FURUNCLE
Infection of a hair follicles, located in the nasal vestibule.
Pathogenic organisms: most common is staphylococci.
🔹
Attend factors:
🔹 1. Micro trauma of nasal skin (during self cleaning).
🔹 2. Irritation of nasal skins by dischargesd
3. Diabetes or other metabolic disorders.
🔹
Clinical picture:
🔹 pain in the nose especially in the site of furuncle.
🔹🔹 Fever.
Edema of nasal skin and surrounding tissues.
Painful and edema of the external nose and surrounding
🔹Redness of nasal skin, it is tense and very sensible.
tissue: cheek, bridge of the nose, upper lip.
FURUNCLE OF The NOSE
🔹
Complications
🔹 Cervical Lymphadenitis.
🔹 Thrombosis of facial veins.
Thrombosis of cavernous sinus. (through anastomosis between
angular vein - the branch of facial vein and ophthalmic vein – from Etiology:
cavernous sinus).
🔸
🔸Traumatic
Types of deviated septum:
Treatment 🔸Birth moulding theory
Developmental: This is the most acceptable theory today.
🔸
🔸Spur
1. systemic and local antibiotics.
2. Anti-inflammatory drugs.
3. no squeeze
When the nasal septum grows faster in certain individuals
than the palate then the nasal septum starts to buckle under
🔸Deviated c or s shaped
dislocated
pressure.
Recurrent case:blood sugar to exclude DM.
Clinical picture
Incidence 🔸
🔸 Nasal obstruction
Definition:
🔸sequelae.
Nasal discharge.
Mouth breathing: lead to oromaxillary
COPLICATIONS:
Choanal atresia is a developmental defect in which a
failure occurs of one or both posterior nares to canalise
🔸
🔸 Secondary sinusitis: bad aereation .
Recurrent pharyngitis
Recurrent otitis media
as consequence of a congenital malformation of the
posterior portion of the nasal cavity.
🔸 Snoring.
🔸Epistaxis.
External deformity: twisted nose
Recurrent sinusitis
1:5000-1:8000 live births
2:1 female predominance
More commonly unilateral Deviated septum
🔹 🔶 Septal Abscess
🔹Mixed
Pure bony atresia 29%
bony and membranous 71%s
It is pus and purulent secretion collected
between the mucoperichondrial flap and the 🔸
Complications of septal abscess:
Septal necrosis in neglected cases with
septum
🔸
saddling of the nose.
🔸 Septal perforation.
🔹
Etiology
🔹 Persistence of buccopharyngeal membrane.
Management of symptomatic
🔸 Etiology Thrombophlebitis and possibility of
Abnormal persistence of mesoderm in the
nasochoanal region. Choanal Atresia 🔹
septum
Adults( 16 years and above):
-Submucous resection SMR 🔸
Infected septal haematoma
Clinical picture:
cavernous sinus thrombosis.
🔹
-Septoplasty -Signs and symptoms of acute inflammation.
-Redness ,tenderness , edema of the nose. 🔸
Treatment:
Incision and drainage AND nasal
🔹
Presentation Children ( below 16 years):
Bilateral atresia:
-Respiratory distress at birth
-Conservative septoplasty -Fever, malaise, pain and headache.
-Swelling of the septal mucosa with cystic 🔸
packing.
🔸 Antibiotic passing blood brain barrier .
-Cyanosis at birth that resolves with crying Complications of SMR: consistency and tenderness.
🔸 Analgesic and anti-inflammatory.
🔹
CHARGE Syndrome Observation for complication.
🔹
-Oral airway, McGovern Nipple or intubation 1. Septal hematoma
Unilateral atresia
Presents later (5-24 months) with unilateral nasal 🔹 Coloboma
Heart disease (TOF, PDA, VSD,
2. Septal abscess
3. Septal perforation
discharge
🔹
ASD, Right Aortic Arch)
🔹 Atresia choanae
Retarded growth (CNS
4. Nasal deformities (saddle nose ,)due
to excessive removal of dorsal strut of 🔶 Septal Hematoma
Definition: it is collection of blood between
the septum ,(dropped nasal tip ) due to
Work up
Attempt to pass a catheter through the nares 🔹
anomalies)
Genital anomalies
removal of the columella cartilage. mucoperichondrial layer and septal cartilage .
