deviated nasal septum n.
Download
Skip this Video
Loading SlideShow in 5 Seconds..
Deviated Nasal Septum PowerPoint Presentation
Download Presentation
Deviated Nasal Septum

Loading in 2 Seconds...

play fullscreen
1 / 67

Deviated Nasal Septum - PowerPoint PPT Presentation


  • 1511 Views
  • Uploaded on

Deviated Nasal Septum. Dr. Vishal Sharma. Aetiology. 1. Trauma: blow on nose 2. Developmental:  Birth moulding  High arched palate  Unequal growth b/w skull base & palate 3. Mass in opposite nasal cavity 4. Racial factors: common in Europeans

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

Deviated Nasal Septum


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
    Presentation Transcript
    1. Deviated Nasal Septum Dr. Vishal Sharma

    2. Aetiology 1.Trauma: blow on nose 2.Developmental:  Birth moulding  High arched palate  Unequal growth b/w skull base & palate 3.Mass in opposite nasal cavity 4.Racial factors: common in Europeans 5.Hereditary: in posterior D.N.S.

    3. Types 1. Anterior / caudal dislocation 2. C-shaped deformity 3. S-shaped deformity 4. Septal Spur: shelf-like projection 5. Septal Thickening: organized hematoma or over-riding of septal fragments 6. Impacted septum: despite decongestion

    4. Anterior / caudal dislocation

    5. C - shaped

    6. S - shaped

    7. Nasal septal spur

    8. Thickened & impacted nasal septum

    9. C-shaped DNS not touching lateral nasal wall

    10. C-shaped DNS touching lateral nasal wall

    11. Compensatory turbinate hypertrophy

    12. Clinical features • Nasal block: present on side of D.N.S. C/L paradoxical nasal obstruction due to compensatory inferior turbinate hypertrophy. 2. Recurrent cold: due to associated sinusitis 3. Headache: due to contact with lateral wall (Sluder’s neuralgia), sinusitis

    13. Clinical features 4. Epistaxis: stretched mucosa on DNS  dry crusting & bleeding on removal; stretched blood vessels over spur. 5. Hyposmia: seen in high D.N.S. 6. External nasal deformity

    14. Sequelae • Sinusitis • Mouth breathing snoring, pharyngitis • Atrophic rhinitis & myiasis • Otitis media

    15. History of septal surgeries

    16. Edwin Smith Surgical Papyrus (dated 17th century BC): world's oldest surgical document & only surviving copy of a part of an Ancient Egyptian textbook on trauma surgery written in 3500 B.C. Listed are 48 traumatic injury cases, with description of examination, diagnosis & treatment. • Treatment of DNS:fracture reduction of DNS with internal pack using grease coated linen & external packing with stiff rolls of linen.

    17. Edwin Smith Papyrus

    18. Bosworth operation (late 19th century):deviated part of septum amputated along with mucosa • Asch (1899):full thickness cruciate incisions on septal cartilage • Freer (1902):SMR of total septal cartilage • Killian (1904):SMR with preservation of dorsal & caudal portion of septal cartilage • Metzenbaum (1929):Swinging door technique for caudal septal dislocation • Peer (1937):Removal of caudal septum & replacement after its alteration • Cottle (1948) :Maxilla-Premaxilla septoplasty

    19. Gustav Killian

    20. Maurice Cottle

    21. Indications for septal surgery 1. D.N.S.: nasal obstruction / sinusitis / headache / epistaxis 2. Along with rhinoplasty 3. Harvesting of septal cartilage graft 3. Trans-septal surgeries:  Hypophysectomy  Vidian neurectomy 4. Hereditary telengiectasia

    22. Septoplasty

    23. Freer’s Incision

    24. Cottle’s line Drawn from frontal spine to anterior nasal spine. Deviations anterior to it can be treated by septoplasty only. Posterior to it by SMR or septoplasty.

    25. Muco-perichondrial flap elevation on right side

    26. Anterior + Inferior tunnels

    27. Inferior cartilage strip removal

    28. Dislocation of bony cartilaginous junction

    29. Muco-periosteal flap elevation on both sides

    30. Cartilage + Bone removed

    31. Scoring & cross-hatching

    32. Wedge excision & shaving

    33. Anterior nasal packing

    34. Outer nasal packing

    35. Submucosal Resection

    36. Killian’s incision

    37. Muco-perichondrial flap elevation on right side

    38. Cutting of cartilage & elevation of opposite flap

    39. Excision of septal cartilage

    40. Excision of septal cartilage

    41. Cartilage + Bone removed

    42. Anterior nasal packing

    43. Complications of septal surgery 1. Haemorrhage 2. Septal haematoma 3. Septal abscess 4. Septal perforation 5. Saddle nose 6. Columellar retraction 7. Flapping septum 8. Persistent deviation 9. Nasal synechia 10. C.S.F. rhinorrhoea 11. Infection 12. Toxic shock syndrome

    44. Septal haematoma Collection of blood under perichondrium & periosteum of nasal septum. Aetiology: 1. Nasal trauma 2. Septal surgery 3. Bleeding disorders

    45. Clinical features • Bilateral nasal obstruction • Sense of pressure over nasal bridge • B/L smooth, rounded septal swelling • On palpation mass is soft & fluctuant • Absence of raised temperature, erythema, swelling & tenderness of skin over nose.

    46. Septal Haematoma

    47. Treatment 1. Small: wide bore needle aspiration 2. Large: a. incision & drainage b. nasal packing (prevent recurrence) c. systemic antibiotics (prevent abscess)

    48. Complications • Thickened nasal septum • Septal abscess with cartilage necrosis • Saddle nose • Supra-tip deformity • Septal perforation

    49. Septal abscess Collection of pus under perichondrium & periosteum of nasal septum. Aetiology: 1. secondary infection of septal hematoma 2. following furuncle of nose or upper lip 3. following typhoid or measles