Diseases of External Nose

Cellulitis

Red, swollen, tender nose due to invasion of streptococci and staphylococci in nasal skin.

Treatment: Antibacterial, hot fermentation and analgesics.

Nasal Deformities

• Saddle Nose

Depressed nasal dorsum involve bone, cartilaginous or both. Caused by Nasal trauma, SMR, Haematoma or abscess.

Treatment: Augmentation Rhinoplasty. If deformity involves bone also, iliac crest is best for graft.

• Hump Nose

This may involve bone or Cartilage or both. Treatment: Reduced Rhinoplasty

• Crooked or a deviated Nose

The midline of dorsum from frontonasal angle to the tip is curved in C or S shaped manner.

Caused: Trauma, injuries during birth, neonatal, childhood

Treatment: Rhinoplasty or septorhinoplasty.

Tumours

Congenital Tumours

• Dermoid Cyst

Simple dermoid: midline swelling under the skin. No external opening

Dermoid with a sinus: Seen in infant and children. Represent by pit or sinus on midline of dorsum, hair may be present. May connect upper part of nasal septum or have an intracranial dural connection. Mengititis occur if infection travels.

Treatment: Neurosurgical-Otolaryngologic.

• Encephalocele or Meningioencephalocele

Herniation of Brain tissue along with meninges through Congential bony defect. Naso-frontal, Naso-ethmoidal, Naso-orbital Variety. Swelling show Cough impulse.

Treatment: Neuro surgical

• Encephalocele or Meningioencephalocele.

Herniation of Brain tissue along with meninges through Congential bony defect. Naso-frontal, Naso-ethmoidal, Naso-orbital Variety. Swelling show Cough impulse.

Treatment: Neuro surgical

• Glioma

It is nipped off portion on Encephalocele during embryonic development. It is extranasal and intranasal. Extranasal removed by external approach.

Benign Tumours

• Rhinophyma (Potato tumour)

Slow-Growing tumour due to hypertrophy of sebaceous gland. Seen in long standing case of Acne Rosacea.

Treatment: Paring down the bulk of tumour by Sharp knife or Carbon dioxide laser.

Malignant tumour

• Basal cell Carcinoma (Rodent Ulcer)

Most common malignant tumour involving Skin, affecting male and female. Present as cyst or papulopearly nodule or ulcer with rolled edges. Nodal metastases are rare.

Treatment: Early lesion by Cryosurgery, irradiation or surgical excision.

• Squamous cell Carcinoma

Second most common malignant tumour. Both sexes in 40-60 age.

Treatment: Early lesion Respond to Radiotherapy

• Melanoma

Least common. Slow growing. Nodular invasion.

Treatment: surgical excision.

Diseases Of Nasal Vestibule

Furuncie or Boil

Acute infection of Hair follicle by Staphylococcus aureus. Small painful, tender, red and swollen.

Causes: Picking of nose, plucking of nasl vibrissae.

Treatment: Warm compression, Analgesics, Antibiotics (Tropical & Systemic). If fluctuations appear, incisions & drainage. Don’t squeezed or prematurely incised.

Complication: Spread to Cavernous sinus through venous thrombophlebitis. Cellulitis, septal abscess.

Vestibulitis

Diffuse dermatitis of nasal vestibule. Causative organism S. Aureus.

Acute form: Red Swollen. Chronic form: painful fissure and Crusting.

Treatment: Cleaning with cotton soaked in hydrogen peroxide + Application of antibiotics and steriods.

• Stenosis and Atresia of nares

Accidental and surgical Trauma to nasal tip and vestibule lead to web formation and stenosis of anterior nares.

Caused: Young operation to treat atrophic rhinitis, Small pox.

Treatment: Reconstructive procedures

Tumours

Nasoalveolar Cyst: Smooth bulge in lateral wall and floor.

Papilloma or wart: multiple, pedunculated or sessile.

Squamous cell Carcinoma: Extend from lateral wall to nasal floor to upper lip.