SlideShare a Scribd company logo
NASAL SEPTAL
    ANATOMY AND
        SMR

Col Dr Anwar ul Haq ENT Consultant   +923018513303
ANATOMY OF NASAL
        SEPTUM

 Columellar septum

  It is formed of columella
  Containing the medial crura of alar
 cartilages united together by fibrous
 tissue
 Covered on either side by skin
MEMBRANOUS SEPTUM
 It lies b/w columella and caudal
border of septal cartilage

 No bony or cartilaginous support

 Above two parts freely movable
from side to side
SEPTUM PROPER
 Consist of osteocortilaginous frame work

 Its main Constitutes are

   Perpendicular plate of ethmoid
   vomer bone
   Large septal cartilage (quadrilateral) wedged
  between the above two bones anteriorly
SEPTUM PROPER
 Minor contributions

  Crest of nasal bone
   Nasal spine of frontal bone
   Rostum of spnenoid
   Crest of palatine bone
   Crest of maxilla and anterior nasal spine of
  maxilla
BLOOD SUPPLY OF NASAL SEPTUM

 Internal carotid system

   Anterior ethmoidal artery   Branches of
   Post ethmoidal artery       opthalmic
                                artery
EXTERNAL CAROTID SYSTEM
 Spheno palatine artery (maxillary)

   Nasopalotine branches
   Post nasal septal branches


 Septal branch of great palatine artery
(maxillary)
 Septal branch of superior labial artery
    (Facial)
LITTLE’S AREA (KIESSEL BACH’S
             PLEXUS)
 Anterior ethmoidal

 Septal branch of supeior labial

Septal branch of sphenopalotine

Septal branch of greater palatine
VENOUS DRAINAGE
 Posteriorly through sephenopalatine veins
into pterygoid venous plexus
 Anteriorly drain into facial veins
 Superiorly in ethmoidal veins
NERVE SOPPLY OF NASAL SEPTUM

 Olfactory nerves
   Carry sense of smell
   Supply olfactory region of nose
   Can Carry sheath of dura, archnoid and pia
  matter
NERVE SUPPLY
 Nerves of common sensation

   Anterior ethmoidal nerve
   Branches of nasopalatine nerve
   Branches of infra orbital nerve
AUTONOMIC NERVES
 Parasympathetic nerve fibers supply nasal
glands and control nasal secretions

   Greater superfacial petrosal nerve.


 Sympathetic nerve fibers
   Upper two thoracic segments
   Deep petrosal nerve
LYMPHATIC DRAINAGE
 Submandibular lymph nodes
 Rest of nasal cavity drain
into upper jugular nodes
directly or through
retropharyngeal nodes
SUBMUCOUS RESECTION OF
      NASAL SEPTUM
• INDICATIONS
 – DNS causing symptoms of nasal obstruction and
   recurrent headache.
 – DNS causing obstruction of paranasal sinuses and
   middle ear.
 – Recurrent epistaxis from septal spur
 – As a part of septorhinoplasty
 – As a preliminary step in
  Hypophsectomy (Trans septal trans sphenoidal
   approach)
  Vidian neurectomy (Trans septal apprach)
CONTRA INDICATIONS
•   Pt’s below 17 years age
•   Acute respiratory infection
•   Bleeding diathesis
•   Untreated diabetes or hypertension
ANASTHESIA
• LA is preffered
• GA is used in children and apprehensive
  adults
POSITION
• Reclining position with head-end of the
  table raised
STEPS OF OPERATION
• Infiltration of nasal septum
• Incision
  – A curvilinear incision with forward convexity is
    made at 5mm behind the mucocutaneous
    junction on the deviated side of septum
STPES OF OPERATION
• Elevation of mucopeichondrial and
  periosteal flap.
• Incision of the cartilage
• Elevation of opposite mucopeichondrium
  and periostium.
STEPS OF OPERATION
• Removal of cartilage & bone
  – Preserve a strip of cartilage about 1cm along
    the dorsal and caudal border of the septum to
    prevent collapse of the nasal bridge.
• Stiching
  – One or two catgut or silk stitches are applied
• Packing
  – Ribbon gauze, smeared with furacin oinment
    or liquid paraffin
POST OPERATIVE CARE
•   Semi sitting position
•   Soft diet
•   Analgesics
•   Antibiotic cover for 5-6 days.
•   Nasal pack removed after 24 hours
•   Decongestant and steam inhalation
•   Avoid nasal trauma
COMPLICATIONS
•   Bleeding
•   Septal haematoma
•   Septal abscess
•   Perforation
•   Depression of nasal bridge
•   Retraction of columella
•   Flapping of nasal septum
•   Toxic shock syndrome
SEPTOPLASTY
• Septoplasty is a conservative approch to
  septal surgery as much of the septal
  framework as possible is retained

