nose Flashcards
saddle nose causes
tertiary syphillis, tb, trauma, septal surgery
Cottles test
Done to check blockage of nasal valve
Two fingers on check fit it upwards breathing better - +ve indicates nasal valve prolapse
Saddle nose Rx
Augmentation rhinoplasty by using ilaic crest
Hump nose Rx
Reduction rhinoplasty
Crooked vs deviated nose
Crooked - dorsum deviated, tip midline
Deviated- both deviated to midline but to one side
young child with cystic swelling in or around the nose IOC?
CT
3 Cystic swellings - young child - area: in or around nose
1) nasal DERMOID
2) nasal encephalocele
3) nasal glioma
nasal dermoid
1) types
2) rx
types 3
a) simple
b) + sinus
c) + hair + sinus
rx: surgical excision with sinus tract
Fur sten berg test
A) positive
B) negative
Swelling- pulsatile, reducible and increased in size on coughing or crying
A) nasal encephalocele
B) nasal glioma
m/c type of malignancy of skin of external nose ?
presentation?
Basal cell carcinoma
ulcerative, telangectatic lesion with rolled out edges
Choanal atresia is persistence of ?
Bucconasal membrane
Blue baby turns pink on crying in labour room or ot and Pediatrician not able to pass suction catheter through the nose ???
cause and treatment ?
Cho Anal atresia
Rx: immediate management - McGoverns technique => putting a wide bore nipple in the baby’s mouth to keep it open
Then trache os tomy
At 1 year of age - recanalisation surgery
Followed by MITOMYCIN C
Concha parts of which bone
Inferior - independent bone
Middle and superior- ethmoid bone
nose and paranasal sinus is lined with
pseudo stratified ciliated columar epithelium
another name of maxillary sinus
antrum of HIGH MORE
oroantral fistula is a complication of _______
dental extraction
Sphneoid sinusitis pt developed suddenly develops neuro symptoms
Cause?
Rx?
Cavernous sinus thrombosis
Urgent ct brain
Best surgical approach for pituitary adenoma revomal
Endoscopic endonasal transphenoid hypophysectomy
Ethmoid bond fracture lead to?
Csf rhinorrhea
Anterior Ethmoid air cells constant cells
A) no?
B) name
A) 2
B) bulla ethmoidalis - constant and largest
Agger nasi - constant anterior most
3 unusual locations of ethm air cells and complications
In Orbital floor -> haller cells
Close to optic nerve -> onodi cells
Inside middle turbinate-> concha bullosa ( complication sinusitis)
m/c anatomical variation of ethm air cells
lead to ?
concha bullosa - inside the middle turbinate
leads to sinusitis
Drain into?
A) nasolacrimal duct
B) maxillary sinus
C) frontal sinus
D) anterior ethmoid air cells
E) posterior
F) sphenoid sinus
A) inferior meatus
B c d ) middle meatus
E) superior meatus
F) SER ( spheno ethmoidal recess)
DCR ( dacryo cysto rhin os tomy)
Procedure?
Instrument?
Surgical procedure to make a Opening in the lacrimal sac into the middle meatus.
Instrument- KERRISUN’s endoscopic DCR bone punch
OMC ?
Key pathology of ?
Osteo meatal complex
= BE + UP + EI + 3 sinus opening
Key pathology of sinusitis
Bulla ethmoidalis
Uncinate process
Ethmoid infundibulum
3 sinus - frontal, ant.ethmoid air cells, maxillary
Investigation for sinusitis
A) Endoscopy name? 3 Passes?
B) best investigation for sinusitis
A) DNE diagnostic nasal endoscopy
EGREES endoscope
(30 or 0 degree)
1st pass- along IT
2nd - above MT
3rd- inside MM
B) CT scan
Waters view shows all sinuses expect
Posterior ethmoid air cells
Caldwell view shows sinuses?
Frontal and ethmoid sinus
FESS
A) Main aim
B) steps
C) complications
Functional endoscopic sinus surgery
A) - to re establish the sinus drainage
B) uncinectomy -> removing BE
C) orbital hematoma, enophthalmos, diplopia, csf rhinorrhea, ON and ICA injury
Orbital hematoma after FESS is due to
Injury of anterior ethmoidal artery
Most common long term complication of FESS or any nasal surgery + Rx
Synechiae formation (adhesions)
Rx: local application of MITOMICIN C
Potts puffy tumour
Frontal sinusitis leads to frontal osteomyelitis leads to sub periosteal frontal abcess
Presents as red, painful forehead swelling
Samp ters triad
Nasal polyp (ethmoid)
Bronichal asthma
Allergy to NSAIDS (like aspirin)
Allergic fungal sinusitis
A) c/f
B) best invg
A) allergic nasal mucin, nasal polyp - CT : heterogenous / double density shadow
B) mri
Bent and kunn criteria to diagn allergic fungal rhino sinusitis
Mucor myco sis
Invg
Biopsy > MRI with contrast
Koh mount - no value
Mucor myco sis
C/f
Mucor myco sis
Rx
1- debridement 1st
2- DOC AMPHO TERI CIN B
Kallman’s syndrome 2 features
1- ansomia
2- hypogonadism ( infertility)
Test for ciliary function
Sacchrine test
Tests for olfactory
UPSIT
smell diskettes
Olfactory threshold test
Mulberry appearance of nasal mucosa of ITH
DNS of patent side of inf turbinate hypertrophy
Sludder headache
Headache due to contact btw DNS and middle turbinate lead to neuralgic headache. Also known as ant ethmoidal neuralgia
Rx for DNS
Septoplasty
Why should you drain septal hematoma immediately ?
C/f ?
If you don’t drain -> lead to septal abscess -> lead to septal perforation
C/f : b/L after trauma
Perforation of bony part of nasal septum is caused by
Syphilis
Wegeners granulomatosis
Invgt
C ANCA
Wegeners granulomatosis
Invgt
C ANCA
Treatment for nasal bone #
immediate closed reduction before edema starts using WALSHAM FORCEPS
Edema already present-> wait for 7 days for edema to subside
nasal septum #
Types
Rx
Types:
JAR JA VAY #, CHE VALLET #
Rx:
Septal reduction using ASCH forceps
Cheek anaesthesia due to injury of ______ nerve in what conditions?
Infra orbital nerve
conditions- ca maxillary sinus , zygomatic # and maxilla #
Guerin sign seen in
Le fort I mid face #
Target sign or double halo or halo sign
M/c site of ______ leak
Traumatic leak of CSF rhinorrhea
M/c site FOVEA ETHMOIDALIS roof of ethmoid
Best invgt to d/b btw csf vs nasal discharge
Beta 2 transferrin estimation in csf
Best radiological invg of csf leak
HRCT skull base
Artery of epistaxis
Sphenopalatine artery
Kiessel bach plexus
1- Present in
2- contains
3- doesn’t contain
1- little area
2- GPA, SPA, SLA, AEA
3- PEA
