SlideShare a Scribd company logo
Conditions of the Nasal
Septum
Dr. Krishna Koirala
2017-08-15
Deviated Nasal Septum
( DNS)
Etiology
• Traumatic
• Developmental
− Birth moulding
− High arched palate
− Unequal growth between skull base and palate
• Mass in opposite nasal cavity
• Racial factors
• Hereditary : posterior DNS
Types of DNS
• Anterior / caudal dislocation
• C - shaped deformity
• S-shaped deformity
• Septal Spur : shelf-like projection between
bone and cartilage
• Septal Thickening: organized hematoma or
over-riding of septal fragments
Types of DNS
Cottle’s classification of DNS
• Simple
• Obstructed
• Impacted
Clinical features
• Nasal obstruction
– On side of DNS
– Paradoxical nasal obstruction on opposite side due
to compensatory inferior turbinate hypertrophy
• Recurrent cold
– Associated sinusitis, allergy
• Headache : Sluder’s neuralgia, sinusitis
• Epistaxis
– Stretched mucosa on DNS  dry crusting 
bleeding on removal
– Stretched blood vessels over spur
• Hyposmia
– High D.N.S.
• External nasal deformity
Sequelae
• Sinusitis
• Mouth breathing  snoring, pharyngitis
• Atrophic rhinitis and myiasis
• Otitis media
Indications for septal surgery
1. D.N.S. : nasal obstruction / sinusitis / headache / epistaxis
2. Along with rhinoplasty
3. Harvesting of septal cartilage graft
3. Trans-septal route to
− Hypophysectomy
− Vidian neurectomy
4. Hereditary Hemorrhagic telengiectasia
•Commonly performed Surgeries
to correct the deviated nasal
septum
–Septoplasty
–Submucosal resection of the
septum (SMR)
Cottle’s line
Imaginary line drawn from
frontal nasal spine to
maxillary nasal spine
• Deviations anterior to it can
be corrected only by
septoplasty
• Deviations posterior to it
can be corrected either by
SMR or septoplasty
S.M.R. Septoplasty
Radical surgery Conservative
Not done below 17 yrs of age Done after 4 yrs
Killian’s incision Freer’s incision
Cannot correct anterior DNS Can correct
B/L mucoperichondrium elevated One side only
Radical removal of cartilage Only inferior strip
Can’t be combined with rhinoplasty Can
Revision surgery difficult Relatively easy
Cartilage graft can be harvested No
Complications common Rare
Septoplasty
Incision : Freer’s
Muco - perichondrial flap elevation
Creation of Anterior and Inferior
tunnels
Ant
tunnel
Inf tunnel
Dislocation of bony cartilaginous
junction
Muco-periosteal flap elevation on both
sides
Removal of inferior cartilage strip
Spur and deviated portion of Cartilage and Bone
removed
Scoring and cross-hatching
Wedge excision and shaving
Anterior nasal packing
Bolster application (Outer pack)
Submucosal Resection
Killian’s incision
Muco-perichondrial flap elevation
Cutting of cartilage and elevation of
opposite flap
Excision of septal cartilage
Excision of septal cartilage
Cartilage + Bone removed
Anterior nasal packing
Complications of septal surgery
1. Hemorrhage
2. Septal hematoma/ infection/ abscess /perforation
3. Saddle nose / supratip depression/ Columellar retraction
4. Flapping septum
5. Persistent deviation
6. Nasal synechia
7. C.S.F. rhinorrhoea
8. Infection
9. Toxic shock syndrome
Septal Hematoma
• Collection of blood under the perichondrium/
periosteum of nasal septum
• Etiology
–Nasal trauma
–Septal surgery
–Bleeding disorders
Clinical features
• Bilateral nasal obstruction
• Sense of pressure over nasal bridge
• B/L smooth, fusiform, round septal swelling
• On palpation mass is soft & fluctuant
• Absence of raised temperature, erythema, swelling &
tenderness of skin over nose
Treatment
1. Small: wide bore needle aspiration
2. Large:
–Incision and drainage
–Nasal packing (prevent recurrence)
–Systemic antibiotics (prevent abscess)
Complications
• Septal abscess with cartilage necrosis
• Septal perforation
• Saddle nose
• Supra-tip deformity
• Thickened nasal septum due to organized
hematoma
Septal abscess
• Collection of pus under perichondrium /periosteum
of nasal septum
• Etiology
– Secondary infection of septal hematoma
– Following furuncle of nose or upper lip
– Following typhoid or measles
– Immunocompromised hosts
Clinical Features
• Bilateral nasal obstruction with fever
• Skin over nose shows raised temperature, erythema,
swelling and tenderness
• B/L smooth, soft, fluctuant septal swelling
• Septal mucosa congested
• Submandibular node enlarged and tender
Treatment
• Abscess drained immediately by making an
incision on the most dependent part
• Pus and necrosed cartilage removed
• Nasal packing done
• Systemic antibiotics administered for 7-10
days
Complications
• Necrosis of septal cartilage
• Saddle nose
• Supra-tip deformity
• Septal perforation
• Meningitis
• Cavernous sinus thrombosis
Septal Perforation
Etiology
1. Trauma: septal surgery, nose picking, septal cautery,
ornamentation
2. Infection: septal abscess
3. Nasal Irritants: snuff, cocaine
4. Foreign body, Rhinolith, Nasal myiasis
5. Granuloma: TB, leprosy, syphilis, Wegener’s
6. Malignancy
7. Idiopathic
Clinical features
• Small perforation
–Whistling sound during respiration
• Large perforation
–Nasal crusting  nasal obstruction 
epistaxis on crust removal
Treatment
• Treat the cause of septal perforation
• Alkaline nasal douche for crusting
• Small perforation
– Closed by mucosal advancement flaps
• Large perforation
– Silastic obturator, Alloderm
– Results of surgery are poor
Nasal mucosal flaps
Sublabial flap
Silastic obturator