• Mucoperichondrial / periosteal flap is
  generally raised only one side.
STEPS OF OPERATION
• Infiltrate the septum with 1% lignocaine
  with adrenaline
• In case of deviated septum make a slightly
  curveline incision 2-3 mm above the
  caudal end of septal cartiflage on the
  concave side in case of caudal dislocation
  a transfixition or hemi transfixition incision
  is made
• Raise mucoperichondrial / mucoperiosteal
  flap on one side only
• Seprate septal cartilage from the vomer
  and ethmoid plate and raise
  mucoperiosteal flap on the apposite side
  of septum.
• Remove maxillary crest to realign the septal
  cartilage
• Correct the bony septum by removing the
  deformed parts
• Deformed septal cartilage is corrected by
  various methods such as
  – Scoring on the concave side
  – Cross hatching
  – Shaving
  – Wedge excision
  – Trans septal sutures are put to coapt
    mucoperichondrial flaps
  – Nasal pack
Anatomy Nasal Septum and Septoplasty - Pakistan
Anatomy Nasal Septum and Septoplasty - Pakistan
Anatomy Nasal Septum and Septoplasty - Pakistan
Anatomy Nasal Septum and Septoplasty - Pakistan

More Related Content

What's hot

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
 
Nasal septum & septoplasty
Nasal  septum & septoplastyNasal  septum & septoplasty
Nasal septum & septoplasty
Dr Soumya Singh
 
The pneumatic system of the temporal bone
The pneumatic system of the temporal boneThe pneumatic system of the temporal bone
The pneumatic system of the temporal bone
Surbhi narayan
 
All Things Septoplasty
All Things SeptoplastyAll Things Septoplasty
All Things Septoplasty
Ronald Agador
 
endoscopic anatomy of nasal cavity
endoscopic anatomy of nasal cavityendoscopic anatomy of nasal cavity
endoscopic anatomy of nasal cavity
drashokentmmc
 
Panendoscopy
PanendoscopyPanendoscopy
Canal wall up Mastoidectomy ( Intact Bridge Mastoidectomy) by Dr.Aditya Tiwari
Canal wall up Mastoidectomy ( Intact Bridge Mastoidectomy) by Dr.Aditya TiwariCanal wall up Mastoidectomy ( Intact Bridge Mastoidectomy) by Dr.Aditya Tiwari
Canal wall up Mastoidectomy ( Intact Bridge Mastoidectomy) by Dr.Aditya Tiwari
Aditya Tiwari
 
Surgical anatomy of nose
Surgical anatomy of noseSurgical anatomy of nose
Surgical anatomy of nose
Augustine raj
 
Measurements of nasal airway(dr ravindra daggupati),rhinomanometry,acoustic r...
Measurements of nasal airway(dr ravindra daggupati),rhinomanometry,acoustic r...Measurements of nasal airway(dr ravindra daggupati),rhinomanometry,acoustic r...
Measurements of nasal airway(dr ravindra daggupati),rhinomanometry,acoustic r...
Ravindra Daggupati
 
Anatomy of Internal Nose
Anatomy of Internal Nose  Anatomy of Internal Nose
Anatomy of Internal Nose
Arjun Graison
 
Epistaxis
EpistaxisEpistaxis
Epistaxis
krishnakoirala4
 
Fess complications
Fess complicationsFess complications
Fess complications
Balasubramanian Thiagarajan
 
Myringoplasty ppt
Myringoplasty pptMyringoplasty ppt
Myringoplasty ppt
Vaibhav Lahane
 
Diseases of external nose
Diseases of external noseDiseases of external nose
Diseases of external nose
Anwaaar
 
Complications of Endoscopic Sinus Surgery (ESS)
Complications of Endoscopic Sinus Surgery (ESS)Complications of Endoscopic Sinus Surgery (ESS)
Complications of Endoscopic Sinus Surgery (ESS)
Ausaf Khan
 
Spaces of middle ear and their surgical importance
Spaces of middle ear  and their surgical importanceSpaces of middle ear  and their surgical importance
Spaces of middle ear and their surgical importance
Dr Soumya Singh
 
11 surgery for otosclerosis.ppt copy
11 surgery for otosclerosis.ppt   copy11 surgery for otosclerosis.ppt   copy
11 surgery for otosclerosis.ppt copy
social service
 
Surgical mx of otosclerosis
Surgical mx of otosclerosisSurgical mx of otosclerosis
Surgical mx of otosclerosis
Sanjay Maharjan
 
Complications of rhinosinusitis(Dr ravindra daggupati)
Complications of rhinosinusitis(Dr ravindra daggupati)Complications of rhinosinusitis(Dr ravindra daggupati)
Complications of rhinosinusitis(Dr ravindra daggupati)
Ravindra Daggupati
 

What's hot (20)

Endoscopic anatomy of nose and PNS
Endoscopic anatomy of nose and PNSEndoscopic anatomy of nose and PNS
Endoscopic anatomy of nose and PNS
 
The nasal valve & its management
The nasal valve & its managementThe nasal valve & its management
The nasal valve & its management
 
Nasal septum & septoplasty
Nasal  septum & septoplastyNasal  septum & septoplasty
Nasal septum & septoplasty
 
The pneumatic system of the temporal bone
The pneumatic system of the temporal boneThe pneumatic system of the temporal bone
The pneumatic system of the temporal bone
 
All Things Septoplasty
All Things SeptoplastyAll Things Septoplasty
All Things Septoplasty
 
endoscopic anatomy of nasal cavity
endoscopic anatomy of nasal cavityendoscopic anatomy of nasal cavity
endoscopic anatomy of nasal cavity
 
