1) The nasal septum consists of three parts - the columellar septum, membranous septum, and septum proper. The septum proper contains cartilage and bones that provide support to the nose.
2) Deviations, fractures, and injuries to the nasal septum can cause problems like nasal obstruction, epistaxis, and deformities. Surgical procedures like submucous resection (SMR) and septoplasty are used to correct septal abnormalities.
3) Complications of nasal septum diseases and their surgeries include bleeding, septal hematoma, infection, and saddle nose deformity. Accurate diagnosis and treatment of septal fractures or deviations is
External ear,tympanic membrane and auditory tube Dr.N.Mugunthan.M.S.,mgmcri1234
External ear,tympanic membrane and auditory tube - Lecture by Dr.N.Mugunthan.M.S.,Associate Professor, Mahatma Gandhi Medical College & Research Institute, Pondicherry,
Sri Balaji Vidyapeeth University.
External ear,tympanic membrane and auditory tube Dr.N.Mugunthan.M.S.,mgmcri1234
External ear,tympanic membrane and auditory tube - Lecture by Dr.N.Mugunthan.M.S.,Associate Professor, Mahatma Gandhi Medical College & Research Institute, Pondicherry,
Sri Balaji Vidyapeeth University.
Introduction
Functions
Development
Structure
Nasal cavity
Nasal septum
Lateral wall
Applied anatomy and pathology –
- danger area of nose
- nose bleeding
- foreign body in nose
- developmental nasal deformities
- nasal polyps
- mouth breathing
- rhinitis
Introduction
Functions
Development
Structure
Nasal cavity
Nasal septum
Lateral wall
Applied anatomy and pathology –
- danger area of nose
- nose bleeding
- foreign body in nose
- developmental nasal deformities
- nasal polyps
- mouth breathing
- rhinitis
surgical anatomy of nose is a humble attempt to make the anatomy of nose simpler and easy for medical students and fellow physicians. at the end of the presentation the students will be able to identify all the structures.
The nasal septum is the cartilage and bone in your nose. The septum divides the nasal cavity (inside your nose) into a right and left side. When the septum is off-center or leans to one side of the nasal cavity, it has “deviated.” Healthcare providers call this a deviated nasal septum.
Any deviation in the normal nasal septum is called DNS (Deviated Nasal Septum).
Deviated Nasal Septum may be caused by mechanical trauma and may be
associated with some developmental defects.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Couples presenting to the infertility clinic- Do they really have infertility...
Nasal septum and its diseases
1. NASAL SEPTUM AND ITS DISEASES
DEPT OF
OTORHINOLARYNGOLOG
Y
JJM M C
DAVANAGERE
2. Nasal septum and its diseases
Anatomy of nasal septum:
Nasal septum consists of three parts:
1. Columellar septum
2. Membranous septum
3. Septum proper: principle constituents of septum proper are
a)perpendicular plate of ethmoid
b)vomer
c)septal(quadrilateral cartilage)
minor contributions from crest of nasal bone,nasal spine of
frontal bone,rostrum of sphenoid,crest of palatine and maxilla
and anterior nasal spine of maxilla.
3. Nasal septum and its diseases
o Septal cartilage forms a partition between right and left
nasal cavities and provides support to tip and dorsum of
cartilagenous part of nose.
o Septal destruction may occur in septal abscess, injuries,
tuberculosis, excess removal during SMR leads to
depression of lower part of nose and drooping of tip.
o Septal cartilage lies in a groove in the anterior edge of
vomer and rests anteriorly on anterior nasal spine. during
trauma, it may get dislocated from nasal spine or vomer
causing caudal septal deviation and spur respectively.
6. Fractures of nasal septum
Aetiopathogenisis:
-Trauma inflicted from front, side or below.the septum
may buckle on itself, fracture vertically, horizontally
or get crushed.
-fracture of septal cartilage or its dislocation can occur
without nasal bones fracture in cases of trauma to
lower nose.
-septal injuries with mucosal tears cause profuse
epistaxis while with intact mucosa result in septal
hematoma.
7. Fractures of nasal septum
Types :
1}Jarjaway fracture: result from blow from front.
fracture line starts just above the anterior nasal
spine and runs horizontally backwards just
above the junction of septal cartilage with the
vomer.
2}Chevallet fracture: results from blow from below.
it runs vertically from anterior nasal spine
upwards to the junction of bony and
cartilaginous dorsum of nose.