More Related Content

What's hot

Nasal septum & septoplasty
Nasal  septum & septoplastyNasal  septum & septoplasty
Nasal septum & septoplasty
Dr Soumya Singh
 
Congenital anomalies of larynx
Congenital anomalies of larynxCongenital anomalies of larynx
Congenital anomalies of larynx
Sanjay Maharjan
 
Nasal polyposis
Nasal polyposis Nasal polyposis
Nasal polyposis
SREENIVAS KAMATH
 
Nasal septum & its diseases
Nasal septum & its diseasesNasal septum & its diseases
Nasal septum & its diseases
Navas Shareef
 
Endoscopic anatomy of nose and PNS
Endoscopic anatomy of nose and PNSEndoscopic anatomy of nose and PNS
Endoscopic anatomy of nose and PNS
Lady Hardinge Medical College
 
Nasopharynx and its diseases
Nasopharynx and its diseasesNasopharynx and its diseases
Nasopharynx and its diseasesVinay Bhat
 
NASAL SEPTAL DISEASES
NASAL SEPTAL DISEASESNASAL SEPTAL DISEASES
NASAL SEPTAL DISEASES
Vishnu Narayanan
 
Maringoplasty
Maringoplasty Maringoplasty
Maringoplasty
Dr Asmatullah Achakzai
 
Nasal septum and its diseases
Nasal septum and its diseasesNasal septum and its diseases
Nasal septum and its diseasesVinay Bhat
 
Anatomy of adenoid
Anatomy of adenoidAnatomy of adenoid
Anatomy of adenoid
Gitanjali Kumari
 
Physiology of nose and pns
Physiology of nose and pnsPhysiology of nose and pns
Physiology of nose and pns
Manpreet Nanda
 
Tumours of nasopharynx (2) itp class dr.davis - 03.06.16
Tumours of nasopharynx (2) itp class   dr.davis - 03.06.16Tumours of nasopharynx (2) itp class   dr.davis - 03.06.16
Tumours of nasopharynx (2) itp class dr.davis - 03.06.16
ophthalmgmcri
 