Panendoscopy
PanendoscopyPanendoscopy
Panendoscopy
 
Canal wall up Mastoidectomy ( Intact Bridge Mastoidectomy) by Dr.Aditya Tiwari
Canal wall up Mastoidectomy ( Intact Bridge Mastoidectomy) by Dr.Aditya TiwariCanal wall up Mastoidectomy ( Intact Bridge Mastoidectomy) by Dr.Aditya Tiwari
Canal wall up Mastoidectomy ( Intact Bridge Mastoidectomy) by Dr.Aditya Tiwari
 
Surgical anatomy of nose
Surgical anatomy of noseSurgical anatomy of nose
Surgical anatomy of nose
 
Measurements of nasal airway(dr ravindra daggupati),rhinomanometry,acoustic r...
Measurements of nasal airway(dr ravindra daggupati),rhinomanometry,acoustic r...Measurements of nasal airway(dr ravindra daggupati),rhinomanometry,acoustic r...
Measurements of nasal airway(dr ravindra daggupati),rhinomanometry,acoustic r...
 
Anatomy of Internal Nose
Anatomy of Internal Nose  Anatomy of Internal Nose
Anatomy of Internal Nose
 
Epistaxis
EpistaxisEpistaxis
Epistaxis
 
Fess complications
Fess complicationsFess complications
Fess complications
 
Myringoplasty ppt
Myringoplasty pptMyringoplasty ppt
Myringoplasty ppt
 
Diseases of external nose
Diseases of external noseDiseases of external nose
Diseases of external nose
 
Complications of Endoscopic Sinus Surgery (ESS)
Complications of Endoscopic Sinus Surgery (ESS)Complications of Endoscopic Sinus Surgery (ESS)
Complications of Endoscopic Sinus Surgery (ESS)
 
Spaces of middle ear and their surgical importance
Spaces of middle ear  and their surgical importanceSpaces of middle ear  and their surgical importance
Spaces of middle ear and their surgical importance
 
11 surgery for otosclerosis.ppt copy
11 surgery for otosclerosis.ppt   copy11 surgery for otosclerosis.ppt   copy
11 surgery for otosclerosis.ppt copy
 
Surgical mx of otosclerosis
Surgical mx of otosclerosisSurgical mx of otosclerosis
Surgical mx of otosclerosis
 
Complications of rhinosinusitis(Dr ravindra daggupati)
Complications of rhinosinusitis(Dr ravindra daggupati)Complications of rhinosinusitis(Dr ravindra daggupati)
Complications of rhinosinusitis(Dr ravindra daggupati)
 

Viewers also liked

BACK OF NECK & SUB OCCIPITAL TRIANGLE
BACK OF NECK & SUB OCCIPITAL TRIANGLEBACK OF NECK & SUB OCCIPITAL TRIANGLE
BACK OF NECK & SUB OCCIPITAL TRIANGLE
Kanav Bhanot
 
Rhinoplasty (Nose Anatomy)
Rhinoplasty  (Nose Anatomy) Rhinoplasty  (Nose Anatomy)
Rhinoplasty (Nose Anatomy)
yellow_sunfire102
 
Nasal septum and its diseases
Nasal septum and its diseasesNasal septum and its diseases
Nasal septum and its diseasesVinay Bhat
 
Surgical Anatomy Of The Nose
Surgical Anatomy Of The NoseSurgical Anatomy Of The Nose
Surgical Anatomy Of The Nose
Chih-Yen Wei
 
8. triangles of the neck
8. triangles of the neck8. triangles of the neck
8. triangles of the neckMBBS IMS MSU
 
Anatomy of nose and paranasal sinus
Anatomy of nose and paranasal sinusAnatomy of nose and paranasal sinus
Anatomy of nose and paranasal sinusMBBS IMS MSU
 

Viewers also liked (7)

BACK OF NECK & SUB OCCIPITAL TRIANGLE
BACK OF NECK & SUB OCCIPITAL TRIANGLEBACK OF NECK & SUB OCCIPITAL TRIANGLE
BACK OF NECK & SUB OCCIPITAL TRIANGLE
 
Rhinoplasty (Nose Anatomy)
Rhinoplasty  (Nose Anatomy) Rhinoplasty  (Nose Anatomy)
Rhinoplasty (Nose Anatomy)
 
Nasal septum and its diseases
Nasal septum and its diseasesNasal septum and its diseases
Nasal septum and its diseases
 
Septoplasty
SeptoplastySeptoplasty
Septoplasty
 
Surgical Anatomy Of The Nose
Surgical Anatomy Of The NoseSurgical Anatomy Of The Nose
Surgical Anatomy Of The Nose
 
8. triangles of the neck
8. triangles of the neck8. triangles of the neck
8. triangles of the neck
 
Anatomy of nose and paranasal sinus
Anatomy of nose and paranasal sinusAnatomy of nose and paranasal sinus
Anatomy of nose and paranasal sinus
 

