Atrophic rhinitis ppt

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Atrophic rhinitis ppt

  1. 1. ATROPHIC RHINITIS MEGHA.V 4061
  2. 2. CONTENTS: • • • • • • • • • DEFINITION HISTORY ETIOLOGY PATHOLOGY SYMPTOMS & SIGNS RADIOLOGICAL FINDINGS COMPLICATIONS DIFFERENTIAL DIAGNOSIS TREATMENT
  3. 3. DEFINITION CHRONIC INFLAMMATORY DISEASE ATROPHY
  4. 4. HISTORY • Dr. Spencer Watson(1875) • Dr. Bernhard Fraenkel(1876) : TRIAD of atrophy fetor crusts
  5. 5. Synonyms: • OZAENA • MERCIFUL ANOSMIA • DRY RHINITIS
  6. 6. ETIOLOGICAL TYPES •PRIMARY ATROPHIC RHINITIS •SECONDARY ATROPHIC RHINITIS
  7. 7. CAUSES OF PRIMARY ATROPHIC RHINITIS HERNIA
  8. 8. HERNIA HEREDITY
  9. 9. HERNIA ENDOCRINAL DISTURBANCE
  10. 10. HERNIA RACIAL FACTORS
  11. 11. HERNIA NUTRIONAL DEFICIENCY
  12. 12. HERNIA INFECTIVE
  13. 13. HERNIA AUTOIMMUNE PROCESS
  14. 14. SECONDARY ATROPHIC RHINITIS 1. Chronic specific infections Lupus vulgaris syphilis leprosy
  15. 15. SECONDARY ATROPHIC RHINITIS 2. Extensive surgery of the nose (turbinectomy)
  16. 16. SECONDARY ATROPHIC RHINITIS 3. Severe deviated nasal septum
  17. 17. PATHOLOGY: • Microscopic changes NORMAL
  18. 18. squamous metaplasia Absence of cilia Atrophy of muscosal glands
  19. 19. Normal Atrophy of nerve endings and olfactory nerve
  20. 20. Why nasal obstruction even in the presence of roomy nasal cavity?
  21. 21. Why nasal obstruction even in the presence of roomy nasal cavity? PARADOXICAL NASAL OBSTRUCTION
  22. 22. SIGNS : EXTERNAL NOSE:
  23. 23. SIGNS : ANTERIOR RHINOSCOPY: ATROPHIED TURBINATES GREENISH FOUL SMELLING CRUSTS PALE & ATROPHIC MUCOSA
  24. 24. Radiological findings : • 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
  25. 25. Differential diagnosis
  26. 26. Differential diagnosis
  27. 27. Differential diagnosis
  28. 28. TREATMENT MEDICAL THERAPY - LOCAL SYSTEMIC  SURGICAL THERAPY
  29. 29. ALKALINE NASAL DOUCHE
  30. 30. Sodium biborate (28.4 g) Sodium carbonate (28.4 g) Sodium chloride (56.7 g) mixed in 280 ml of luke warm water.
  31. 31. Nasal drops • 25% glucose in glycerine  Chloramphenicol & streptomycin drops  oetradiol spray
  32. 32. Kemicetine(local antibiotic)
  33. 33. Placental Extracts
  34. 34. Potassium iodide
  35. 35. Systemic : • Streptomycin (1 g/day) • Vitamin A • Vasodilators
  36. 36. Surgical : • • • • • • Young’s operation Modified young’s operation Wilson’s procedure Whitmaack’s operation Other volume reduction procedures Denervating operations
  37. 37. Young’s operation
  38. 38. Modified Young’s operation
  39. 39. Quick note for treatment of atrophic rhinitis ATROPI In Young Girls A- antibiotic spray T- teflon paste R- remove crust O- oetradiol therapy P-potassium iodide ,placental extracts I- irrigation In- insertion of fat,cartilage Y- young’s operation G-glucose in glycerine Girls- (more in females)
  40. 40. 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-R hinitis-050330/Atrophic-Rhinitis-050330.htm

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