SURGICAL ANATOMY OF DEEP NECK SPACES
SURGICAL ANATOMY OF DEEP NECK SPACESSURGICAL ANATOMY OF DEEP NECK SPACES
SURGICAL ANATOMY OF DEEP NECK SPACES
Ajay Manickam
 
5 deviated-nasal-septum
5 deviated-nasal-septum5 deviated-nasal-septum
5 deviated-nasal-septum
Abdu Raheem
 
External approaches to sinus surgery
External approaches to sinus surgeryExternal approaches to sinus surgery
External approaches to sinus surgery
Balasubramanian Thiagarajan
 
Disease of middle ear
Disease of middle earDisease of middle ear
Disease of middle ear
Shakeel Ahmed
 
Nasal fracture ent ppt
Nasal fracture ent ppt Nasal fracture ent ppt
Nasal fracture ent ppt
Ayushree Sharma
 
septoplasty and smr
septoplasty and smrseptoplasty and smr
septoplasty and smr
Arunachalam L
 

What's hot (20)

Nasal septum & septoplasty
Nasal  septum & septoplastyNasal  septum & septoplasty
Nasal septum & septoplasty
 
Congenital anomalies of larynx
Congenital anomalies of larynxCongenital anomalies of larynx
Congenital anomalies of larynx
 
Nasal polyposis
Nasal polyposis Nasal polyposis
Nasal polyposis
 
LASERs in ent
LASERs in ent LASERs in ent
LASERs in ent
 
Nasal septum & its diseases
Nasal septum & its diseasesNasal septum & its diseases
Nasal septum & its diseases
 
Endoscopic anatomy of nose and PNS
Endoscopic anatomy of nose and PNSEndoscopic anatomy of nose and PNS
Endoscopic anatomy of nose and PNS
 
Nasopharynx and its diseases
Nasopharynx and its diseasesNasopharynx and its diseases
Nasopharynx and its diseases
 
NASAL SEPTAL DISEASES
NASAL SEPTAL DISEASESNASAL SEPTAL DISEASES
NASAL SEPTAL DISEASES
 
Maringoplasty
Maringoplasty Maringoplasty
Maringoplasty
 
Nasal septum and its diseases
Nasal septum and its diseasesNasal septum and its diseases
Nasal septum and its diseases
 
Adenoids Hypertrophy
Adenoids HypertrophyAdenoids Hypertrophy
Adenoids Hypertrophy
 
Anatomy of adenoid
Anatomy of adenoidAnatomy of adenoid
Anatomy of adenoid
 
Physiology of nose and pns
Physiology of nose and pnsPhysiology of nose and pns
Physiology of nose and pns
 
Tumours of nasopharynx (2) itp class dr.davis - 03.06.16
Tumours of nasopharynx (2) itp class   dr.davis - 03.06.16Tumours of nasopharynx (2) itp class   dr.davis - 03.06.16
Tumours of nasopharynx (2) itp class dr.davis - 03.06.16
 
SURGICAL ANATOMY OF DEEP NECK SPACES
SURGICAL ANATOMY OF DEEP NECK SPACESSURGICAL ANATOMY OF DEEP NECK SPACES
SURGICAL ANATOMY OF DEEP NECK SPACES
 
5 deviated-nasal-septum
5 deviated-nasal-septum5 deviated-nasal-septum
5 deviated-nasal-septum
 
External approaches to sinus surgery
External approaches to sinus surgeryExternal approaches to sinus surgery
External approaches to sinus surgery
 
Disease of middle ear
Disease of middle earDisease of middle ear
Disease of middle ear
 
Nasal fracture ent ppt
Nasal fracture ent ppt Nasal fracture ent ppt
Nasal fracture ent ppt
 
septoplasty and smr
septoplasty and smrseptoplasty and smr
septoplasty and smr
 

Similar to 2. conditions of the nasal septum

Diseases of nasal septum
Diseases of nasal septumDiseases of nasal septum
Diseases of nasal septum
LALIT KARKI
 