Similar to Anatomy Nasal Septum and Septoplasty - Pakistan

The Nose and nasal cavity, anatomy, and clinical diseases of nasal cavity and...
The Nose and nasal cavity, anatomy, and clinical diseases of nasal cavity and...The Nose and nasal cavity, anatomy, and clinical diseases of nasal cavity and...
The Nose and nasal cavity, anatomy, and clinical diseases of nasal cavity and...
HamzehKYacoub
 
Dentist in pune.(BDS. MDS) - Dr. Amit T. Suryawanshi. Nose & Paranasal sinuses.
Dentist in pune.(BDS. MDS) - Dr. Amit T. Suryawanshi. Nose & Paranasal sinuses.Dentist in pune.(BDS. MDS) - Dr. Amit T. Suryawanshi. Nose & Paranasal sinuses.
Dentist in pune.(BDS. MDS) - Dr. Amit T. Suryawanshi. Nose & Paranasal sinuses.
All Good Things
 
Nasal cavity and paranasal sinuses
Nasal cavity and paranasal sinusesNasal cavity and paranasal sinuses
Nasal cavity and paranasal sinuses
Dr Bhavik Miyani
 
Surgical anatomy of Maxillary Sinus , Lateral wall of nose and Soft Palate
Surgical anatomy of Maxillary Sinus , Lateral wall of nose and Soft Palate Surgical anatomy of Maxillary Sinus , Lateral wall of nose and Soft Palate
Surgical anatomy of Maxillary Sinus , Lateral wall of nose and Soft Palate
Dr. Hani Yousuf
 
Endoscopic nasal anatomy
Endoscopic nasal anatomyEndoscopic nasal anatomy
Endoscopic nasal anatomy
Kode Sashanka
 
Anatomy and physiology of nose and paranasal sinuses
Anatomy and physiology of nose and  paranasal sinusesAnatomy and physiology of nose and  paranasal sinuses
Anatomy and physiology of nose and paranasal sinuses
Anwaaar
 
Nasal_Anatomy.pdf
Nasal_Anatomy.pdfNasal_Anatomy.pdf
Nasal_Anatomy.pdf
LisaMandy1
 
Nose, nasal cavity and paranasal sinuses.pptx
Nose, nasal cavity and paranasal sinuses.pptxNose, nasal cavity and paranasal sinuses.pptx
Nose, nasal cavity and paranasal sinuses.pptx
Sundip Charmode
 
EPISTAXIS.pptx
EPISTAXIS.pptxEPISTAXIS.pptx
EPISTAXIS.pptx
ArpitaHalder8
 
12130764 nose
12130764 nose12130764 nose
12130764 noseYoAmoNYC
 
12130764 nose
12130764 nose12130764 nose
12130764 noseabctutor
 
Anatomy and physiology of the nose
Anatomy and physiology of the noseAnatomy and physiology of the nose
Anatomy and physiology of the nose
Prajwal Dange
 
Nasal septal anatomy and septoplasty
Nasal septal anatomy and septoplastyNasal septal anatomy and septoplasty
Nasal septal anatomy and septoplasty
Dr Safika Zaman
 
Anatomy of Nose and PNS
Anatomy of Nose and PNSAnatomy of Nose and PNS
Anatomy of Nose and PNS
Victoria2021
 
airway anatomy 1.pptx
airway anatomy 1.pptxairway anatomy 1.pptx
airway anatomy 1.pptx
DrVANDANA17
 
Anat class nose on dec7
Anat class nose on dec7Anat class nose on dec7
Anat class nose on dec7
Giri Dharan
 
paranasal air sinuses
paranasal air sinusesparanasal air sinuses
paranasal air sinuses
manipal college of dental sciences
 
PARANASAL AIR SINUS.pptx
PARANASAL AIR SINUS.pptxPARANASAL AIR SINUS.pptx
PARANASAL AIR SINUS.pptx
SanaKhwaja2
 
nasal_cavity human anatomy lateral wall and venous drainage_1.pptx
nasal_cavity human anatomy lateral wall and venous drainage_1.pptxnasal_cavity human anatomy lateral wall and venous drainage_1.pptx
nasal_cavity human anatomy lateral wall and venous drainage_1.pptx
siddhimeena3
 
paranasal_air_sinuses.pptx
paranasal_air_sinuses.pptxparanasal_air_sinuses.pptx
paranasal_air_sinuses.pptx
nandhinivenkat4
 

Similar to Anatomy Nasal Septum and Septoplasty - Pakistan (20)

The Nose and nasal cavity, anatomy, and clinical diseases of nasal cavity and...
The Nose and nasal cavity, anatomy, and clinical diseases of nasal cavity and...The Nose and nasal cavity, anatomy, and clinical diseases of nasal cavity and...
The Nose and nasal cavity, anatomy, and clinical diseases of nasal cavity and...
 
Dentist in pune.(BDS. MDS) - Dr. Amit T. Suryawanshi. Nose & Paranasal sinuses.
Dentist in pune.(BDS. MDS) - Dr. Amit T. Suryawanshi. Nose & Paranasal sinuses.Dentist in pune.(BDS. MDS) - Dr. Amit T. Suryawanshi. Nose & Paranasal sinuses.
Dentist in pune.(BDS. MDS) - Dr. Amit T. Suryawanshi. Nose & Paranasal sinuses.
 
