This document outlines the various symptoms associated with nasal diseases, including nasal obstruction, nasal discharge, epistaxis, disturbance of smell, sneezing, post-nasal drip, cough, headache, swelling or deformity, change in voice, and snoring. It describes the potential causes of each symptom and provides examples of diseases that can cause intermittent, progressive, or persistent nasal obstruction and watery, purulent, or bloody nasal discharge.

1. SYMPTOMATOLOGY
OF NASAL DISEASES
By Dr. Vijay Kumar

2. NASAL SYMPTOMS
• Nasal Obstruction
• Nasal Discharge
• Epistaxis
• Disturbance of smell
• Sneezing
• Post-nasal drip
• Cough
• Headache and facial pain
• Swelling or deformity
• Change in voice
• Snoring

3. Nasal obstruction
Unilateral Bilateral
U/L Choanal atresia B/L Choanal atresia
C-shaped DNS S-shaped DNS
FB (children) Chronic sinusitis
U/L Atrophic rhinitis Atrophic rhinitis
Antro-choanal polyp Ethmoidal polyp
U/L Rhinosporidiosis B/L Rhinosporidiosis
Turbinate Hypertrophy AR, VMR, Septal abscess
Synechia, Rhinolith Enlarged Adenoids, JNA
U/L Benign/Malignant Growth Occupying
lesion of nose & PNS Nasopharynx.

4. • Intermittent Nasal Obstruction:
• VMR, AR, Early Ethmoidal Polyposis
• Progressive Nasal Obstruction:
• Polyp late stage, Malignancies
• Persistent Nasal Obstruction:
• DNS, Polyp late stage, Malignancies late stage
Nasal obstruction...

5. Nasal Discharge
Unilateral Bilateral
FB (children) Enlarged Adenoids
U/l Choanal atresia B/l Choanal atresia
Antro-choanal polyp Ethmoidal polyp
U/L Chronic sinusitis B/LChronic sinusitis
U/L Rhinosporidiosis B/L Rhinosporidiosis
Rhinolith , CSF Rhinorrhea AR, VMR
Neoplasm Nose & PNS

6. Watery Nasal Discharge :
• Common cold
• AR , VMR
• CSF Leak
Purulent Nasal Discharge :
• Chronic Sinusitis
• Atrophic Rhinitis with Secondary Sinusistis
• Neoplasm with Secondary Sinusisti
• Impacted FB
Nasal Discharge...

7. Bloody Nasal Discharge:
• Chronic Sinusitis
• Rhinolith
• FB, myiasis
• Fungal Sinusitis
• TB, Leprosy, Lupus
• Rhinosporidiosis
• Neoplasm
Nasal Discharge...

8. Epistaxis
1. Local:
• Trauma – self Inflicted (Nose Pricking)
» Surgery
» Fracture
» Violent sneezing, Barotrauma
• Infection – Vestibulitis
» Viral rhinitis, diphtheric rhinitis
» Atrophic rhinitis
» Fungal infection
» TB, Lupus, Leprosy
• Foreign Body- Rhinolith, myiasis
• Neoplasm- JNA, Benign/Malignant tumours of nose &
PNS

9. Epistaxis...
2. Systemic Disease:
• Hypertension , Anemia, Leukemia, liver failure, Vit. K
deficiency, Bleeding disorders.
3 Hormonal factors : Puberty, Pregnancy

10. Disturbance of smell
• Anosmia – Total loss of smell : Nasal polyps, turbinate
hypertrophy, AR, VMR, DNS, Synechia, Tumors of nose &
nasopharynx, Enlarged Adenoids
• Hyposmia – Reduced sense of smell: Nasal polyps, turbinate
hypertrophy, AR, VMR, DNS, Synechia, Tumors of nose &
nasopharynx
• Hyperosmia – Exaggerated sense of smell: Acute/ Chronic
Rhinitis, Pregnancy, hysteria, Neuresthenia.

11. Disturbance of smell..
• Parosmia – Altered sense of smell: Smoking, Chemical
Exposure, Bacterial/Viral infection, Traumatic Brain Injury.
• Cacosmia – Every odor perceived as foul smell:
Intoxication, Cocaine abuse, Aspirin abuse, Pregnancy

12. Sneezing
• AR, VMR, polyps, Myiasis, Exposure to
Irritants.
Post-nasal drip
• AR, Acute/ Chronis sinusitis

13. Headache
• Frontal Sinusitis (office Headache), Ethmoidal
Sinusitis(Spectacle Headache), Maxillary
Sinusitis(Facialpain), Sphenoidal
Sinusitis(Occipital Headache), DNS,
Spur(Anterior Ethmoidal Nerve syndrome),
Trigeminal Neuralgia.
• Rule out other cuses of headache

14. Swelling or deformity
• Deformities includes- Frog Face, Telecanthus,
Saddle nose(congenital syphilis,
Rhinoscleroma), Crooked nose(trauma), bifid
nose(due maldevelopment), Tapir
Nose(Rhinoscleroma, Leishmaniasis)
Deformity due to tumours of nasal cavity

15. Change in voice
1. Rhinolalia Aperta: Excessive nasal intonation
due palatal cuses.
• Cleft Palate
• Palatal Paralysis
• Submucous Cleft
• Following Adenoidectomy with development of
Velopharyngeal Insufficiency
• Palatal Perforation

16. Change in voice...
2.Rhinolalia Clausa: Loss of nasal intonation due
nasal or nasopharyngeal obstruction.
• Nasal Polyp,
• Turbinate Hypertrophy
• DNS, Rhinitis Medicamentosa
• Adenoids, JNA, other nasopharyngeal mass.

17. Snoring
• Sleep Apnea Syndrome, Enlarged Adenoids,
Tumours of Nasopharynx.