Diseases of the nasal septum
Diseases of the nasal septumDiseases of the nasal septum
Diseases of the nasal septum
Anwaaar
 
Differential diagnosis of haziness of maxillary sinus
Differential diagnosis of haziness of maxillary sinusDifferential diagnosis of haziness of maxillary sinus
Differential diagnosis of haziness of maxillary sinus
NarmathaN2
 
Complications of sinusitis
Complications of sinusitisComplications of sinusitis
Complications of sinusitis
krishnakoirala4
 
Complications of sinusitis
Complications of sinusitisComplications of sinusitis
Complications of sinusitis
krishnakoirala4
 
Complications of sinusitis
Complications of sinusitisComplications of sinusitis
Complications of sinusitis
krishnakoirala4
 
Complications of sinusitis
Complications of sinusitisComplications of sinusitis
Complications of sinusitis
krishnakoirala4
 
Complications of sinusitis
Complications of sinusitisComplications of sinusitis
Complications of sinusitis
Dr Krishna Koirala
 
Lateral sinus thrombosis
Lateral sinus thrombosisLateral sinus thrombosis
Lateral sinus thrombosisDr. S. Mughal
 
Differential Diagnosis Of Maxillary Sinus Pathology
Differential Diagnosis Of Maxillary Sinus Pathology  Differential Diagnosis Of Maxillary Sinus Pathology
Differential Diagnosis Of Maxillary Sinus Pathology
Shiji Antony
 
Diseases of nasal septum
Diseases of nasal septumDiseases of nasal septum
Diseases of nasal septum
Anwaaar
 
Complications of csom
Complications of csomComplications of csom
Complications of csom
Oshin Manoharan
 
SEPTOPLASTY.pptx
SEPTOPLASTY.pptxSEPTOPLASTY.pptx
SEPTOPLASTY.pptx
22hzmjssws
 
Vishnasalseptum 120811115920-phpapp02
Vishnasalseptum 120811115920-phpapp02Vishnasalseptum 120811115920-phpapp02
Vishnasalseptum 120811115920-phpapp02Munish Saroch
 
Treatment of sinusitis
Treatment of sinusitisTreatment of sinusitis
Treatment of sinusitis
krishnakoirala4
 
Complications of sinusitis
Complications of sinusitisComplications of sinusitis
Complications of sinusitis
Dr Krishna Koirala
 
6. diseases of the external ear
6. diseases of the external ear6. diseases of the external ear
6. diseases of the external ear
krishnakoirala4
 
Diseases of the external ear
Diseases of the external earDiseases of the external ear
Diseases of the external ear
Dr Krishna Koirala
 
Diseases of the nasal septum
Diseases of the nasal septumDiseases of the nasal septum
Diseases of the nasal septum
Dr Asmatullah Achakzai
 
Diseases of the External Ear.ppt
Diseases of the External Ear.pptDiseases of the External Ear.ppt
Diseases of the External Ear.ppt
DrKrishnaKoiralaENT
 

Similar to 2. conditions of the nasal septum (20)

Diseases of nasal septum
Diseases of nasal septumDiseases of nasal septum
Diseases of nasal septum
 
Diseases of the nasal septum
Diseases of the nasal septumDiseases of the nasal septum
Diseases of the nasal septum
 
Differential diagnosis of haziness of maxillary sinus
Differential diagnosis of haziness of maxillary sinusDifferential diagnosis of haziness of maxillary sinus
Differential diagnosis of haziness of maxillary sinus
 
Complications of sinusitis
Complications of sinusitisComplications of sinusitis
Complications of sinusitis
 
Complications of sinusitis
Complications of sinusitisComplications of sinusitis
Complications of sinusitis
 
Complications of sinusitis
Complications of sinusitisComplications of sinusitis
Complications of sinusitis
 
Complications of sinusitis
Complications of sinusitisComplications of sinusitis
Complications of sinusitis
 
Complications of sinusitis
Complications of sinusitisComplications of sinusitis
Complications of sinusitis
 