🔸
5. Synechia Management
ENT exam
CT of sinuses and skull base after decongestion and suctioning 🔹Ear anomalies
(hypogonadism)
🔸
Etiology
🔸 Traumatic : direct nasal trauma, post septal surgery.
Evacuation under LA or G A, necessary because no
Spontaneous : Rare as in hypertension , blood diseases, 🔸
spontaneous resolution.
🔸🔸Mucosal incision and aspiration .
🔹
Timing of Surgical Repair
Most bilateral can be done within the first few days of life nose
🔸
Clinical picture:
Anterior nasal packing for 48 hours.
antibiotic , anti-inflammatory and analgesic.
🔹
to aid in growth and development
CHARGE syndrome may require a delay 🔸Nasal
Headache.🔸Smooth swelling of septal mucosa
obstruction.
🔹
Tracheostomy typically needed obstructing the nasal cavity with cystic boggy sensation , it
Unilateral atresia may Unilateral or Bilateral.
Before school age
Surgical Repair- Endoscopic Approach
More commonly used (stent)
🔹
Etiology:
Road traffic accidents, sport accident, personal
🔹
assult.
M>F Adult >children
Investigations
🔹
C/P:
🔹 Obstruction
🔹
🔹
Epistaxis
Deformity: deviation or saddling
🔹 Ecchymosis , Tenderness over fracture line
🔹Careful palpation: crepitus.
Nasal cavity examination: role out septal
Etiology: hematoma
Children and mentally retarded adults
🔹
Types of F.B:
🔹Animate : Myasis
Inanimate : metallic , vegetable , non vegetable
🔹
Pathophysiology Facture Nasal Nose 🔹
Management:
Reduction under local or G A using Walsham
🔹Fixation by nasal pack and external splint
Nasal foreign bodies can cause damage to the nasal cavity and the surrounding and Ash forceps
structures. They can produce local inflammation which may result in pressure
necrosis. This in turn can cause mucosal ulceration and erosion into blood vessels
🔹
producing epistaxis.
The swelling can cause obstruction to sinus drainage and lead to secondary
🔹
sinusitis.
Firmly impacted and unrecognized foreign bodies can in time become coated
🔹
with calcium,magnesium,phosphate or carbonate and become a rhinolith.
Rhinoliths are radio-opaque and are typically found on the floor of the nasal
🔹
complications of nasal trauma:
🔹
cavity.
Rhinoliths can remain undetected for years and only upon growth do they 🔹
🔹
septal deviation
septal hematoma
produce symptoms that lead to their discovery.
🔹 septal abscess
causes of cosmetic defects :
-poor initial management
Treatment -secondary infection
REMOVAL USING HOOKED INSTRUMENT
General Anesthesia is Indicated in :
🔹
Clinical picture
🔹 F.B discovered if patient tell to his parent
🔹
🔹 Uncooperative uncontrollable patient
Unilateral fetid purulent blood stained discharge is
🔹 Posteriorly located F. B
Associated granulation in neglected F. B with possibility of
🔹Excoriation around the nostril
characteristic
bleeding
FORIGN BODY NOSE
🔹
PATOLOGY
🔹Large
🔹
🔹
irregular
hard
🔹may cause pressure necrosis of lateral wall
septum hard palate.
Clinical picture:
Unilateral nasal obstruction
Nasal discharge: offensive , bloody
Neuralgic pain
🔹
O\E:
🔹Gray ,greenish Black
🔹Irrigular
🔹Stony Hard By Probying
Granulation Tissue
Rhinolith
Etiology: FB forms around the nidus:
-Exogenous FB
-blood clot
inspissated secretions
🔹
DIAGNOSIS
🔹History
Slow Deposition of calcium salts
and magnesium salt
by fatema okoff
🔹Anterior Rhinoscopy
🔹Endoscopic
ct Scan
Exam
TREATMENT
Surgical removal under general anesthesia
Infection of a hair follicles, located in the nasal vestibule.