Nasal cavity and paranasal sinuses
Nasal cavity and paranasal sinusesNasal cavity and paranasal sinuses
Nasal cavity and paranasal sinuses
 
Surgical anatomy of Maxillary Sinus , Lateral wall of nose and Soft Palate
Surgical anatomy of Maxillary Sinus , Lateral wall of nose and Soft Palate Surgical anatomy of Maxillary Sinus , Lateral wall of nose and Soft Palate
Surgical anatomy of Maxillary Sinus , Lateral wall of nose and Soft Palate
 
Endoscopic nasal anatomy
Endoscopic nasal anatomyEndoscopic nasal anatomy
Endoscopic nasal anatomy
 
Anatomy and physiology of nose and paranasal sinuses
Anatomy and physiology of nose and  paranasal sinusesAnatomy and physiology of nose and  paranasal sinuses
Anatomy and physiology of nose and paranasal sinuses
 
Nasal_Anatomy.pdf
Nasal_Anatomy.pdfNasal_Anatomy.pdf
Nasal_Anatomy.pdf
 
Nose, nasal cavity and paranasal sinuses.pptx
Nose, nasal cavity and paranasal sinuses.pptxNose, nasal cavity and paranasal sinuses.pptx
Nose, nasal cavity and paranasal sinuses.pptx
 
EPISTAXIS.pptx
EPISTAXIS.pptxEPISTAXIS.pptx
EPISTAXIS.pptx
 
12130764 nose
12130764 nose12130764 nose
12130764 nose
 
12130764 nose
12130764 nose12130764 nose
12130764 nose
 
Anatomy and physiology of the nose
Anatomy and physiology of the noseAnatomy and physiology of the nose
Anatomy and physiology of the nose
 
Nasal septal anatomy and septoplasty
Nasal septal anatomy and septoplastyNasal septal anatomy and septoplasty
Nasal septal anatomy and septoplasty
 
Anatomy of Nose and PNS
Anatomy of Nose and PNSAnatomy of Nose and PNS
Anatomy of Nose and PNS
 
airway anatomy 1.pptx
airway anatomy 1.pptxairway anatomy 1.pptx
airway anatomy 1.pptx
 
Anat class nose on dec7
Anat class nose on dec7Anat class nose on dec7
Anat class nose on dec7
 
paranasal air sinuses
paranasal air sinusesparanasal air sinuses
paranasal air sinuses
 
PARANASAL AIR SINUS.pptx
PARANASAL AIR SINUS.pptxPARANASAL AIR SINUS.pptx
PARANASAL AIR SINUS.pptx
 
nasal_cavity human anatomy lateral wall and venous drainage_1.pptx
nasal_cavity human anatomy lateral wall and venous drainage_1.pptxnasal_cavity human anatomy lateral wall and venous drainage_1.pptx
nasal_cavity human anatomy lateral wall and venous drainage_1.pptx
 
paranasal_air_sinuses.pptx
paranasal_air_sinuses.pptxparanasal_air_sinuses.pptx
paranasal_air_sinuses.pptx
 

More from Anwaaar

Diseases of nasal septum
Diseases of nasal septumDiseases of nasal septum
Diseases of nasal septum
Anwaaar
 
ASOM & Mastoiditis
ASOM & MastoiditisASOM & Mastoiditis
ASOM & Mastoiditis
Anwaaar
 
Anatomy of ear
Anatomy of earAnatomy of ear
Anatomy of ear
Anwaaar
 
ENT INSTRUMENTS & IMPLANTS
ENT INSTRUMENTS & IMPLANTSENT INSTRUMENTS & IMPLANTS
ENT INSTRUMENTS & IMPLANTS
Anwaaar
 
Tumours of the larynx
Tumours of the larynxTumours of the larynx
Tumours of the larynx
Anwaaar
 
Larynx anatomy and physiology
Larynx anatomy and physiologyLarynx anatomy and physiology
Larynx anatomy and physiology
Anwaaar
 
Ludwig's angina
Ludwig's anginaLudwig's angina
Ludwig's angina
Anwaaar
 
Quinsy or Peritonsillar Abscess
Quinsy or Peritonsillar AbscessQuinsy or Peritonsillar Abscess
Quinsy or Peritonsillar Abscess
Anwaaar
 
Diphtheria
DiphtheriaDiphtheria
Diphtheria
Anwaaar
 
Pharyngitis
PharyngitisPharyngitis
Pharyngitis
Anwaaar
 
Peritonsillar abscess, parapharyngeal abscess, retropharyngeal abscess
Peritonsillar abscess, parapharyngeal abscess, retropharyngeal abscessPeritonsillar abscess, parapharyngeal abscess, retropharyngeal abscess
Peritonsillar abscess, parapharyngeal abscess, retropharyngeal abscess
Anwaaar
 
Anatomy of Pharynx
Anatomy of PharynxAnatomy of Pharynx
Anatomy of Pharynx
Anwaaar
 
Counselling in Medical Profession
Counselling in Medical ProfessionCounselling in Medical Profession
Counselling in Medical Profession
Anwaaar
 
Diseases of the nasal septum
Diseases of the nasal septumDiseases of the nasal septum
Diseases of the nasal septum
Anwaaar
 
