinusitis (acute infective) doesn’t setttle, what is this known as?
Chronic infective sinusitis.
Sinusitis can be as a result of ______ eg.asthma.
allergy.
What is produced by the sinuses?
Mucus.
Where does the mucus produced by the sinuses normally drain?
It normally drains into the nise through small channels.
In sinusitis, what becomes blocked and why?
The small channels to the nose.
because the lining of the sinuses are inflamed
When does sinusitis usually occur?
After an upper respiratory tract infection.
The symptoms of sinusitis often clear up within a few weeks (_____sinusitis), although occasionally they can last three months or more (_____ sinusitis).
Acute.
Chronic.
How is sinusitis treated?
Antibiotic spray/drops.
If no improvement then referred to an ENT specialist who drains the sinuses.
What are nasal polyps?
Nasal polyps are swellings of the normal nasal lining that occur inside the nasal passages and sinuses.
Why can sinusitis lead to complications?
The infection can spread (cause other areas to become inflamed).
Give some examples of the complications sinusitis can cause.
Orbital Cellulitis Brain Abscess Meningitis Cavernous sinus thrombosis mucocoele formation
What is orbital cellulitis?
Inflammation of eye tissues behind the orbital septum. It most commonly refers to an acute spread of infection into the eye socket from the adjacent sinuses.
Name this:
A pus-filled swelling in the brain, usually occuring when bacteria or fungi enter the brain tissue after an infection.
A Brain Abcess.
What is meningitis?
An infection of the meninges.
What is cavernous sinus thrombosis?
A blood clot in the cavernous sinuses.
As a result of swelling, often fluid collects, what is a name for this?
Mucocoele Formation.
sinusitis can spread and cause…
- blindness
- dental problems
- obstruct nasal passages (breathing affected)
- in severe cases cause nasal bone deterioration.
What is a tumour in a paranasal sinus called?
A sino-nasal tumour.
Sino-nasal tumours account for ___% of all head and neck cancers.
5
The symptoms for a sin-nasal tumour often seem ______.
minor.
Bescause the symptoms of sino-nasal cancer seem so innocent/minor, what tends to happen?
It has a very late presentation.
The penny finally drops that it is more than a cold.
Why are often the tumours very big without anyone noticing?
Because they have space to grow inside the sinus, it’s not until it touches the side of a sinus that it becomes obvious, but at this point it’s v. big!
What is the prognosis for sino-nasal tumours?
Its generally poor - because its too large and has spread to other tissues aka. at T4/T3 by the time it’s discovered.
What are some worrying nasal symptoms that may suggest sino-nasal cancer?
- Unilateral blocked nose
- Blood stained mucus
- Orbit/visual symptoms eg. eyes puffy/swollen, double vision
- Cheek swelling
- Upper gum/dental problems.
What is a unilateral blocked nose?
When the nose is blocked on one side. (
What is the problem with having a unilateral blocked nose?
Doctors often give them a nasal spray when in fact they have a tumour!
why is head and neck cancer quite good?
It is normally quite contained therefore the tumour can be surgically removed- patient cured completely :)
Name an example of a surgery to remove a sino-nasal tumour.
Osteoplastic Flap- peels back face from hair line to remove tumour.