Pathogenic organisms: most common is staphylococci.
🔹
Attend factors:
🔹 1. Micro trauma of nasal skin (during self cleaning).
🔹 2. Irritation of nasal skins by dischargesd
3. Diabetes or other metabolic disorders.
🔹
Clinical picture:
🔹 pain in the nose especially in the site of furuncle.
🔹🔹 Fever.
Edema of nasal skin and surrounding tissues.
Painful and edema of the external nose and surrounding
🔹Redness of nasal skin, it is tense and very sensible.
tissue: cheek, bridge of the nose, upper lip.
FURUNCLE OF The NOSE
🔹
Complications
🔹 Cervical Lymphadenitis.
🔹 Thrombosis of facial veins.
Thrombosis of cavernous sinus. (through anastomosis between
angular vein - the branch of facial vein and ophthalmic vein – from Etiology:
cavernous sinus).
🔸
🔸Traumatic
Types of deviated septum:
Treatment 🔸Birth moulding theory
Developmental: This is the most acceptable theory today.
🔸
🔸Spur
1. systemic and local antibiotics.
2. Anti-inflammatory drugs.
3. no squeeze
When the nasal septum grows faster in certain individuals
than the palate then the nasal septum starts to buckle under
🔸Deviated c or s shaped
dislocated
pressure.
Recurrent case:blood sugar to exclude DM.
Clinical picture
Incidence 🔸
🔸 Nasal obstruction
Definition:
🔸sequelae.
Nasal discharge.
Mouth breathing: lead to oromaxillary
COPLICATIONS:
Choanal atresia is a developmental defect in which a
failure occurs of one or both posterior nares to canalise
🔸
🔸 Secondary sinusitis: bad aereation .
Recurrent pharyngitis
Recurrent otitis media
as consequence of a congenital malformation of the
posterior portion of the nasal cavity.
🔸 Snoring.
🔸Epistaxis.
External deformity: twisted nose
Recurrent sinusitis
1:5000-1:8000 live births
2:1 female predominance
More commonly unilateral Deviated septum
🔹 🔶 Septal Abscess
🔹Mixed
Pure bony atresia 29%
bony and membranous 71%s
It is pus and purulent secretion collected
between the mucoperichondrial flap and the 🔸
Complications of septal abscess:
Septal necrosis in neglected cases with
septum
🔸
saddling of the nose.
🔸 Septal perforation.
🔹
Etiology
🔹 Persistence of buccopharyngeal membrane.
Management of symptomatic
🔸 Etiology Thrombophlebitis and possibility of
Abnormal persistence of mesoderm in the
nasochoanal region. Choanal Atresia 🔹
septum
Adults( 16 years and above):
-Submucous resection SMR 🔸
Infected septal haematoma
Clinical picture:
cavernous sinus thrombosis.
🔹
-Septoplasty -Signs and symptoms of acute inflammation.
-Redness ,tenderness , edema of the nose. 🔸
Treatment:
Incision and drainage AND nasal
🔹
Presentation Children ( below 16 years):
Bilateral atresia:
-Respiratory distress at birth
-Conservative septoplasty -Fever, malaise, pain and headache.
-Swelling of the septal mucosa with cystic 🔸
packing.
🔸 Antibiotic passing blood brain barrier .
-Cyanosis at birth that resolves with crying Complications of SMR: consistency and tenderness.
🔸 Analgesic and anti-inflammatory.
🔹
CHARGE Syndrome Observation for complication.
🔹
-Oral airway, McGovern Nipple or intubation 1. Septal hematoma
Unilateral atresia
Presents later (5-24 months) with unilateral nasal 🔹 Coloboma
Heart disease (TOF, PDA, VSD,
2. Septal abscess
3. Septal perforation
discharge
🔹
ASD, Right Aortic Arch)
🔹 Atresia choanae
Retarded growth (CNS
4. Nasal deformities (saddle nose ,)due
to excessive removal of dorsal strut of 🔶 Septal Hematoma
Definition: it is collection of blood between
the septum ,(dropped nasal tip ) due to
Work up
Attempt to pass a catheter through the nares 🔹
anomalies)
Genital anomalies
removal of the columella cartilage. mucoperichondrial layer and septal cartilage .