Radiology in ENT
Radiology in ENTRadiology in ENT
Radiology in ENT
Anwaaar
 
Tracheostomy
TracheostomyTracheostomy
Tracheostomy
Anwaaar
 
Pharyngitis
PharyngitisPharyngitis
Pharyngitis
Anwaaar
 
Granulomatous disease of nose
Granulomatous disease of noseGranulomatous disease of nose
Granulomatous disease of nose
Anwaaar
 
Congenital lesions of larynx and Stridor in Neonates
Congenital lesions of larynx and Stridor in NeonatesCongenital lesions of larynx and Stridor in Neonates
Congenital lesions of larynx and Stridor in Neonates
Anwaaar
 
DISEASES OF OESOPHAGUS
DISEASES OF OESOPHAGUSDISEASES OF OESOPHAGUS
DISEASES OF OESOPHAGUS
Anwaaar
 

More from Anwaaar (20)

Diseases of nasal septum
Diseases of nasal septumDiseases of nasal septum
Diseases of nasal septum
 
ASOM & Mastoiditis
ASOM & MastoiditisASOM & Mastoiditis
ASOM & Mastoiditis
 
Anatomy of ear
Anatomy of earAnatomy of ear
Anatomy of ear
 
ENT INSTRUMENTS & IMPLANTS
ENT INSTRUMENTS & IMPLANTSENT INSTRUMENTS & IMPLANTS
ENT INSTRUMENTS & IMPLANTS
 
Tumours of the larynx
Tumours of the larynxTumours of the larynx
Tumours of the larynx
 
Larynx anatomy and physiology
Larynx anatomy and physiologyLarynx anatomy and physiology
Larynx anatomy and physiology
 
Ludwig's angina
Ludwig's anginaLudwig's angina
Ludwig's angina
 
Quinsy or Peritonsillar Abscess
Quinsy or Peritonsillar AbscessQuinsy or Peritonsillar Abscess
Quinsy or Peritonsillar Abscess
 
Diphtheria
DiphtheriaDiphtheria
Diphtheria
 
Pharyngitis
PharyngitisPharyngitis
Pharyngitis
 
Peritonsillar abscess, parapharyngeal abscess, retropharyngeal abscess
Peritonsillar abscess, parapharyngeal abscess, retropharyngeal abscessPeritonsillar abscess, parapharyngeal abscess, retropharyngeal abscess
Peritonsillar abscess, parapharyngeal abscess, retropharyngeal abscess
 
Anatomy of Pharynx
Anatomy of PharynxAnatomy of Pharynx
Anatomy of Pharynx
 
Counselling in Medical Profession
Counselling in Medical ProfessionCounselling in Medical Profession
Counselling in Medical Profession
 
Diseases of the nasal septum
Diseases of the nasal septumDiseases of the nasal septum
Diseases of the nasal septum
 
Radiology in ENT
Radiology in ENTRadiology in ENT
Radiology in ENT
 
Tracheostomy
TracheostomyTracheostomy
Tracheostomy
 
Pharyngitis
PharyngitisPharyngitis
Pharyngitis
 
Granulomatous disease of nose
Granulomatous disease of noseGranulomatous disease of nose
Granulomatous disease of nose
 
Congenital lesions of larynx and Stridor in Neonates
Congenital lesions of larynx and Stridor in NeonatesCongenital lesions of larynx and Stridor in Neonates
Congenital lesions of larynx and Stridor in Neonates
 
DISEASES OF OESOPHAGUS
DISEASES OF OESOPHAGUSDISEASES OF OESOPHAGUS
DISEASES OF OESOPHAGUS
 

Recently uploaded

Alcohol_Dr. Jeenal Mistry MD Pharmacology.pdf
Alcohol_Dr. Jeenal Mistry MD Pharmacology.pdfAlcohol_Dr. Jeenal Mistry MD Pharmacology.pdf
Alcohol_Dr. Jeenal Mistry MD Pharmacology.pdf
Dr Jeenal Mistry
 
ACUTE SCROTUM.....pdf. ACUTE SCROTAL CONDITIOND
ACUTE SCROTUM.....pdf. ACUTE SCROTAL CONDITIONDACUTE SCROTUM.....pdf. ACUTE SCROTAL CONDITIOND
ACUTE SCROTUM.....pdf. ACUTE SCROTAL CONDITIOND
DR SETH JOTHAM
 
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
 
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
 
New Drug Discovery and Development .....
New Drug Discovery and Development .....New Drug Discovery and Development .....
New Drug Discovery and Development .....
NEHA GUPTA
 
How to Give Better Lectures: Some Tips for Doctors
How to Give Better Lectures: Some Tips for DoctorsHow to Give Better Lectures: Some Tips for Doctors
How to Give Better Lectures: Some Tips for Doctors
LanceCatedral
 
Flu Vaccine Alert in Bangalore Karnataka
Flu Vaccine Alert in Bangalore KarnatakaFlu Vaccine Alert in Bangalore Karnataka
Flu Vaccine Alert in Bangalore Karnataka
addon Scans
 
KDIGO 2024 guidelines for diabetologists
KDIGO 2024 guidelines for diabetologistsKDIGO 2024 guidelines for diabetologists
KDIGO 2024 guidelines for diabetologists
د.محمود نجيب
 