Lateral sinus thrombosis
Lateral sinus thrombosisLateral sinus thrombosis
Lateral sinus thrombosis
 
Differential Diagnosis Of Maxillary Sinus Pathology
Differential Diagnosis Of Maxillary Sinus Pathology  Differential Diagnosis Of Maxillary Sinus Pathology
Differential Diagnosis Of Maxillary Sinus Pathology
 
Diseases of nasal septum
Diseases of nasal septumDiseases of nasal septum
Diseases of nasal septum
 
Complications of csom
Complications of csomComplications of csom
Complications of csom
 
SEPTOPLASTY.pptx
SEPTOPLASTY.pptxSEPTOPLASTY.pptx
SEPTOPLASTY.pptx
 
Vishnasalseptum 120811115920-phpapp02
Vishnasalseptum 120811115920-phpapp02Vishnasalseptum 120811115920-phpapp02
Vishnasalseptum 120811115920-phpapp02
 
Treatment of sinusitis
Treatment of sinusitisTreatment of sinusitis
Treatment of sinusitis
 
Complications of sinusitis
Complications of sinusitisComplications of sinusitis
Complications of sinusitis
 
6. diseases of the external ear
6. diseases of the external ear6. diseases of the external ear
6. diseases of the external ear
 
Diseases of the external ear
Diseases of the external earDiseases of the external ear
Diseases of the external ear
 
Diseases of the nasal septum
Diseases of the nasal septumDiseases of the nasal septum
Diseases of the nasal septum
 
Diseases of the External Ear.ppt
Diseases of the External Ear.pptDiseases of the External Ear.ppt
Diseases of the External Ear.ppt
 

More from krishnakoirala4

Complications of csom
Complications of csomComplications of csom
Complications of csom
krishnakoirala4
 
Acute suppurative otitis media and and cortical mastoidectomy
Acute suppurative otitis media and  and cortical mastoidectomyAcute suppurative otitis media and  and cortical mastoidectomy
Acute suppurative otitis media and and cortical mastoidectomy
krishnakoirala4
 
Principles of rhinoplasty
Principles of rhinoplastyPrinciples of rhinoplasty
Principles of rhinoplasty
krishnakoirala4
 
Neoplasms of nose and paranasal sinuses
Neoplasms of nose and paranasal sinuses Neoplasms of nose and paranasal sinuses
Neoplasms of nose and paranasal sinuses
krishnakoirala4
 
Nasopharyngeal carcinoma
Nasopharyngeal carcinomaNasopharyngeal carcinoma
Nasopharyngeal carcinoma
krishnakoirala4
 
Nasal polyps
Nasal polypsNasal polyps
Nasal polyps
krishnakoirala4
 
Epistaxis
EpistaxisEpistaxis
Epistaxis
krishnakoirala4
 
Deviated nasal septum and other septal conditions
Deviated nasal septum and other septal conditionsDeviated nasal septum and other septal conditions
Deviated nasal septum and other septal conditions
krishnakoirala4
 
Complication of fess
Complication of fessComplication of fess
Complication of fess
krishnakoirala4
 
Atrophic rhinitis
Atrophic rhinitisAtrophic rhinitis
Atrophic rhinitis
krishnakoirala4
 
Angiofibroma
AngiofibromaAngiofibroma
Angiofibroma
krishnakoirala4
 
Allergic and intrinsic rhinitis
Allergic and intrinsic rhinitisAllergic and intrinsic rhinitis
Allergic and intrinsic rhinitis
krishnakoirala4
 
Otosclerosis
OtosclerosisOtosclerosis
Otosclerosis
krishnakoirala4
 
Vestibular schwannoma and glomus tumors
Vestibular schwannoma and  glomus tumorsVestibular schwannoma and  glomus tumors
Vestibular schwannoma and glomus tumors
krishnakoirala4
 
Meniere's disease
Meniere's diseaseMeniere's disease
Meniere's disease
krishnakoirala4
 
Facial nerve palsy
Facial nerve palsyFacial nerve palsy
Facial nerve palsy
krishnakoirala4
 