9. Fractures of nasal septum
Treatment: -early recognition and treatment of septal
injuries is essential.
-dislocated or fractured fragments should be
repositioned and supported between
mucoperichondrial flaps.
-haematomas should be drained.
Complications: a) deviation of cartilagenous nose.
b) asymmetry of nasal
tip,columella,or
nostril.
10. DEVIATED NASAL SEPTUM
AETIOLOGY:
1) Trauma:
lateral blow-displacement of septal cartilage from vomer.
blow from front-buckling, fracture, duplication of septum with
telescoping of fragments.
2) Developmental: the septum should grow at the same rate as
that of face. if septum grows at faster rate it becomes
buckled. unequal growth between palate and base of skull
may also cause buckling (high arched palate)
3) Congenital: abnormal intrauterine posture cause compressing
forces acting on nose and upper jaw.
4) Hereditary
5) Racial: Caucasians are more affected
6) Secondary: to a tumour, mass or polyp.
11. DEVIATED NASAL SEPTUM
Types:
1) Deviations: upper or lower, anterior or posterior, C
shaped, S shaped. nasal cavity on the concave
side of the septum will be wider and may show
compensatory hypertrophy of turbinates.
2) Anterior Dislocation: seen on tilting the patients
head backwards.
3) Spurs: shelf like projection at the junction of bone
and cartilage. may predispose for epistaxis and
headache.
4) Thickening: it may be due to organized haematoma
or over-riding of dislocated septal fragments
13. Clinical features
Nasal obstruction: depending on the type it
may be unilateral or bilateral. It is the most
common symptom
headache
Recurrent attacks of cold
Epistaxis
Anosmia
External deformity
Middle ear infection
14. Clinical features
Cottle’s test: used in nasal obstruction due to
abnormality of nasal valve. In this test cheek
is drawn laterally while the patient breathes
quietly. If the nasal airway improves on test
side the test is positive and indicates
abnormality of nasal valve
17. Treatment- surgery
Submucous resection of nasal septum (SMR)
It is generally done in adults
It consists of elevating mucoperichondrial
and mucoperiosteal flap on either side of the
septum, removing the deflected parts of bony
and cartilagenous septum and then
repositioning the flaps
18. SMR
Indications
Deviated nasal septum causing nasal obstruction and
recurrent headaches
Deviated nasal septum causing obstruction to
ventilation of paranasal sinuses and middle ear
resulting in recurrent infections
Recurrent epistaxis from septal spur
As a part of septorhinoplasty
Harvesting cartilage graft for tympanoplasty and
rhinoplasty
As an approach to surgeries of sphenoidal sinus,
vidian nerve and pituitary gland
19. SMR
Contraindications
Acute URTI
Patient below 17 yrs of age
Bleeding disorders
Uncontrolled hypertension and diabetes
mellitus
20. SMR
Anesthesia - Local anesthesia/ general
anesthesia
Positioning: reclining position with head end
of the table raised
21. SMR - STEPS
Infiltration:subperichondrial infiltration with 2%
xylocaine with adrenaline
Incision: killian’s incision- curvilinear incision 2-
3mm behind the anterior end of septal cartilage
Elevation of flaps: the mucoperichondrial and
mucoperiosteal flap is elevated
Incision of the cartilage- cartilage is incised just
posterior to the first incision
Elevation of opposite mucoperichondrial and
mucoperiosteal flap
22. SMR – STEPS (cont…)
Removal of cartilage and bone - cartilage
can be removed with Ballinger swivel knife or
luc’s forceps. Bony spur is removed using
gouge and hammer
Preserve a strip of 1cm wide cartilage along
the dorsal and caudal borders (struts)
Nasal packing
24. complications
Bleeding
Septal haematoma
Damage to surrounding structures
Septal abscess
Septal Perforation
Depression of bridge
Retraction of columella
Synichae
Flapping septum
Infection- sinus and middle ear
CSF rhinorrhoea
25. Cottle’s line
A vertical line between
the nasal process of
frontal bone and nasal
spine of maxillary crest.