For Better Surat #ℂall #Girl Service ❤85270-49040❤ Surat #ℂall #Girls
For Better Surat #ℂall #Girl Service ❤85270-49040❤ Surat #ℂall #GirlsFor Better Surat #ℂall #Girl Service ❤85270-49040❤ Surat #ℂall #Girls
For Better Surat #ℂall #Girl Service ❤85270-49040❤ Surat #ℂall #Girls
Savita Shen $i11
 
heat stroke and heat exhaustion in children
heat stroke and heat exhaustion in childrenheat stroke and heat exhaustion in children
heat stroke and heat exhaustion in children
SumeraAhmad5
 
Pharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptx
Pharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptxPharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptx
Pharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptx
Dr. Rabia Inam Gandapore
 
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
 
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
 
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
 
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
 
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
 
NVBDCP.pptx Nation vector borne disease control program
NVBDCP.pptx Nation vector borne disease control programNVBDCP.pptx Nation vector borne disease control program
NVBDCP.pptx Nation vector borne disease control program
Sapna Thakur
 
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
 
Triangles of Neck and Clinical Correlation by Dr. RIG.pptx
Triangles of Neck and Clinical Correlation by Dr. RIG.pptxTriangles of Neck and Clinical Correlation by Dr. RIG.pptx
Triangles of Neck and Clinical Correlation by Dr. RIG.pptx
Dr. Rabia Inam Gandapore
 
Physiology of Chemical Sensation of smell.pdf
Physiology of Chemical Sensation of smell.pdfPhysiology of Chemical Sensation of smell.pdf
Physiology of Chemical Sensation of smell.pdf
MedicoseAcademics
 

Recently uploaded (20)

Alcohol_Dr. Jeenal Mistry MD Pharmacology.pdf
Alcohol_Dr. Jeenal Mistry MD Pharmacology.pdfAlcohol_Dr. Jeenal Mistry MD Pharmacology.pdf
Alcohol_Dr. Jeenal Mistry MD Pharmacology.pdf
 
ACUTE SCROTUM.....pdf. ACUTE SCROTAL CONDITIOND
ACUTE SCROTUM.....pdf. ACUTE SCROTAL CONDITIONDACUTE SCROTUM.....pdf. ACUTE SCROTAL CONDITIOND
ACUTE SCROTUM.....pdf. ACUTE SCROTAL CONDITIOND
 
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
 
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
 
New Drug Discovery and Development .....
New Drug Discovery and Development .....New Drug Discovery and Development .....
New Drug Discovery and Development .....
 
How to Give Better Lectures: Some Tips for Doctors
How to Give Better Lectures: Some Tips for DoctorsHow to Give Better Lectures: Some Tips for Doctors
How to Give Better Lectures: Some Tips for Doctors
 
Flu Vaccine Alert in Bangalore Karnataka
Flu Vaccine Alert in Bangalore KarnatakaFlu Vaccine Alert in Bangalore Karnataka
Flu Vaccine Alert in Bangalore Karnataka
 
KDIGO 2024 guidelines for diabetologists
KDIGO 2024 guidelines for diabetologistsKDIGO 2024 guidelines for diabetologists
KDIGO 2024 guidelines for diabetologists
 
For Better Surat #ℂall #Girl Service ❤85270-49040❤ Surat #ℂall #Girls
For Better Surat #ℂall #Girl Service ❤85270-49040❤ Surat #ℂall #GirlsFor Better Surat #ℂall #Girl Service ❤85270-49040❤ Surat #ℂall #Girls
For Better Surat #ℂall #Girl Service ❤85270-49040❤ Surat #ℂall #Girls
 
heat stroke and heat exhaustion in children
heat stroke and heat exhaustion in childrenheat stroke and heat exhaustion in children
heat stroke and heat exhaustion in children
 
Pharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptx
Pharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptxPharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptx
Pharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptx
 
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...
 
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
 
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
 
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
 
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
 
NVBDCP.pptx Nation vector borne disease control program
NVBDCP.pptx Nation vector borne disease control programNVBDCP.pptx Nation vector borne disease control program
NVBDCP.pptx Nation vector borne disease control 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
 
Triangles of Neck and Clinical Correlation by Dr. RIG.pptx
Triangles of Neck and Clinical Correlation by Dr. RIG.pptxTriangles of Neck and Clinical Correlation by Dr. RIG.pptx
Triangles of Neck and Clinical Correlation by Dr. RIG.pptx
 
Physiology of Chemical Sensation of smell.pdf
Physiology of Chemical Sensation of smell.pdfPhysiology of Chemical Sensation of smell.pdf
Physiology of Chemical Sensation of smell.pdf
 

