Nasal Obstruction.pptVIP

Common causes Diagnosis Symptoms Tests Turbinate hypertrophy Turbinate enlargement (usually inferior) on PE Direct inspection Vasomotor rhinitis Clear glary mucus Rule out other etiologies Septal perforation Septal perforation on physical examination Direct inspection Valvular collapse Nasal “valvular” collapse on deep inspiration Cottle test, observation of a deep inspiration Choanal atresia Unilateral (or bilateral) nasal obstruction with clear rhinorrhea Sagittal CTs through nasopharynx Treatment Diagnosis Treatment Septal deviation Septoplasty Turbinate hypertrophy Decongestants, turbinoplasty, turbinate resection Septal perforation Septal button, septal repair Valvular collapse Breathe-Ease strips,valvular reconstruction Choanal atresia Transpalatal repair Neoplasm Resection Treatment Diagnosis Treatment Nasal polyposis Polypectomy, topical steroids Viral infection Self-limited, symptomatic treatment (e.g., decongestant) Allergic rhinitis Avoidance of or desensitization to the allergen Septal hematoma I and D Septal abscess I and D Treatment Diagnosis Treatment Nasal foreign body Foreign body removal Rhinoscleroma Tetracycline early in its development or surgical resection of fibrotic material in its later stages Rhinitis medicamentosa Steroids (temporary) and avoidance of nasal decongestant sprays NASAL OBSTRUCTION Anatomy And Physiology Functions of the nose Airway Conduction of environmental air into and out of the respirator system Filtration Mucus, vibrissae, and cillia trap and remove airborne viral, bacterial, and particulate matter (usually 30 um) Heating Vascular mucosa overlaying the nasal cartilage and turbinates provides radiant heating of inspired air to 31℃ to 37℃before reaching the nasopharynx Humidification Vascular mucosa increases the relative humidity of inspired air to 95% before reaching the nasopharynx Functions of the nose Chemosensation Olfactory sensation detects irritants, chemicals, and temperature abnormalities of inspired