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Questions and Answers
What is the primary surgical approach for treating a nasal dermoid cyst?
What is the primary surgical approach for treating a nasal dermoid cyst?
The primary surgical approach involves splitting the nasal bones to remove the cyst and its extension.
Differentiate between intranasal and extranasal nasal gliomas in terms of their typical locations.
Differentiate between intranasal and extranasal nasal gliomas in terms of their typical locations.
Intranasal gliomas are located within the nasal cavity, while extranasal gliomas are found outside the nasal structures, typically on the nasal bridge or side of the nose.
Explain how nasal meningoencephaloceles are anatomically related to the intracranial cavity.
Explain how nasal meningoencephaloceles are anatomically related to the intracranial cavity.
Nasal meningoencephaloceles are herniations that connect glial tissue and meninges to the intracranial cavity, leading to enlargement during crying.
What surgical treatment is suggested for agenesis of the nose?
What surgical treatment is suggested for agenesis of the nose?
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Describe the severity range and associated conditions of cleft nose.
Describe the severity range and associated conditions of cleft nose.
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What are the characteristic features observed in an infant with bilateral choanal atresia during examination?
What are the characteristic features observed in an infant with bilateral choanal atresia during examination?
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Identify two diagnostic methods used for assessing choanal atresia.
Identify two diagnostic methods used for assessing choanal atresia.
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Explain the CHARGE association and list its components.
Explain the CHARGE association and list its components.
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What is the primary initial treatment approach for unilateral choanal atresia?
What is the primary initial treatment approach for unilateral choanal atresia?
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Describe the surgical treatment options available for bilateral choanal atresia.
Describe the surgical treatment options available for bilateral choanal atresia.
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What complication can occur following the surgical correction of choanal atresia that requires monitoring?
What complication can occur following the surgical correction of choanal atresia that requires monitoring?
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What distinguishes a simple nasal dermoid cyst from a dermoid cyst with sinus?
What distinguishes a simple nasal dermoid cyst from a dermoid cyst with sinus?
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How can congenital nasal mass conditions be assessed for cerebral spinal fluid communication?
How can congenital nasal mass conditions be assessed for cerebral spinal fluid communication?
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What are the symptoms of acute vestibulitis of the nose?
What are the symptoms of acute vestibulitis of the nose?
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Identify two chronic conditions affecting the external nose.
Identify two chronic conditions affecting the external nose.
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What are the primary treatments for acute vestibulitis of the nose?
What are the primary treatments for acute vestibulitis of the nose?
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What congenital anomaly is characterized by closed non-patent posterior nares?
What congenital anomaly is characterized by closed non-patent posterior nares?
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What is the male to female ratio for choanal atresia incidences?
What is the male to female ratio for choanal atresia incidences?
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Name one neoplastic condition of the external nose.
Name one neoplastic condition of the external nose.
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What complication can arise from squeezing a furuncle in acute vestibulitis?
What complication can arise from squeezing a furuncle in acute vestibulitis?
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Mention one condition associated with bleeding from the nose.
Mention one condition associated with bleeding from the nose.
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What is the primary causative agent of acute vestibulitis of the nose?
What is the primary causative agent of acute vestibulitis of the nose?
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List one symptom of chronic vestibulitis of the nose.
List one symptom of chronic vestibulitis of the nose.
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What type of choanal atresia is most common?
What type of choanal atresia is most common?
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Name one neoplastic condition associated with the external nose.
Name one neoplastic condition associated with the external nose.
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What fatal complication can arise from improper management of acute vestibulitis?
What fatal complication can arise from improper management of acute vestibulitis?
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What are the common manifestations observed in the facial structure of a patient with CHARGE association?
What are the common manifestations observed in the facial structure of a patient with CHARGE association?
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What is one surgical approach used in the definitive treatment of bilateral choanal atresia?
What is one surgical approach used in the definitive treatment of bilateral choanal atresia?
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What kind of follow-up care is often necessary after corrective surgery for choanal atresia?
What kind of follow-up care is often necessary after corrective surgery for choanal atresia?
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How can congenital nasal masses be assessed for communication with cerebrospinal fluid?
How can congenital nasal masses be assessed for communication with cerebrospinal fluid?
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What are the two types of nasal dermoid cysts?
What are the two types of nasal dermoid cysts?
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Study Notes
External Conditions of the Nose
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Infective Conditions:
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Acute:
- Furunculosis: Staphylococcal infection of hair follicles in the nasal vestibule. Symptoms include severe pain, fever, swelling, and tenderness.
- Impetigo: Superficial bacterial infection of the skin, often caused by Staphylococcus aureus or Streptococcus pyogenes.
- Erysipelas: Acute bacterial infection of the skin and subcutaneous tissue, typically caused by group A Streptococcus.
- Herpes Simplex and Zoster: Viral infections that can manifest in the nasal region.
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Chronic:
- Vestibulitis: Repeated fissuring and crust formation in the nasal vestibule, often with bleeding.
- Lupus Vulgaris: Chronic granulomatous infection caused by Mycobacterium tuberculosis.
- Syphilis: Bacterial infection that can cause lesions on the nose.
- Lupus Erythematosus: Autoimmune disease that can affect the nose.
- Acne Rosacea: Chronic inflammatory skin disorder affecting the face, including the nose.
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Acute:
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Neoplastic Conditions:
- Papilloma: Benign growth of the skin or mucous membranes.
- Rodent Ulcer: Malignant skin cancer, also known as basal cell carcinoma.
- Keratoacanthoma: Benign, rapidly growing skin tumor.
- Squamous Cell Carcinoma: Malignant cancer of the squamous epithelial cells.