Complications of csom
Complications of csomComplications of csom
Complications of csom
krishnakoirala4
 
Clinical features and diagnosis of rhinosinusitis
Clinical features and diagnosis of rhinosinusitisClinical features and diagnosis of rhinosinusitis
Clinical features and diagnosis of rhinosinusitis
krishnakoirala4
 
Obstructive sleep apnea syndrome
Obstructive sleep apnea syndromeObstructive sleep apnea syndrome
Obstructive sleep apnea syndrome
krishnakoirala4
 
Neoplasms of nose and pns
Neoplasms of nose and pnsNeoplasms of nose and pns
Neoplasms of nose and pns
krishnakoirala4
 

More from krishnakoirala4 (20)

Complications of csom
Complications of csomComplications of csom
Complications of csom
 
Acute suppurative otitis media and and cortical mastoidectomy
Acute suppurative otitis media and  and cortical mastoidectomyAcute suppurative otitis media and  and cortical mastoidectomy
Acute suppurative otitis media and and cortical mastoidectomy
 
Principles of rhinoplasty
Principles of rhinoplastyPrinciples of rhinoplasty
Principles of rhinoplasty
 
Neoplasms of nose and paranasal sinuses
Neoplasms of nose and paranasal sinuses Neoplasms of nose and paranasal sinuses
Neoplasms of nose and paranasal sinuses
 
Nasopharyngeal carcinoma
Nasopharyngeal carcinomaNasopharyngeal carcinoma
Nasopharyngeal carcinoma
 
Nasal polyps
Nasal polypsNasal polyps
Nasal polyps
 
Epistaxis
EpistaxisEpistaxis
Epistaxis
 
Deviated nasal septum and other septal conditions
Deviated nasal septum and other septal conditionsDeviated nasal septum and other septal conditions
Deviated nasal septum and other septal conditions
 
Complication of fess
Complication of fessComplication of fess
Complication of fess
 
Atrophic rhinitis
Atrophic rhinitisAtrophic rhinitis
Atrophic rhinitis
 
Angiofibroma
AngiofibromaAngiofibroma
Angiofibroma
 
Allergic and intrinsic rhinitis
Allergic and intrinsic rhinitisAllergic and intrinsic rhinitis
Allergic and intrinsic rhinitis
 
Otosclerosis
OtosclerosisOtosclerosis
Otosclerosis
 
Vestibular schwannoma and glomus tumors
Vestibular schwannoma and  glomus tumorsVestibular schwannoma and  glomus tumors
Vestibular schwannoma and glomus tumors
 
Meniere's disease
Meniere's diseaseMeniere's disease
Meniere's disease
 
Facial nerve palsy
Facial nerve palsyFacial nerve palsy
Facial nerve palsy
 
Complications of csom
Complications of csomComplications of csom
Complications of csom
 
Clinical features and diagnosis of rhinosinusitis
Clinical features and diagnosis of rhinosinusitisClinical features and diagnosis of rhinosinusitis
Clinical features and diagnosis of rhinosinusitis
 
Obstructive sleep apnea syndrome
Obstructive sleep apnea syndromeObstructive sleep apnea syndrome
Obstructive sleep apnea syndrome
 
Neoplasms of nose and pns
Neoplasms of nose and pnsNeoplasms of nose and pns
Neoplasms of nose and pns
 

Recently uploaded

Ocular injury ppt Upendra pal optometrist upums saifai etawah
Ocular injury  ppt  Upendra pal  optometrist upums saifai etawahOcular injury  ppt  Upendra pal  optometrist upums saifai etawah
Ocular injury ppt Upendra pal optometrist upums saifai etawah
pal078100
 
POST OPERATIVE OLIGURIA and its management
POST OPERATIVE OLIGURIA and its managementPOST OPERATIVE OLIGURIA and its management
POST OPERATIVE OLIGURIA and its management
touseefaziz1
 
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stock
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in StockFactory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stock
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stock
rebeccabio
 
