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Ebook Color atlas of ENT diagnosis (4/E): Part 2

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Nội dung chi tiết: Ebook Color atlas of ENT diagnosis (4/E): Part 2

Ebook Color atlas of ENT diagnosis (4/E): Part 2

131Inflammation: nasal vestibulitisFig. 3.47 Vestibulitis presents as crusting and irritation in the anterior nares with resulting nasal obstruction.

Ebook Color atlas of ENT diagnosis (4/E): Part 2 Examination shows excoriated vestibular skin and septal mucous membrane. Rubbing or over-diligent cleaning of the nose by the patient usually causes

vestibulitis, particularly if, as in this case, the septum is deviated anteriorly and impinges on the lateral wall of the nose. Advice and the use of Ebook Color atlas of ENT diagnosis (4/E): Part 2

antibiotic and corticosteroid ointment are effective in controlling vestibulitis. Correction of the septum may be necessary.Fig. 3.48 Nasal vestibulit

Ebook Color atlas of ENT diagnosis (4/E): Part 2

is with squamous epithelium replacing the mucosa. A deviation of the septum has predisposed to a chronic vestibulitis. Digital irritation, or the use

131Inflammation: nasal vestibulitisFig. 3.47 Vestibulitis presents as crusting and irritation in the anterior nares with resulting nasal obstruction.

Ebook Color atlas of ENT diagnosis (4/E): Part 2. Usage subject to terms and conditions of license.132 The NoseFig. 3.49 Vestibulitis in a child overlying a grossly deviated anterior septum. Septal

surgery is avoided in children, but cases in which the obstruction is gross require a conservative septoplasty. Exessive cartilage resection may retar Ebook Color atlas of ENT diagnosis (4/E): Part 2

d nasal growth, predisposing to saddling or an infantile nose (Fig 3.27a).Fig. 3.50 Vestibulitis. Painful crusting of the nasal vestibule and anterior

Ebook Color atlas of ENT diagnosis (4/E): Part 2

nares may be a simple eczematous type of skin lesion which settles with a topical antibiotic and steroid ointment. There should, however, be an aware

131Inflammation: nasal vestibulitisFig. 3.47 Vestibulitis presents as crusting and irritation in the anterior nares with resulting nasal obstruction.

Ebook Color atlas of ENT diagnosis (4/E): Part 2sus. A further possibility is an “irritative” vestibulitis from cocaine snuff, or columellar carcinoma, as in this caseFig. 3.51 Granular rhinitis. Gr

anulation tissues in the nose requires biopsy. Sarcoidosis not infrequently involves the upper respiratory tract mucosa of the nasal fossae and larynx Ebook Color atlas of ENT diagnosis (4/E): Part 2

. In the nose the granulations are pale, but tuberculosis, malignant granuloma, and neoplasia are among the differential diagnoses.Bull, Color Atlas o

Ebook Color atlas of ENT diagnosis (4/E): Part 2

f ENT Diagnosis © 2003 ThiemeAll rights reserved. Usage subject to terms and conditions of license.Inflammation: nasal vestibulitis 133Fig. 3.52 Nasal

131Inflammation: nasal vestibulitisFig. 3.47 Vestibulitis presents as crusting and irritation in the anterior nares with resulting nasal obstruction.

Ebook Color atlas of ENT diagnosis (4/E): Part 2rior turbinate to the septum, causing nasal obstruction. Recurrence follows surgical division of the larger adhesions unless an indwelling silastic sp

lint is left in situ until mucosa underlying the adhesion regenerates.Fig. 3.53 Furuncles and cellulitis of the columella (a). These may spread to inv Ebook Color atlas of ENT diagnosis (4/E): Part 2

olve the skin of the nose and face (b). Treatment is with systemic penicillin.Bull, Color Atlas of ENT Diagnosis © 2003 ThiemeAll rights reserved. Usa

Ebook Color atlas of ENT diagnosis (4/E): Part 2

ge subject to terms and conditions of license.134 The NoseFig. 3.54a-c Acute rhinitis. In the common cold, the nasal mucous membrane is edematous, so

131Inflammation: nasal vestibulitisFig. 3.47 Vestibulitis presents as crusting and irritation in the anterior nares with resulting nasal obstruction.