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Traumatic Conditions:
- Fracture Nose: Break in the nasal bones.
- Septal Hematoma: Collection of blood within the nasal septum.
- Saddle Nose: Depression of the nasal bridge, often due to untreated septal hematoma.
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Foreign Bodies in the Nose:
- Rhinolithiasis: Nasal stones, often composed of calcium phosphate.
- Myiasis: Infestation with fly larvae.
- Rhinosporidiosis: Fungal infection, causing polyps in the nasal cavity.
Congenital Conditions
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Posterior Choanal Atresia: Failure of the posterior nasal passage to open.
- Incidence: 1 in 7000, female: male = 2:1
- Aetiology: Embryonic failure of the bucconasal membrane to rupture.
- Types: Bony, membranous, or mixed. Unilateral or bilateral.
- Clinical Features: Unilateral: Asymptomatic at birth, later causing unilateral nasal discharge and obstruction. Bilateral: Emergency at birth, newborn is an obligate nasal breather and presents with pallor, cyanosis, nasal obstruction, and difficulty feeding. Other signs include bulging of the lateral nasal wall, facial asymmetry, high arched palate, and deformed or absent teeth.
- Diagnosis: Mirror test, plastic catheter, cotton wool, fibreoptic endoscopy, contrast radiography, CT scan.
- Treatment: Bilaterally: Maintain an oral airway. Definitive surgical removal of the atretic plate.
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Surgical Approaches:
- Transnasal: Perforation with a probe, electrocautery, laser, or burr followed by stent placement.
- Transpalatal: Surgical approach via the palate.
- Follow Up: Maintenance of the opening with regular bouginage.
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Congenital Nasal Masses:
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Nasal Dermoid: Sequestration of epithelial elements during fusion of the median nasal process.
- Types: Simple (no external opening) or with sinus (external pit).
- Clinical Features: Midline swelling, external pit, protruding hair.
- Treatment: Excision, with neurosurgical approach if intracranial extension.
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Nasal Glioma: Nipped off portions of encephalocele during embryonic development.
- Types: Extranasal, intranasal, or both.
- Clinical Features: Firm subcutaneous swellings.
- Treatment: Surgical removal.
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Nasal Meningoencephaloceles: Herniation of glial tissue and meninges through skull defect.
- Clinical Features: Cystic mass, often over the root of the nose, connected to intracranial cavity, may enlarge during crying.
- Treatment: Surgical excision, correction of associated anomalies.
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Other Congenital Anomalies:
- Agenesis of the Nose: Total or partial absence of the nose, treatment is reconstruction.
- Cleft Nose: Range from minor notching to total midline division, often associated with cleft lip and palate, treatment is reconstruction.
Other Conditions of the Nose
- Epistaxis: Nasal bleeding.
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Affections of the Nasal Septum:
- Deviated Nasal Septum (DNS): Displacement of the nasal septum.
- Anterior Dislocation: Displacement of the septum from its normal position.
- Septal Perforation Hole in the nasal septum.
- Bleeding Polypus of the Septum: Benign growth on the nasal septum that can cause bleeding.
External Nose Conditions
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Acute Vestibulitis:
- Caused by staphylococcal infection
- Presents with redness, excoriation, and fissuring of nasal vestibule skin
- Symptoms: Severe pain, fever, swelling, and tenderness
- Treatment: Broad-spectrum antibiotics, anti-inflammatory drugs, and antibiotic cream
- Avoid squeezing or surgery to prevent cavernous sinus thrombosis
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Chronic Vestibulitis:
- Repeated fissuring with crust formation
- Painful, may bleed with rubbing
- Treatment: Antibiotics and steroid cream
- Diabetes must be ruled out in both acute and chronic cases
Congenital Anomalies
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Choanal Atresia:
- Closed posterior nares, preventing nasal breathing
- Incidence: 1 in 7000 births, female-to-male ratio 2:1
- Etiology: Failure of bucconasal membrane to rupture during development
- Types: Bony (90%), membranous (10%), or mixed; unilateral or bilateral
- Unilateral: Asymptomic at birth, later causes unilateral nasal discharge and obstruction
- Bilateral: Emergency at birth, presents with cyanosis, facial asymmetry, and possible palate deformation
- Diagnosis: Mirror test, plastic catheter, cotton wool, fiberoptic endoscopy, contrast radiography, CT scan
- Treatment: Oral airway until surgery; surgical removal of atretic plate, stent or dilation for maintenance
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Nasal Dermoids:
- Sequestration of epithelial elements during nasal development
- Present as midline swellings, solid or cystic with possible sinus
- Treatment: Surgical removal, consider neurosurgical approach for intracranial extensions
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Nasal Gliomas:
- Nipped off portions of encephalocele during development
- Usually extranasal, firm subcutaneous swellings on nasal bridge, side, or near inner canthus
- Treatment: Surgical removal
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Nasal Meningoencephaloceles:
- Herniation of glial tissue and meninges through skull defect
- Contain CSF and are connected to intracranial cavity
- Present as cystic masses over the root of the nose or intranasal
- Treatment: Surgical excision, correction of associated orbital or facial anomalies
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Agenesis of the Nose:
- Total or partial absence of the nose
- Treatment: Reconstruction
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Cleft Nose:
- Range from minor notching to complete separation of nasal cavities
- Associated with cleft lip and palate
- Treatment: Reconstruction
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Description
This quiz covers various infective conditions affecting the nose, including both acute and chronic infections. Key topics include furunculosis, impetigo, erysipelas, and other related disorders. Test your knowledge on their symptoms, causes, and implications.
