DEFINATIN CHRONIC DISEASE OF NOSE CHARACTERIZED BY PROGRESSIVE ATROPHY OF THE MUCOSA AND UNDERLYING BONES

AGE----------YOUNGER AGE GROUP

SEX----------FEMALE

(A)PRIMARY ATROPHIC RHINITIS (B)SECONDARY ATROPHIC RHINITIS

(A)PRIMARY ATROPHIC RHINITIS -POOR NUTRITIONAL STATUS -HEREDITARY -AUTOIMMUNE PROCESS -ENDOCRINE DISTURBANCE

-INFECTIONS .COCCOBACILLUS FOETIDUS OZAENAE .KLABSIELLA OZAENAE .DIPHTHEROID BACILLI (B)SECONDARY ATROPHIC RHINITIS .DNS .T.B .SYPHILIS .REPEATED CAUTRY

PHYSIOLOGY NASAL SECRETIONS CONSIST OF: -GOBLET CELLS -MUCOSAL GLANDS -LACRIMAL GLANDS -EPITHELIAL CELLS -BACTERIA -CONDENSED WATER

PATHOLOGICAL PROCESS INFECTION ENDARTERITIS+PERIARTERITIS METAPLASTIC CHANGES CILIATED TO SQU ATROPHY OF MUCOSAL GLANDS+VESSEL DECREASED MUCOCILIARY ACTIVITY + DECREASED SECRETIONS CRUST FORMATION

-CRUSTING IN NOSE -NASAL OBSTRUCTION -EPISTAXIS -HYPOSMIA/ANOSMIA -FOUL SMELL FROM NOSE -ATROPHY OF TURBINATES -ROOMY NASAL CAVITY -EXTERNAL NASAL DEFORMITY

-EXTERNAL NASAL DEFORMITY -ATROPHIC PHARYNGITIS -ATROPHIC LARYNGITIS -HEARING IMPAIRMENT

BLOOD INVESTIGATIONS -BLOOD CP+ ESR -SEROLOGICAL TESTS -PROTEIN PROFILE -NASAL SWAB FOR C/S -NASAL ENDOSCOPY

RADIOLOGICAL INVESTIGATIONS -X-RAY PNS .SIZE OF SINUSES .SECONDARY SEPSIS .BONY DESTRUCTION

(A)CONSERVATIVE MEDICAL TREATMENT

(B)SURGICAL TREATMENT

(A)CONSERVATIVE MEDICAL AIM OF TREATMENT -GENTLE SEPRATION OF CRUSTS -AVOID CRUST FORMATION -DECREASED RISK OF BLEEDING -CONTROLL SEC: INFECTION

a)ALKALINE NASAL IRRIGATION -280 ml OF WARM WATER -28.4gm SODIUM BICARBONATE -28.4gm SODIUM DICARBONATE -56.7gm SODIUM CHLORIDE b)25% GLUCOSE IN GLYCERINE c)REGULAR NASAL CLEANING d)RIFAMPICIN 600mg e)STREPTOMYCIN 1Gm f)POTASSIUM IODIDE

AIM:TO DECREASE THE SIZE OF NASAL CAVITY

A)YOUNGS OPERATION SKIN FOLDS OF THE NOSTRILS ARE RAISED AND SUTURED TOGETHER

B) TRANSPLANTATION OF PAROTID DUCT

C)NARROWING OF NASAL CAVITY: -SUB MUCOSAL INGECTION OF PARAFFIN -SUB MUCOSAL INJECTION OF TEFLON PASTE -SUB MUCOSAL INSERTION OF FAT- CARTILAGE -MEDIAL DISPLACEMENT OF LATERAL WALL OF NOSE

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