atrophic rhinitis ppt
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TRANSCRIPT
ATROPHIC RHINITIS
MEGHA.V4061
CONTENTS:
•DEFINITION•HISTORY•ETIOLOGY•PATHOLOGY•SYMPTOMS & SIGNS•RADIOLOGICAL FINDINGS•COMPLICATIONS•DIFFERENTIAL DIAGNOSIS•TREATMENT
DEFINITION
CHRONIC INFLAMMATORY DISEASE
ATROPHY
HISTORY
•Dr. Spencer Watson(1875)•Dr. Bernhard Fraenkel(1876) : TRIAD of
atrophy
fetorcrusts
Synonyms:
•OZAENA •MERCIFUL ANOSMIA•DRY RHINITIS
ETIOLOGICAL TYPES
•PRIMARY ATROPHIC RHINITIS
•SECONDARY ATROPHIC RHINITIS
CAUSES OF PRIMARY ATROPHIC RHINITIS
H E R N I A
H E R N I A HEREDITY
H E R N I A
ENDOCRINALDISTURBANCE
H E R N I A
RACIAL FACTORS
H E R N I A NUTRIONAL DEFICIENCY
H E R N I A
INFECTIVE
H E R N I A AUTOIMMUNE
PROCESS
SECONDARY ATROPHIC RHINITIS1.Chronic specific infections
syphilis
leprosy
Lupus vulgaris
2. Extensive surgery of the nose(turbinectomy)
SECONDARY ATROPHIC RHINITIS
SECONDARY ATROPHIC RHINITIS3. Severe deviated nasal septum
PATHOLOGY:
•Microscopic changes
NORMAL
squamous metaplasia
Absence of cilia
Atrophy of muscosal glands
Normal Atrophy of nerve endings and olfactory nerve
SYMPTOMS
Why nasal obstruction even in the presence of roomy nasal cavity?
Why nasal obstruction even in the presence of roomy nasal cavity?
PARADOXICAL NASAL OBSTRUCTION
SIGNS :
EXTERNAL NOSE:
SIGNS :
ANTERIOR RHINOSCOPY:
PALE & ATROPHIC MUCOSA
GREENISH FOUL SMELLING CRUSTS
ATROPHIED TURBINATES
• Mucoperiosteal thickening of paranasal sinuses
• Loss of definition of osteomeatal complex• Enlargement of nasal cavity with erosion
and bowing of the lateral nasal wall•Atrophy of inferior and middle turbinates•hypoplastic maxillary sinuses
Radiological findings :
Complications
Differential diagnosis
Differential diagnosis
Differential diagnosis
TREATMENTMEDICAL THERAPY - LOCAL SYSTEMIC
SURGICAL THERAPY
ALKALINE NASAL DOUCHE
Sodium biborate (28.4 g)Sodium carbonate (28.4 g)Sodium chloride (56.7 g)
mixed in 280 ml of luke warm water.
Nasal drops
•25% glucose in glycerine
Chloramphenicol & streptomycin drops
oetradiol spray
Kemicetine(local antibiotic)
Placental Extracts
Potassium iodide
Systemic :
•Streptomycin (1 g/day)•Vitamin A •Vasodilators
Surgical :
•Young’s operation•Modified young’s operation•Wilson’s procedure•Whitmaack’s operation•Other volume reduction procedures•Denervating operations
Young’s operation
Modified Young’s operation
Quick note for treatment of atrophic rhinitis
ATROPI In Young GirlsA- antibiotic sprayT- teflon pasteR- remove crustO- oetradiol therapyP-potassium iodide ,placental extractsI- irrigationIn- insertion of fat,cartilageY- young’s operationG-glucose in glycerineGirls- (more in females)
References :
•A short book of E.N.T (K.B.bhargava), 9th edition,”atrophic rhinitis”,pg 158.
•Diseases of E.N.T ,P.L.Dhingra,5th edition•http://www.drtbalu.co.in/atro_rhinitis.html •http://www.utmb.edu/otoref/grnds/
Atrophic Rhinitis 050330/Atrophic Rhinitis 050330.htm