it divides septum into
anterior and posterior
segments
26. Septoplasty
It is a conservative approach to septal surgery as much
of the septal framework is retained
Indications:
Deviated nasal septum causing nasal obstruction and
recurrent headaches
Deviated nasal septum causing obstruction to ventilation
of paranasal sinuses and middle ear resulting in recurrent
infections
Recurrent epistaxis from septal spur
As a part of septorhinoplasty
As an approach to surgeries of sphenoidal sinus, vidian
nerve and pituitary gland
28. Septoplasty (cont…)
Anesthesia: local or general anesthesia
Position: same as SMR
Steps :
Infiltration
Incision: Freer’s incision– a unilateral
hemitransfixation incision at the caudal
border of the septum
Exposure: the mucoperichondrial and
mucoperiosteal flap is elevated on only one
side
29. Septoplasty (cont…)
Separate septal cartilage from vomer and
ethmoid plate
Inferior strip of cartilage is removed
Correct the bony septum by removing deformed
parts
Minor deviations of cartilage are corrected by
criss cross incision which breaks spring action of
cartilage
Nasal packing
30.
31. Post-operative complications
Bleeding
Septal haematoma
Damage to surrounding structures
Septal abscess
Septal Perforation
Depression of bridge
Retraction of columella
Synechiae
Infection- sinus and middle ear
CSF rhinorrhoea
32. Differences between SMR and
septoplasty
SMR Septoplasty
1. Radical surgery 1. Conservative surgery
2. Not done in children 2. Can be done in children
3. Killian’s incision 3. Freer’s incision
4. Flaps elevated on both 4. Flap elevated on concave
sides side only
5. Most of cartilage removed 5. Most of cartilage preserved
6. Caudal dislocation not 6. Caudal dislocation
corrected corrected
7. Perforation chance higher 7. Perforation rare
8. Post operative saddling 8. Post operative deformity
may be present absent
9. Revision surgery difficult 9. Revision surgery easier
33. Septal haematoma
It is collection of blood under the perichondrium or
periosteum of nasal septum
Etiology: nasal trauma, post-operative, in bleeding
disorder
Clinical features:
Bilateral nasal obstruction
Frontal headache
Sense of pressure over nasal bridge
Examination reveals smooth rounded swelling of the
septum in both the nasal cavity. Palpation may show
the mass to be soft and fluctuant
34. Septal haematoma
Treatment: small haematomas can be
aspirated with a wide bore needle, larger
haematomas are incised and drained.
Excision of small piece of mucosa from the
edge of the incision gives better drainage.
Nose is packed on both sides to prevent re-
accumulation. Systemic antibiotics to prevent
septal abscess
35. Septal haematoma
Complications
If not drained may organize into fibrous
tissue leading to a permanently thickened
septum
If secondary infection supervenes leads to
septal abscess with necrosis of cartilage and
saddling
37. Septal abscess
Etiology
Secondary infection of septal haematoma
Furuncle of the nasal vestibule
Clinical features
Severe bilateral nasal obstruction with pain and
tenderness over bridge of nose
Fever with chills
Frontal headache
Skin over the nose may be red and swollen
Smooth bilateral swelling of the nasal septum
Congested septal mucosa
Submandibular nodes may be enlarged and tender
38. Septal abscess
Treatment
Abscess should be drained as early as
possible
Pus and necrosed cartilage removed by
suction
Incision may required to be re-opened daily
for 2-3 days to drain any pus or remove any
necrosed piece of cartilage
Systemic antibiotics to be started as soon as
possible and continued for two weeks
39. Septal abscess
Complications
Depression of the cartilagenous dorsum
Septal perforation
Meningitis and cavernous sinus thrombosis
(rare)
40. Nasal septal perforation
Etiology
Traumatic - post surgical, habitual nose picking, cauterization of
septum with chemicals or galvano-cautery for epistaxis
Pathological perforation
a) Septal abscess
b) Nasal myasis
c) Rhinolith or neglected foreign body
d) Chronic granulomatous conditions like TB, lupus, leprosy, syphilis,
wegener’s
Inhalant irritants- snuff and cocaine irritant, industrial toxins
Malignancy
idiopathic
41. Nasal septal perforation
Clinical features
Whistling sound
Irritation and crusting
Epistaxis
Nasal obstruction
42. Nasal septal perforation
Treatment
Treat the root cause
Inactive small perforation can be surgically
closed by plastic flaps or septal mucosal
flaps
Larger perforations are difficult to close: their
treatment is aimed to keep the nose crust
free by alkaline nasal douch and application
of lubricants, silastic obturator may also be
used