Res.pdf

 Fig (3.2) Allergic nasal polyp seen by endoscopy (left), microscopic picture (right) showing respiratory epithelial covering with underlying edema. Complications: Nasal obstruction lead ing to 2ry infection & spread of the infection , & epistaxis. ADENOIDS Adenoids de...

 Fig (3.2) Allergic nasal polyp seen by endoscopy (left), microscopic picture (right) showing respiratory epithelial covering with underlying edema. Complications: Nasal obstruction lead ing to 2ry infection & spread of the infection , & epistaxis. ADENOIDS Adenoids denote hyperplastic lymphoid tissue at the posterior wall of the nasopharynx, due to chronic infection in infants and ch ildren. Effects: e Mouth breathing with characteristic adenoid face: opened mouth, short upper lip, protruding upper incisors, narrow nasal openings, absent nasolabial folds. Spread of infection leading to otitis media, pharyngitis. Figure (3.3) Adenoid Facies. CHRONIC SPECIFIC INFECTIONS: RHINOSC LEROMA Definition: A granulomatous inflam mation of the nose. May affect other site as the larynx (l aryngoscleroma), and pharynx. Causative organism: It is due to infection with Klebsiella rhinoscleromatis bacteria which is endem ic in Egypt. 39 Morphology: Gross: The lesions appear as small hard nodular mass or masses filling the nasal cavity. Microscopic: There is a chronic inflammatory infiltrate involving the submucosa. The inflammatory cells comprise: 1) Mickulicz cells: These are the predominant cells. The bacteria multiply in macrophages producing a foamy appearance of the cytoplasm. They are large with a small pyknotic nucleus. 2) Plasma cells and Russell bodies (Plasma cells with hyaline change due to accumulated immunoglobulin). Later there is fibrosis. Complications: 1) Nasal obstruction and deformity. 2) Ulceration and secondary infection. TUMORSOFTHENASOPHARYNX JUVENILE ANGIOFIBROMA: An uncommon benign mesenchymal tumor of the nasopharynx. It occurs exclusively in males, usually during adolescence. It is formed of proliferating fibroblasts with wide blood vessels. They are extremely vascular and lead to nasal bleeding (epistaxis) NASOPHARYNGEAL CARCINOMA: Incidence: Nasopharyngeal carcinoma is a rare neoplasm linked to EBV It is common among the Chinese. It may take one of three histological vari ants: 1) Keratinizing squamous cell carcinoma. 2) Non-keratinizing squamous cell carcinoma. 3) Undifferentiated carcinoma with excess lymphocytes in the stroma [lymphoepithelioma]. It is the most common and the one most common ly linked to EBV. Spread: It may spread directly, by lymphatics to cervical lymph nodes and late by blood. Treatment & prognosis: They tend to be radiosensitive. Lymphoepithelioma gives better results than squamous cell carcinoma with irradiation. EPISTAXIS Definition: Bleeding through the nose Causes: 1. Trauma 2. Foreign bodies 40