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• Palpation of the nasal
bones for tenderness
and cripitus in fracture
of the nasal bones
•• This
is called
Thisexamination
examination
is
anterior
rhinoscopy
called ……….
•• The
seen
by by
Thesrtuctures
srtuctures
seen
this
are are
the
thisexamination
examination
anterior
part of:part of:
the anterior
1-Floor
• 1- of the nose
2-Inferior
turbinate & meatus
• 23-Middle turbinate & meatus
• 34-Nasal septum
• 4-
Nasal Air Flow Test
• The metal tongue
depressor is held below
the nostril during quiet
respiration
• The area of fogging
gives an idea about the
patency of the nasal
airway
Rigid endoscope
• Endoscopy can be carried out in the out-patient
clinic
• An optical telescope
• Provide good illumination & visualization
• Used for direct visualization of the nose (and
• Allows
examination
also ear
& throat) of difficult-to-examine
areas
• What is the Value of this instrument ?
• Many therapeutic procedures in the nose and
sinuses can be done by this instrument
Flexible fibro-optic naso-pharyngolaryngoscope
• To examine
-
Nasal cavity
Pharynx
larynx
• Hump Nose
• Bifid Nose
Nasoalveolar cyst
The arrow points to flaring of the ala
• The arrow points to………
• It is used for………………..
What is your diagnosis?
Treatment?
Foreign Body (Bead) in Left Nasal
Cavity
Rhinolith
Saddle Nose
• 25-year-old man complains of midfacial pain, fever,
and general malaise of about 48 hours' duration. He
denied having a cough, rhinorrhea, or nasal
congestion. The patient reported being hit in the
nose about 10 days earlier. The patient's
temperature was 38.1° C orally and he had no frontal
or maxillary sinus tenderness. Nasal examination
(see accompanying figure).
• What is the most likely diagnosis?
• The answer : septal hematoma. The midline
swelling of the septum is typical of septal
hematoma and is consistent with the patient's
history of facial trauma.
• Typically soft and fluctuant when compressed, a
septal hematoma is a collection of blood between
the nasal mucosa and the cartilaginous septum.
• It may occur unilaterally or, more commonly,
bilaterally following nasal trauma with or without
associated nasal fracture.
• This urgent condition warrants immediate referral
to an otolaryngologist.
• Incision and drainage of septal abscess
Vestibulitis
• This child presented also with foul odor from
the right nasal side
• You should suspect……………
FB in the right nasal cavity
• Orbital abscess
• The black arrow points to frontal mucocele
• The red arrow points to the orbit which is
displaced downwads and laterally
• Picture 1(left). A male with orbital cellulitis with
proptosis, ophthalmoplegia, and edema and erythema
of the eyelids. The patient also exhibited pain on eye
movement, fever, headache, and malaise
• The same patient (right) exhibited chemosis and
resistance to retropulsion of the globe
• The cardinal signs of an orbital cellulitis
are decreased eye movements, proptosis,
decreased vision. The conjunctiva may be
injected in either periorbital or orbital
cellulitis
Rhinophyma
Frunculosis
• In this patient
1- incision and squeezing the
lesion is a proper treatment
2- The causative organism is
strptococcus pnumonia
3- diabetes millitus should be
considered especially if the
lesion is bilateral
4- cavernous sinus
thrombophlebitis is never a
complication of this lesion
• This child presented with fever, , pain in the
eye, edema of the right lids, limitations of eye
movements and gave a history of recurrent
attacks of nasal obstruction and discharge.
• Examination of the nose revealed right
yellowish nasal discharge but no masses
• Acute ethmoiditis complicated by orbital
infection
1-Orbital cellulitis
2-Subperiosteal
abscess
3-Orbital abscess
• Patient undergoing Caldwell-Luc
surgery, involving removal of the
diseased lining of the maxillary antrum
Oral-Maxillary Fistula.
• This patient
presented with left
nasal offensive
discharge, and left
nasal regurgitation of
fluids
• ??
Oro-maxillary
fistula
• The patient shown on the right has a small
hole in the middle of a tooth socket. A tooth
had been pulled and a hole was made into the
maxillary sinus. The hole did not fully heal
and a small fistula was left in the middle of the
upper alveolar ridge
Rhinoscleroma
• Bilateral reddish non ulcerating firm nodules which
firstly appear at the muco-cutaneous junction
• As seen below the nodules spread and coalesce to
fill the nasal cavity and broaden the nose
Atrophic Rhinitis
• A 20 years old female presented with crusty
nose and anosmia. Examination revealed
roomy nose, greenish crusts and pale atrophic
nasal mucosa
Anterior nasal packing
• A traditional ribbon gauze pack,
• Prefabricated expandable packs,
• Intranasal balloons
Epistaxis Ballon for anterior and
posterior nasal packing