Diseases of External Nose
Definition
- External nose or nasal pyramid is a complex structure that serves as the external entrance to the nasal cavity.
Types
1. Inflammatory Diseases
- Rhinitis: Inflammation of nasal mucosa
- Sinusitis: Inflammation of paranasal sinuses
- Pharyngitis: Inflammation of pharynx
- Tonsillitis: Inflammation of tonsils
2. Infectious Diseases
- Fungal infections: Aspergillosis, mucormycosis
- Bacterial infections: Staphylococcus aureus, Pseudomonas aeruginosa
- Viral infections: Influenza, measles
3. Neoplastic Diseases
- Benign tumors: Nasal polyps
- Malignant tumors: Squamous cell carcinoma, adenocarcinoma
4. Traumatic Diseases
- Fractures of nasal bones
- Lacerations of nasal skin and cartilage
- Avulsion of nasal septum
Causes
1. Inflammatory Diseases
- Allergic reactions to environmental factors (pollen, dust, etc.)
- Non-allergic rhinitis (infectious, chemical, etc.)
- Anatomical factors (deviated septum, nasal polyps, etc.)
2. Infectious Diseases
- Airborne pathogens (bacteria, viruses, fungi)
- Contaminated water or food
- Poor hygiene and personal care
3. Neoplastic Diseases
- Genetic mutations and chromosomal abnormalities
- Exposure to carcinogens (tobacco smoke, radiation, etc.)
4. Traumatic Diseases
- Direct trauma to the nose (falls, sports injuries, etc.)
- Indirect trauma (car accidents, explosions, etc.)
Clinical Features
1. Inflammatory Diseases
- Nasal congestion and discharge
- Sneezing and coughing
- Headaches and facial pain
- Loss of smell and taste
2. Infectious Diseases
- Fever and chills
- Nasal discharge and congestion
- Sore throat and cough
- Fatigue and weakness
3. Neoplastic Diseases
- Nasal obstruction and bleeding
- Pain and tenderness in the nose and face
- Nasal discharge and crusting
- Loss of smell and taste
4. Traumatic Diseases
- Swelling and bruising of the nose
- Nasal bleeding and discharge
- Deformity and loss of function
- Facial pain and swelling
Investigations
1. Inflammatory Diseases
- Nasal endoscopy
- Imaging studies (X-rays, CT scans, etc.)
- Blood tests (CBC, allergy tests, etc.)
- Nasal smear and culture
2. Infectious Diseases
- Blood tests (CBC, blood cultures, etc.)
- Imaging studies (X-rays, CT scans, etc.)
- Nasal smear and culture
- Sputum and throat cultures
3. Neoplastic Diseases
- Imaging studies (X-rays, CT scans, etc.)
- Biopsy and histopathology
- Blood tests ( CBC, tumor markers, etc.)
- Endoscopy and nasal smear
4. Traumatic Diseases
- Imaging studies (X-rays, CT scans, etc.)
- Nasal endoscopy
- Blood tests (CBC, etc.)
- Physical examination and history
Complications
1. Inflammatory Diseases
- Nasal polyps and septal perforation
- Chronic sinusitis and otitis media
- Facial pain and swelling
- Loss of smell and taste
2. Infectious Diseases
- Respiratory failure and sepsis
- Meningitis and brain abscess
- Osteomyelitis and septic arthritis
- Disseminated intravascular coagulation
3. Neoplastic Diseases
- Local recurrence and metastasis
- Facial disfigurement and loss of function
- Nasal obstruction and bleeding
- Meningeal and brain involvement
4. Traumatic Diseases
- Nasal septum perforation and collapse
- Facial deformity and loss of function
- Nasal bleeding and discharge
- Orbital and eye involvement
Management and Treatment
1. Inflammatory Diseases
- Nasal decongestants and corticosteroids
- Antibiotics and antihistamines
- Nasal saline irrigation and humidification
- Surgery for nasal polyps and septal perforation
2. Infectious Diseases
- Antibiotics and antivirals
- Rest and hydration
- Nasal decongestants and corticosteroids
- Surgery for abscess and empyema
3. Neoplastic Diseases
- Surgery for tumor resection
- Radiation and chemotherapy
- Nasal endoscopy and biopsy
- Palliative care for terminal cases
4. Traumatic Diseases
- Nasal packing and suturing
- Imaging studies and evaluation
- Nasal endoscopy and debridement
- Surgery for septal perforation and collapse
Blood Supply
- Nasal septum: Superior and inferior labial arteries
- Turbinate bones: Sphenopalatine artery
- Nasal bones: Anterior ethmoidal artery
Nerve Supply
- Nasal septum: Anterior ethmoidal nerve
- Turbinate bones: Sphenopalatine nerve
- Nasal bones: Infraorbital nerve
Clinical Anatomy
- Nasal septum: Cartilaginous and bony framework
- Turbinate bones: Longitudinal and transverse bones
- Nasal bones: Maxillary and nasal bones
Homoeopathic Therapeutic Medicines
- Allium cepa: Nasal congestion and discharge
- Kali bichromicum: Nasal polyps and septal perforation
- Pulsatilla: Nasal bleeding and discharge
- Sanguinaria: Nasal polyps and septal perforation
- Silica: Nasal discharge and crusting
Deformities of Nose
- Definition: Deformities of nose refer to any abnormal shape or structure of the nose.