Ebook Color atlas of ENT diagnosis (4/E): Part 2 seen in nasal allergy, either “seasonal hay fever” or perennial allergy, but the edematous turbinate mucous membrane appears gray (c) rather than red

(b). A persistent purulent nasal discharge usually means that there is a sinusitis. Corticosteroid nasal sprays for nasal allergy reduce the obstruct Ebook Color atlas of ENT diagnosis (4/E): Part 2

ion, rhinorrhea, and sneezing that characterize both seasonal and perennial nasal allergy. Skin tests to detect specific allergens are of use with gra

Ebook Color atlas of ENT diagnosis (4/E): Part 2

ss pollen and house dust allergy related to the house dust mite.Nasal sprays, along with allergen avoidance where possible, and oral antihistamines wi

131Inflammation: nasal vestibulitisFig. 3.47 Vestibulitis presents as crusting and irritation in the anterior nares with resulting nasal obstruction.

Ebook Color atlas of ENT diagnosis (4/E): Part 2there is an increased awareness and concern regarding anaphylactic shock.Bull. Color Atlas of ENT Diagnosis © 2003 ThiemeAll rights reserved. Usage su

bject to terms and conditions of license.Inflammation: nasal vestibulitis 135Fig. 3.55 Chronic rhinitis. The turbinate mucous membrane frequently reac Ebook Color atlas of ENT diagnosis (4/E): Part 2

ts to irritants. whether tobacco, excessive use of vasoconstrictor drops, or atmospheric irritants. by enlarging. Thickened red inferior turbinates ar

Ebook Color atlas of ENT diagnosis (4/E): Part 2

e seen adjacent to the septum, limiting the airway. Nasal obstruction, either intermittent or persistent, with a postnasal discharge of mucus (“postna

131Inflammation: nasal vestibulitisFig. 3.47 Vestibulitis presents as crusting and irritation in the anterior nares with resulting nasal obstruction.

Ebook Color atlas of ENT diagnosis (4/E): Part 2hanges due to chronic rhinitis are irreversible, i.e., the nasal obstruction persists when the irritants are removed, it is probable that minor surger

y to reduce the turbinates in size will be necessary.A nasal corticosteroid spray and nonsedating oral antihistamines help, but vasoconstrictor drops Ebook Color atlas of ENT diagnosis (4/E): Part 2

have no place in the treatment of chronic rhinitis and their constant use is a cause of rhinitis medicamentosa.Rhinitis frequently coexists with asthm

Ebook Color atlas of ENT diagnosis (4/E): Part 2

a (the upper and lower respiratory tract sharing a common epithelium), and about 30% of those with rhinitis have asthma. (About 80% of asthmatics have

131Inflammation: nasal vestibulitisFig. 3.47 Vestibulitis presents as crusting and irritation in the anterior nares with resulting nasal obstruction.

Ebook Color atlas of ENT diagnosis (4/E): Part 2mune inflammatory disease which often presents with nasal symptoms of obstruction, crusting, and epistaxis. Damage to the septum may lead to a saddle

deformity (Fig. 3.21-3.23).The granulomas may be limited to the nose, but the respiratory tract may be involved along with a generalized vasculitis an Ebook Color atlas of ENT diagnosis (4/E): Part 2

d glomerulonephritis. The condition is characterized by periods of remission, and treatment with oral steroids and cytotoxic drugs has dramatically im

Ebook Color atlas of ENT diagnosis (4/E): Part 2

proved the prognosis of a previously fatal condition.Bull. Color Atlas of ENT Diagnosis © 2003 ThiemeAll rights reserved. Usage subject to terms and c

131Inflammation: nasal vestibulitisFig. 3.47 Vestibulitis presents as crusting and irritation in the anterior nares with resulting nasal obstruction.

131Inflammation: nasal vestibulitisFig. 3.47 Vestibulitis presents as crusting and irritation in the anterior nares with resulting nasal obstruction.

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