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Nasalobstruction
- 2. Definition
A sense of blockage/ obstruction with in the nose or
difficulty breathing out from one or both nostrils.
- 4. Differential diagnosis of nasal obstruction
Causes of unilateral nasal obstruction
1.Structural: DNS, inf.turbinate
hypertrophy,concha bullosa
2.Infection: Unilateral sinusitis
3.Polyp: Antrochoanal polyp
4.FB
5.Neoplasms
6.Congenital:choanal atresia
7.Trauma
8.Granulomatous Dx:Rhinoscleroma
Causes of Bilateral Nasal obstruction
1.Infection:
-Acute rhinitis
-CRS, Atrophic rhinitis
2.Allergy:Allergic rhinitis
3.Non allergic,non infective:
Vasomotor rhinitis
4.Adenoid hypertrophy
5.Structural: DNS
6.Trauma:Septal hematoma
7. Ethmoidal polyposis
8.Neoplasms
9.Rhinitis medicamentosa
- 5. UNILATERAL NASAL OBSTRUCTION
CONTINUOUS
1. DNS
2. Antrochoanal Polyp
3. FB nose, Rhinolith
4. Benign lesions of maxilla
extending to nasal cavity eg.
Maxillary cyst,
Dental Cyst,
Dentigerous Cyst,
5. Rhinosporidiosis
6.Inverted Papilloma
7. JNA
8. Malignancy
9. Choanal Atresia
INTERMITTENT
1. Hypertrophy Turbinate
Middle / Infeerior
2.Sinusitis
- 6. BILATERAL NASAL OBSTRUCTION
Continuous
1. Adenoids
2. DNS
3. Ethmoidal polyps
4. Atrophic rhinitis
5. Septal Heamatoma
6. Septal abscess
7. Rhinoscleroma
8. Neoplasm
9. Bilateral Choanal Atresia
Intermittent
1. Sinusitis, CRS
2. Allergic Rhinitis
3. Vasomotor Rhinitis
4. Acute Rhinitis
5. Rhinitis Medicamentosa
- 7. How to Evaluate?
ENT examination
1. External Pyramid
2. Anterior Rhinoscopy
3. Posterior Rhinoscopy
4. Cold Spatula Test
5. PNS tenderness
- 9. Anterior rhinoscopy(ARS):
Nasal mucosa- pale/congested/bluish
Septum- deviated/straight/perforated
Lateral wall- inferior and middle turbinates & meati
Floor-Any growth/polyp/presence of mucopus