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Nose, sinuses and nasopharynx - 2. page

L ’ turbinate hypertrophy and turbinoplasty

turbinoplasty
Diagram on Coronal CT examination of ’ intervention of bilateral inferior turbinoplasty

The turbinates are bone covered with mucous membrane that define the lateral wall of the nasal cavity. In each nasal passage there are 3 the turbinates are always present (bottom, medium, top) and one accessory (Supreme).

The turbinates are able to increase or decrease their thickness checking blood flow of the submucosa: they can adjust the air flow ’. The inferior turbinates are mainly responsible for this phenomenon since the passage of the higher air ’ in the lower part of the nasal cavity. Continue reading

Septal perforation

Wide nasal septum perforation in vision from the nasal cavity right
Wide nasal septum perforation in vision from the nasal cavity right

Nasal Ilsetto has two important properties: the first is to split the two nasal cavities by optimizing the passage of air ’, the second is to support the tip of the nose.

Nasal septum can punch for several reasons causing a variety of symptoms that can be of different severity based on the size, the shape and position of drilling. This condition can cause nasal respiratory obstruction, frequent nosebleeds, formation of abundant crusts, It can promote the formation of rhinosinusitis, You may have hissing during nasal breathing, perception of odors (cacosmia) and, rarely, the fall of the tip of the nose.

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Sinusitis

The term ’ means sinusitis inflammation of one or more paranasal sinuses, which are the cavities face covered with mucosa, full d ’ air and communicating with the nasal cavities. You recognize the maxillary sinuses, ethmoidal cells, the sphenoid and frontal sinuses.

Healthy mucous membranes produce small quantities of serum and mucus that protect the sinuses from infection, These secretions are normally drained through small Ostia to the nasal cavities.

A stagnation of secretions all ’ inside paranasal sinuses cause inflammation and encourages the development of bacterial colonies.
Most sinus infections are associated with rhinitis (rhinosinusitis), a more limited number of infections are associated with dental disease (Odontogenic sinusitis).
Most infections are caused by bacteria, less frequently sinusitis can be caused by fungus (fungal sinusitis).

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Wegener with polyangiitis (Wegener's Granulomatosis)

image14Wegener with polyangiitis (GPA or with an old terminology Wegener's Granulomatosis) is a rare Vasculitis affecting small and medium-sized vessels that may involve many organs with predilection for the upper and lower Airways and for kidneys.
Has a prevalence of 2.4-15.7 people each 100000, has a slight predilection for males (♂ : ♀ = 1,5 : 1), the first diagnosis is generally has between 40-55 years. Current treatments allow excellent survival with a good symptom control.
The first symptoms are very often at the level of the upper airways and is therefore often the Otolaryngologist physician who sees patients first and must suspect this disease and confirm the diagnosis and then follow with the patient to an immunologist.

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The nasal bone fractures

TCFONAre very frequent, can be isolated or associated with other cranial fractures.
Are composed and decomposed, the first do not require treatment, can affect the nasal bones and/or the septum.

Can be classified into side and front trauma fractures.
In those side can be affected by trauma 3 plans as a function of increasing kinetic:
I floor: ipsilateral nasal bones with evident sinking;
II floor: nasal septum and nasal bones contralateral;
III floor: fracture of the frontal process of the maxilla and lacrimal bone with possible fragmentation and damage lacrimal apparatus.

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L ’ epistaxis

Epistaxis from the television series Scrubs
Epistaxis from the television series Scrubs

Epistaxis, namely bleeding from the nose is not a disease but a symptom of local or systemic diseases.

Systemic causes (60-70%): arterial hypertension, antiplatelet drugs or anticoagulants, bleeding disorders, piastrinopatie, piastrinopenie, liver failure, kidney failure, scurvy.

Local causes (30-40%): microtrauma from scratching and foreign objects (especially in children), small varicose veins, nasal trauma, facial tissues, craniofacial, rhinitis, Granulomatous rhinitis, vasomotor phenomena (excessive sun exposure), irritating dust, benign tumors (bleeding polyps septal, juvenile fibroangioma), trophic ulcer of nasal septum (cocaine, chrome, cement), malignant tumors (typically cause brownish discharge, streaked with blood), post surgical, Telangiectasia (Rendu-Osler).

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Map of the concentration of pollen – Po Valley

Allergic rhinitis affects about 40 millions of people only in United States of America and may involve up to one person in 6 with a higher prevalence in childhood.
And’ so it's important to understand which are the allergens that trigger the problem and learn which are the levels of concentration in the air of the major parks

Below is a summary of the concentration of pollen found in the Po Valley (including the cities of Turin and Milan) the last week and what the forecast for next week.

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Adenoid hypertrophy

ipertrofiaadenoideaPharyngeal tonsils or adenoids are lymphatic organ which is part of Waldeyer's ring and ’ are placed in the posterior wall of the nasopharyngeal cable, Anatomic area that connects the nasal cavity and oropharynx ’ where l drain the auditory tube tube. Given the small size of the bones of the child the nasopharyngeal cable has a greatly reduced volume than that of adult ’, also given the increased activity of lymphatic tissue in children volume adenoids is greater than that of adult ’. We understand how much easier it can occupy the adenoid tissue nasopharyngeal cable in the child. Adenoid tissue in children is physiologically hypertrophy but we speak of adenoid hypertrophy real when l ’ dimensions given lymphatic tissue causing problems.

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