24 Upakrama.pptx class ppt useful in all
24 Upakrama.pptx class ppt useful in all24 Upakrama.pptx class ppt useful in all
24 Upakrama.pptx class ppt useful in all
DrSathishMS1
 
Charaka Samhita Sutra sthana Chapter 15 Upakalpaniyaadhyaya
Charaka Samhita Sutra sthana Chapter 15 UpakalpaniyaadhyayaCharaka Samhita Sutra sthana Chapter 15 Upakalpaniyaadhyaya
Charaka Samhita Sutra sthana Chapter 15 Upakalpaniyaadhyaya
Dr KHALID B.M
 
Are There Any Natural Remedies To Treat Syphilis.pdf
Are There Any Natural Remedies To Treat Syphilis.pdfAre There Any Natural Remedies To Treat Syphilis.pdf
Are There Any Natural Remedies To Treat Syphilis.pdf
Little Cross Family Clinic
 
Superficial & Deep Fascia of the NECK.pptx
Superficial & Deep Fascia of the NECK.pptxSuperficial & Deep Fascia of the NECK.pptx
Superficial & Deep Fascia of the NECK.pptx
Dr. Rabia Inam Gandapore
 
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journey
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness JourneyTom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journey
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journey
greendigital
 
micro teaching on communication m.sc nursing.pdf
micro teaching on communication m.sc nursing.pdfmicro teaching on communication m.sc nursing.pdf
micro teaching on communication m.sc nursing.pdf
Anurag Sharma
 
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdf
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfMANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdf
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdf
Jim Jacob Roy
 
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?Report Back from SGO 2024: What’s the Latest in Cervical Cancer?
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?
bkling
 
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...
VarunMahajani
 
Phone Us ❤85270-49040❤ #ℂall #gIRLS In Surat By Surat @ℂall @Girls Hotel With...
Phone Us ❤85270-49040❤ #ℂall #gIRLS In Surat By Surat @ℂall @Girls Hotel With...Phone Us ❤85270-49040❤ #ℂall #gIRLS In Surat By Surat @ℂall @Girls Hotel With...
Phone Us ❤85270-49040❤ #ℂall #gIRLS In Surat By Surat @ℂall @Girls Hotel With...
Savita Shen $i11
 
Surgical Site Infections, pathophysiology, and prevention.pptx
Surgical Site Infections, pathophysiology, and prevention.pptxSurgical Site Infections, pathophysiology, and prevention.pptx
Surgical Site Infections, pathophysiology, and prevention.pptx
jval Landero
 
Prix Galien International 2024 Forum Program
Prix Galien International 2024 Forum ProgramPrix Galien International 2024 Forum Program
Prix Galien International 2024 Forum Program
Levi Shapiro
 
ANATOMY AND PHYSIOLOGY OF URINARY SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF URINARY SYSTEM.pptxANATOMY AND PHYSIOLOGY OF URINARY SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF URINARY SYSTEM.pptx
Swetaba Besh
 
Cervical & Brachial Plexus By Dr. RIG.pptx
Cervical & Brachial Plexus By Dr. RIG.pptxCervical & Brachial Plexus By Dr. RIG.pptx
Cervical & Brachial Plexus By Dr. RIG.pptx
Dr. Rabia Inam Gandapore
 
Non-respiratory Functions of the Lungs.pdf
Non-respiratory Functions of the Lungs.pdfNon-respiratory Functions of the Lungs.pdf
Non-respiratory Functions of the Lungs.pdf
MedicoseAcademics
 
The POPPY STUDY (Preconception to post-partum cardiovascular function in prim...
The POPPY STUDY (Preconception to post-partum cardiovascular function in prim...The POPPY STUDY (Preconception to post-partum cardiovascular function in prim...
The POPPY STUDY (Preconception to post-partum cardiovascular function in prim...
Catherine Liao
 
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...
Oleg Kshivets
 

Recently uploaded (20)