Anatomy Nasal Septum and Septoplasty - Pakistan

  • 1.
  • 2. NASAL SEPTAL ANATOMY AND SMR Col Dr Anwar ul Haq ENT Consultant +923018513303
  • 3. ANATOMY OF NASAL SEPTUM  Columellar septum  It is formed of columella  Containing the medial crura of alar cartilages united together by fibrous tissue Covered on either side by skin
  • 4. MEMBRANOUS SEPTUM  It lies b/w columella and caudal border of septal cartilage  No bony or cartilaginous support  Above two parts freely movable from side to side
  • 5. SEPTUM PROPER  Consist of osteocortilaginous frame work  Its main Constitutes are  Perpendicular plate of ethmoid  vomer bone  Large septal cartilage (quadrilateral) wedged between the above two bones anteriorly
  • 6.
  • 7. SEPTUM PROPER  Minor contributions Crest of nasal bone  Nasal spine of frontal bone  Rostum of spnenoid  Crest of palatine bone  Crest of maxilla and anterior nasal spine of maxilla
  • 8.
  • 9. BLOOD SUPPLY OF NASAL SEPTUM  Internal carotid system  Anterior ethmoidal artery Branches of  Post ethmoidal artery opthalmic artery
  • 10. EXTERNAL CAROTID SYSTEM  Spheno palatine artery (maxillary)  Nasopalotine branches  Post nasal septal branches  Septal branch of great palatine artery (maxillary)  Septal branch of superior labial artery (Facial)
  • 11.
  • 12. LITTLE’S AREA (KIESSEL BACH’S PLEXUS)  Anterior ethmoidal  Septal branch of supeior labial Septal branch of sphenopalotine Septal branch of greater palatine
  • 13.
  • 14. VENOUS DRAINAGE  Posteriorly through sephenopalatine veins into pterygoid venous plexus  Anteriorly drain into facial veins  Superiorly in ethmoidal veins
  • 15. NERVE SOPPLY OF NASAL SEPTUM  Olfactory nerves  Carry sense of smell  Supply olfactory region of nose  Can Carry sheath of dura, archnoid and pia matter
  • 16. NERVE SUPPLY  Nerves of common sensation  Anterior ethmoidal nerve  Branches of nasopalatine nerve  Branches of infra orbital nerve
  • 17.
  • 18. AUTONOMIC NERVES  Parasympathetic nerve fibers supply nasal glands and control nasal secretions  Greater superfacial petrosal nerve.  Sympathetic nerve fibers  Upper two thoracic segments  Deep petrosal nerve
  • 19. LYMPHATIC DRAINAGE  Submandibular lymph nodes  Rest of nasal cavity drain into upper jugular nodes directly or through retropharyngeal nodes
  • 20. SUBMUCOUS RESECTION OF NASAL SEPTUM • INDICATIONS – DNS causing symptoms of nasal obstruction and recurrent headache. – DNS causing obstruction of paranasal sinuses and middle ear. – Recurrent epistaxis from septal spur – As a part of septorhinoplasty – As a preliminary step in  Hypophsectomy (Trans septal trans sphenoidal approach)  Vidian neurectomy (Trans septal apprach)
  • 21. CONTRA INDICATIONS • Pt’s below 17 years age • Acute respiratory infection • Bleeding diathesis • Untreated diabetes or hypertension
  • 22. ANASTHESIA • LA is preffered • GA is used in children and apprehensive adults
  • 23. POSITION • Reclining position with head-end of the table raised
  • 24. STEPS OF OPERATION • Infiltration of nasal septum • Incision – A curvilinear incision with forward convexity is made at 5mm behind the mucocutaneous junction on the deviated side of septum
  • 25. STPES OF OPERATION • Elevation of mucopeichondrial and periosteal flap. • Incision of the cartilage • Elevation of opposite mucopeichondrium and periostium.
  • 26. STEPS OF OPERATION • Removal of cartilage & bone – Preserve a strip of cartilage about 1cm along the dorsal and caudal border of the septum to prevent collapse of the nasal bridge. • Stiching – One or two catgut or silk stitches are applied • Packing – Ribbon gauze, smeared with furacin oinment or liquid paraffin
  • 27.
  • 28.
  • 29.
  • 30.
  • 31. POST OPERATIVE CARE • Semi sitting position • Soft diet • Analgesics • Antibiotic cover for 5-6 days. • Nasal pack removed after 24 hours • Decongestant and steam inhalation • Avoid nasal trauma
  • 32. COMPLICATIONS • Bleeding • Septal haematoma • Septal abscess • Perforation • Depression of nasal bridge • Retraction of columella • Flapping of nasal septum • Toxic shock syndrome
  • 33. SEPTOPLASTY • Septoplasty is a conservative approch to septal surgery as much of the septal framework as possible is retained • Mucoperichondrial / periosteal flap is generally raised only one side.
  • 34. STEPS OF OPERATION • Infiltrate the septum with 1% lignocaine with adrenaline • In case of deviated septum make a slightly curveline incision 2-3 mm above the caudal end of septal cartiflage on the concave side in case of caudal dislocation a transfixition or hemi transfixition incision is made
  • 35. • Raise mucoperichondrial / mucoperiosteal flap on one side only • Seprate septal cartilage from the vomer and ethmoid plate and raise mucoperiosteal flap on the apposite side of septum.
  • 36. • Remove maxillary crest to realign the septal cartilage • Correct the bony septum by removing the deformed parts • Deformed septal cartilage is corrected by various methods such as – Scoring on the concave side – Cross hatching – Shaving – Wedge excision – Trans septal sutures are put to coapt mucoperichondrial flaps – Nasal pack