MISCELLANEOUS DISEASES OF NOSE AND SINUS

Cerebrospinal Rhinorrhoea

• Definition: Cerebrospinal rhinorrhoea refers to the leakage of cerebrospinal fluid through the nose.

• Causes:

  • Trauma to the skull or spine
  • Spinal surgery
  • Congenital defects
  • Infection (meningitis)

• Clinical Features:

  • Clear fluid discharge from the nose
  • Headache
  • Fever
  • Confusion

• Investigations:

  • Imaging studies (CT/MRI)
  • Cerebrospinal fluid analysis

• Complications:

  • Meningitis
  • Bacterial infection
  • Cerebral abscess

• Management:

  • Conservative management (bed rest, antibiotics)
  • Surgical repair (epidural or subdural repair)
  • Endoscopic repair

Foreign Body in Nose

• Definition: A foreign body is an object that enters the nasal cavity.
• Causes:
  • Accidental insertion
  • Intentional insertion (by children)
  • Medical procedures (nasal intubation)
• Clinical Features:
  • Complaint of foreign body sensation
  • Discharge or bleeding
  • Difficulty breathing
• Investigations:
  • Endoscopy
  • Imaging studies (X-ray/CT)
• Complications:
  • Infection
  • Perforation of the nasal septum
  • Respiratory obstruction
• Management:
  • Attempt to remove the object (endoscopy or nasopharyngoscopy)
  • Antibiotics (if infection occurs)
  • Surgical removal (if object is not visible or not removable)

Rhinolith

• Definition: Rhinolith is a calcified mass formed within the nasal cavity.
• Causes:
  • Long-standing foreign body (e.g., a stone)
  • Trauma to the nasal cavity
  • Infection (sino-nasal infection)
• Clinical Features:
  • Discharge or bleeding
  • Difficulty breathing
  • Nasal obstruction
• Investigations:
  • Imaging studies (X-ray/CT)
  • Endoscopy
• Complications:
  • Infection
  • Perforation of the nasal septum
  • Respiratory obstruction
• Management:
  • Surgical removal
  • Antibiotics (if infection occurs)

Choanal Atresia

• Definition: Choanal atresia is a congenital condition where the posterior nasal passage is blocked.
• Types:
  • Bony atresia
  • Membranous atresia
• Causes:
  • Congenital defect
  • Trauma to the nasal cavity
• Clinical Features:
  • Nasal obstruction
  • Breathing difficulty
  • Cyanosis
• Investigations:
  • Imaging studies (CT/MRI)
  • Nasal endoscopy
• Complications:
  • Respiratory obstruction
  • Infection
  • Deafness
• Management:
  • Surgical repair (endoscopic or open surgery)
  • Tracheostomy (if severe respiratory distress)

Oroantral Fistula

• Definition: Oroantral fistula is an abnormal connection between the oral cavity and the maxillary sinus.
• Causes:
  • Trauma to the maxillary sinus
  • Dental extraction
  • Infection (sino-nasal infection)
• Clinical Features:
  • Discharge or bleeding
  • Difficulty eating
  • Nasal obstruction
• Investigations:
  • Imaging studies (X-ray/CT)
  • Endoscopy
• Complications:
  • Infection
  • Perforation of the maxillary sinus
  • Respiratory obstruction
• Management:
  • Conservative management (nasal packing)
  • Surgical repair (endoscopic or open surgery)

Proptosis

• Definition: Proptosis is the protrusion of the eyeball.
• Causes:
  • Thyroid ophthalmopathy
  • Orbital tumours (e.g., rhabdomyosarcoma)
  • Infection (orbital cellulitis)
• Clinical Features:
  • Protrusion of the eyeball
  • Diplopia
  • Ptosis
• Investigations:
  • Imaging studies (CT/MRI)
  • Orbital ultrasound
• Complications:
  • Corneal exposure
  • Vision loss
  • Respiratory obstruction
• Management:
  • Conservative management (antibiotics or steroid treatment)
  • Surgical repair (orbital decompression or exenteration)

Homoeopathic Therapeutic Medicines

• Cerebrospinal Rhinorrhoea:
  • Cinchona officinalis (for meningitis)
  • Eupatorium perfoliatum (for headache and fever)
  • Gelsemium sempervirens (for fatigue and weakness)
• Foreign Body in Nose:
  • Aurum metallicum (for chronic foreign body sensation)
  • Graphites (for bleeding and discharge)
  • Sulfur (for infection and respiratory distress)
• Rhinolith:
  • Silica (for chronic nasal obstruction and discharge)
  • Kali bichromicum (for chronic sinusitis and nasal bleeding)
  • Lachesis (for chronic respiratory distress and nasal obstruction)
• Choanal Atresia:
  • Coccus corynebacterium (for infection and respiratory distress)
  • Aconitum napellus (for acute respiratory distress and cyanosis)
  • Pulsatilla (for chronic respiratory distress and nasal obstruction)
• Oroantral Fistula:
  • Calcarea carbonica (for chronic infection and nasal bleeding)
  • Silica (for chronic sinusitis and nasal obstruction)
  • Sulfur (for chronic respiratory distress and nasal obstruction)
• Proptosis:
  • Aurum metallicum (for thyroid ophthalmopathy and diplopia)
  • Graphites (for chronic respiratory distress and nasal obstruction)
  • Kali bichromicum (for chronic sinusitis and nasal bleeding)