🔸
5. Synechia Management
ENT exam
CT of sinuses and skull base after decongestion and suctioning 🔹Ear anomalies
(hypogonadism)
🔸
Etiology
🔸 Traumatic : direct nasal trauma, post septal surgery.
Evacuation under LA or G A, necessary because no
Spontaneous : Rare as in hypertension , blood diseases, 🔸
spontaneous resolution.
🔸🔸Mucosal incision and aspiration .
🔹
Timing of Surgical Repair
Most bilateral can be done within the first few days of life nose
🔸
Clinical picture:
Anterior nasal packing for 48 hours.
antibiotic , anti-inflammatory and analgesic.
🔹
to aid in growth and development
CHARGE syndrome may require a delay 🔸Nasal
Headache.🔸Smooth swelling of septal mucosa
obstruction.
🔹
Tracheostomy typically needed obstructing the nasal cavity with cystic boggy sensation , it
Unilateral atresia may Unilateral or Bilateral.
Before school age
Surgical Repair- Endoscopic Approach
More commonly used (stent)
🔹
Etiology:
Road traffic accidents, sport accident, personal
🔹
assult.
M>F Adult >children
Investigations
🔹
C/P:
🔹 Obstruction
🔹
🔹
Epistaxis
Deformity: deviation or saddling
🔹 Ecchymosis , Tenderness over fracture line
🔹Careful palpation: crepitus.
Nasal cavity examination: role out septal
Etiology: hematoma
Children and mentally retarded adults
🔹
Types of F.B:
🔹Animate : Myasis
Inanimate : metallic , vegetable , non vegetable
🔹
Pathophysiology Facture Nasal Nose 🔹
Management:
Reduction under local or G A using Walsham
🔹Fixation by nasal pack and external splint
Nasal foreign bodies can cause damage to the nasal cavity and the surrounding and Ash forceps
structures. They can produce local inflammation which may result in pressure
necrosis. This in turn can cause mucosal ulceration and erosion into blood vessels
🔹
producing epistaxis.
The swelling can cause obstruction to sinus drainage and lead to secondary
🔹
sinusitis.
Firmly impacted and unrecognized foreign bodies can in time become coated
🔹
with calcium,magnesium,phosphate or carbonate and become a rhinolith.
Rhinoliths are radio-opaque and are typically found on the floor of the nasal
🔹
complications of nasal trauma:
🔹
cavity.
Rhinoliths can remain undetected for years and only upon growth do they 🔹
🔹
septal deviation
septal hematoma
produce symptoms that lead to their discovery.
🔹 septal abscess
causes of cosmetic defects :
-poor initial management
Treatment -secondary infection
REMOVAL USING HOOKED INSTRUMENT
General Anesthesia is Indicated in :
🔹
Clinical picture
🔹 F.B discovered if patient tell to his parent
🔹
🔹 Uncooperative uncontrollable patient
Unilateral fetid purulent blood stained discharge is
🔹 Posteriorly located F. B
Associated granulation in neglected F. B with possibility of
🔹Excoriation around the nostril
characteristic
bleeding
FORIGN BODY NOSE
🔹
PATOLOGY
🔹Large
🔹
🔹
irregular
hard
🔹may cause pressure necrosis of lateral wall
septum hard palate.
Clinical picture:
Unilateral nasal obstruction
Nasal discharge: offensive , bloody
Neuralgic pain
🔹
O\E:
🔹Gray ,greenish Black
🔹Irrigular
🔹Stony Hard By Probying
Granulation Tissue
Rhinolith
Etiology: FB forms around the nidus:
-Exogenous FB
-blood clot
inspissated secretions
🔹
DIAGNOSIS
🔹History
Slow Deposition of calcium salts
and magnesium salt
by fatema okoff
🔹Anterior Rhinoscopy
🔹Endoscopic
ct Scan
Exam
TREATMENT
Surgical removal under general anesthesia
