Nasal obstruction Flashcards
what are the general causes of nasal obstruction ?
either unilateral or bilateral
what are the subtitles that go under the unilateral causes of nasal obstruction ?
congenital
developmental
traumatic
inflammatory
odontogenic sinusitis
Neoplastic
Malignant
Miscellaneous
what are the unilateral congenital causes of nasal obstruction ?
unilateral choanal atresia
Meningocele
what are the tests used to diagnose unilateral choanal atresia ?
Catheter cannot pass
CT scan is diagnostic
May be accidentally discovered in older children
how is meningocele diagnosed ?
CT scan or MRI is diagnostic
what are the developmental causes of nasal obstruction ?
deviated nasal septum “ C shaped “
persistent unilateral obstruction
can also causee bilateral nasal obstruction
what inflammatory causes can lead to unilateral nasal obstruction ?
allergic fungal sinusitis
what does odontogenic sinusitis mean ?
nasal obstruction of dental origin
what are thee benign neoplastic causes of unilateral nasal obstruction ?
inverted papilloma
nasopharyngeal angiofibroma
what is the embryological tissue origin of an inverted papilloma ?
ectodermal in origin
what is the presentation of an inverted papilloma ?
unilateral nasal obstruction iis the main presentation
epistaxis
nasal discharge
epiphora
facial pain
does an inverted papilloma stay benign ?
has a small chance of turning malignant
what is thee imaging and treatment of choice in cases of inverted papilloma ?
imaging : CT
treatment : endoscopic medial maxillectomy
what is observed on examination of an inverted papilloma ?
unilateral irregular reddish gray polypoidal mass
nasal septum may bee bowed on the contralateral side
which group of p[atieents are exclusivley affected by juvenile nasopharyngeal angiofibroma ?
adolescent males
what typee of benign tumor is JNA ?
vascular benign tumor
where do inverted papillomas arise from ?
the lateral nasal wall ( locally aggressive )
where is the sphenopalatine foramen in relation to the nasal turbinates ?
near thee posterior attachment of the middle turbinate
where is the eustachian tube opening in relation to the nasal turbinates ?
posterior to the inferior turbinate
what is the most common clinical presentation of JNA ?
severe epistaxis with unilateral nasal obstruction iin a teenagee boy
on gross examination what would juvenile nasopharyngeal angiofibroma look like ?
tumor is usually sessile
lobulated
rubbery
red pink to tan-gray in appearance
microscopically what would a juvenile nasopharyngeal angiofibroma look like ?
predominance of collagen fibres and less elastic fibres
absent or incomplete smooth muscle
what is the management of juvenile nasopharyngeal angiofibroma ?
embolization and subsequent surgical removal
what are thee malignant causes of unilateral nasal obstruction ?
squamous cell carcinoma
nasopharyngeal carcinoma
what is an antrochonal polyp ?
a polyp originattiing from tthee mucosa of the maxillary sinus extending out towards the nasopharynx
are antrochoanal polyps more commonly associated with unilateral or bilateral nasal obstruction ?
unilateral nasal obstructiion
what are the causes of bilateral congenital nasal blockage ?
bilateral chonal atresia
in septal hematomas where is the blood usually accumulated ?
under the mucoperichondrium or mucoperiosteum
what other miscellaneous conditions may cause bilateral nasal obstruction ?
rhinitis medicamentosa
adenoids in children
what is the commoneest causee of unilateral nasal obstruction in children ?
foreign body
what is the commonest cause of bilateral nasal obstruction in children ?
adenoids
what are the complications of septal hematomas that could also cause nasal obstruction ?
septal abscess
what is rhinitis medicamentosa ?
overuse of xylometazoline causes hypertrophy of the inferior turbinates
what type of obstruction is more commonly associated with acute rhinosinusitis ?
bilateral nasal obstruction
owing to nasal polyps
