Nose Conditions Flashcards
What is implied if symptoms are unilateral?
More likely to be an anatomical abnormality
Rhinitis - definition
Irritation and inflammation of the mucous membranes inside the nose
Rhinitis - 2 main types
Infective
Non-infective
Rhinitis - infective cause
URTI
Rhinitis - non-infective causes
Allergic
- intermittent
- persistent
Non-allergic
- nasal polyps
Rhinitis - clinical features
Nose blockage Lots of mucous is produced Loss of smell Nasal discharge Facial pain Secondary symptoms - dry mouth - sore throat - hallitosis - snoring - loss of taste
Rhinitis - non infective, allergic rhinitis
Skin prick test
RAST
Rhinitis - management (infective)
Nasal decongestant
Analgesia
Rhinitis - management (noninfective - allergic)
Allergen avoidance Anti-histamines Topical steroids Immunotherapy Surgery
Rhinitis - complications
Nasal polyps
Sinusitis - definition
Inflammation of the mucosa of the paranasal sinuses
Sinus becomes filled of infected mucous
Sinusitis - which sinus is most commonly affected?
Maxillary sinuses
- the maxillary sinus ostia is located superiorly which means that the mucous has to drain against gravity
Sinusitis - causes
Infection
Allergy
Autoimmune issues
Dental abscesses
Sinusitis - clinical features
Sinus pain
Mild discomfort over frontal and maxillary sinuses due to congestion
May have referred pain to the teeth (if maxillary sinusitis due to the common sensory nerve supply from CNV)
Sinusitis - which CN’s are responsible for the pain?
Sensation provided by CNV1 and CNV2
Sinusitis - management
Most are self limiting
Reserve antibiotics for severe cases over 10 day duration
- amoxicillin
- doxycycline
Sinusitis - complications
Infections from the ethmoid sinus can give rise to orbital cellulitis
Nasal polyps - who gets it?
Common in adults
NOT common in children
Nasal polyps - children
If found in children, further investigations are required and think about cystic fibrosis
Nasal polyps - what is more worrying: unilateral or bilateral nasal polyps?
Unilateral
Nasal polyps - cause
Allergy Infection Asthma Aspirin sensitivity Nickel exposure
Nasal polyps - clinical features
Painless
Very oedematous and inflammatory
Nasal polyps - pathology
Lots of white areas (fluid)
Nasal polyps - management
Oral steroids -> topical steroids
If this doesn’t work, refer for surgery
Schneiderian papillomas
Recur often
Can potentially become malignant
Nasopharyngeal carcinoma - association
Epstein Barr Virus (EBV)
- infects epithelial cells of oropharynx and B cells
Nasopharyngeal carcinoma - investigations
Test for EBV (EBV stains blue)