- Types: • Deviated nose • Crooked nose • Hump nose • Flat nose • Asymmetrical nose • Septal deviation • Nasal polyps
- Causes: • Genetic factors • Injury or trauma • Congenital conditions • Allergies • Infections • Tumors
- Clinical features: • Abnormal shape or structure of the nose • Difficulty breathing • Nasal congestion • Facial asymmetry
- Investigations: • Physical examination • Imaging studies (X-rays, CT scans, MRI) • Nasal endoscopy
- Complications: • Respiratory problems • Sinusitis • Facial deformity • Emotional distress
- Management: • Conservative treatment (nasal strips, humidifiers) • Surgery (rhinoplasty) • Nasal dilators
- Treatment: • Rhinoplasty (open or closed approach) • Septoplasty • Turbinate reduction
Fracture of Nose
- Definition: Fracture of the nose refers to a break in the bones of the nose.
- Types: • Simple fracture (single break) • Complex fracture (multiple breaks)
- Causes: • Direct blow to the nose • Fall on the face • Sports injury • Assault
- Clinical features: • Swelling and bruising of the nose • Nasal congestion • Difficulty breathing • Facial pain
- Investigations: • Physical examination • Imaging studies (X-rays, CT scans) • Nasal endoscopy
- Complications: • Respiratory problems • Sinusitis • Facial deformity • Emotional distress
- Management: • Conservative treatment (nasal packing, ice packs) • Surgery (open reduction internal fixation)
- Treatment: • Open reduction internal fixation • Nasal packing • Ice packs • Nasal dilators
Vestibulitis
- Definition: Vestibulitis refers to inflammation of the vestibule of the nose.
- Causes: • Bacterial or fungal infections • Allergies • Irritants (perfumes, tobacco smoke) • Anatomical abnormalities
- Clinical features: • Pain or tenderness in the nose • Nasal congestion • Discharge or crusting • Facial pain
- Investigations: • Physical examination • Imaging studies (X-rays, CT scans) • Nasal endoscopy
- Complications: • Respiratory problems • Sinusitis • Facial deformity • Emotional distress
- Management: • Conservative treatment (nasal saline irrigations, antibiotics) • Surgery (vestibuloplasty)
- Treatment: • Nasal saline irrigations • Antibiotics (oral or topical) • Nasal dilators • Vestibuloplasty (surgical removal of inflamed tissue)
Blood Supply to the Nose
- The nasal cavity is supplied by the sphenopalatine artery (SPAA) and the greater palatine artery (GPA).
- The SPAA is a branch of the maxillary artery and supplies the nasal septum, superior and middle nasal turbinates, and the lateral nasal wall.
- The GPA is a branch of the maxillary artery and supplies the inferior nasal turbinates.
Nerve Supply to the Nose
- The nasal cavity is innervated by the nasopalatine nerve, the sphenopalatine ganglion, and the external nasal branches of the anterior ethmoidal nerve.
- The nasopalatine nerve is a branch of the maxillary nerve and supplies the nasal septum and the anterior part of the nasal cavity.
Clinical Anatomy of the Nose
- The nasal cavity is a complex structure composed of the nasal septum, turbinates, and the lateral nasal wall.
- The nasal septum is a thin wall of cartilage and bone that divides the nasal cavity into two nostrils.
- The turbinates are long, thin bones that project into the nasal cavity and help to warm and humidify the air we breathe.
- The lateral nasal wall is the outer wall of the nasal cavity and is composed of bone and cartilage.
Homoeopathic Therapeutic Medicines
- For deformities of the nose: • Calcarea carbonica: for nasal congestion and deformity • Silica: for nasal polyps and congestion • Pulsatilla: for nasal discharge and congestion
- For fracture of the nose: • Arnica montana: for swelling and bruising • Calendula officinalis: for wound healing and tissue repair • Chamomilla: for pain and discomfort
- For vestibulitis: • Staphysagria: for pain and inflammation • Aconitum napellus: for acute onset of symptoms • Belladonna: for pain and inflammation