Ocular injury ppt Upendra pal optometrist upums saifai etawah
Ocular injury  ppt  Upendra pal  optometrist upums saifai etawahOcular injury  ppt  Upendra pal  optometrist upums saifai etawah
Ocular injury ppt Upendra pal optometrist upums saifai etawah
 
POST OPERATIVE OLIGURIA and its management
POST OPERATIVE OLIGURIA and its managementPOST OPERATIVE OLIGURIA and its management
POST OPERATIVE OLIGURIA and its management
 
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stock
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in StockFactory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stock
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stock
 
24 Upakrama.pptx class ppt useful in all
24 Upakrama.pptx class ppt useful in all24 Upakrama.pptx class ppt useful in all
24 Upakrama.pptx class ppt useful in all
 
Charaka Samhita Sutra sthana Chapter 15 Upakalpaniyaadhyaya
Charaka Samhita Sutra sthana Chapter 15 UpakalpaniyaadhyayaCharaka Samhita Sutra sthana Chapter 15 Upakalpaniyaadhyaya
Charaka Samhita Sutra sthana Chapter 15 Upakalpaniyaadhyaya
 
Are There Any Natural Remedies To Treat Syphilis.pdf
Are There Any Natural Remedies To Treat Syphilis.pdfAre There Any Natural Remedies To Treat Syphilis.pdf
Are There Any Natural Remedies To Treat Syphilis.pdf
 
Superficial & Deep Fascia of the NECK.pptx
Superficial & Deep Fascia of the NECK.pptxSuperficial & Deep Fascia of the NECK.pptx
Superficial & Deep Fascia of the NECK.pptx
 
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journey
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness JourneyTom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journey
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journey
 
micro teaching on communication m.sc nursing.pdf
micro teaching on communication m.sc nursing.pdfmicro teaching on communication m.sc nursing.pdf
micro teaching on communication m.sc nursing.pdf
 
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdf
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfMANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdf
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdf
 
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?Report Back from SGO 2024: What’s the Latest in Cervical Cancer?
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?
 
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...
 
Phone Us ❤85270-49040❤ #ℂall #gIRLS In Surat By Surat @ℂall @Girls Hotel With...
Phone Us ❤85270-49040❤ #ℂall #gIRLS In Surat By Surat @ℂall @Girls Hotel With...Phone Us ❤85270-49040❤ #ℂall #gIRLS In Surat By Surat @ℂall @Girls Hotel With...
Phone Us ❤85270-49040❤ #ℂall #gIRLS In Surat By Surat @ℂall @Girls Hotel With...
 
Surgical Site Infections, pathophysiology, and prevention.pptx
Surgical Site Infections, pathophysiology, and prevention.pptxSurgical Site Infections, pathophysiology, and prevention.pptx
Surgical Site Infections, pathophysiology, and prevention.pptx
 
Prix Galien International 2024 Forum Program
Prix Galien International 2024 Forum ProgramPrix Galien International 2024 Forum Program
Prix Galien International 2024 Forum Program
 
ANATOMY AND PHYSIOLOGY OF URINARY SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF URINARY SYSTEM.pptxANATOMY AND PHYSIOLOGY OF URINARY SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF URINARY SYSTEM.pptx
 
Cervical & Brachial Plexus By Dr. RIG.pptx
Cervical & Brachial Plexus By Dr. RIG.pptxCervical & Brachial Plexus By Dr. RIG.pptx
Cervical & Brachial Plexus By Dr. RIG.pptx
 
Non-respiratory Functions of the Lungs.pdf
Non-respiratory Functions of the Lungs.pdfNon-respiratory Functions of the Lungs.pdf
Non-respiratory Functions of the Lungs.pdf
 
The POPPY STUDY (Preconception to post-partum cardiovascular function in prim...
The POPPY STUDY (Preconception to post-partum cardiovascular function in prim...The POPPY STUDY (Preconception to post-partum cardiovascular function in prim...
The POPPY STUDY (Preconception to post-partum cardiovascular function in prim...
 
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...
 

2. conditions of the nasal septum

Editor's Notes

  1. Inf tunnel