DISEASES OF EXTERNAL NOSE

 CELLULITIS
 Causes: Streptococci or staphylococci invasion of nasal skin
 Symptoms: Red, swollen, and tender nose
 Treatment: Systemic antibacterials, hot fomentation, and analgesics

NASAL DEFORMITIES

 SADDLE NOSE
 Causes: Trauma, septal cartilage destruction (hematoma, abscess),
leprosy, tuberculosis, syphilis
 Correction: Augmentation rhinoplasty with cartilage, bone, or synthetic
implant
 HUMP NOSE
 Causes: Bone or cartilage involvement
 Correction: Reduction rhinoplasty, hump removal, narrowing of lateral
walls
 CROOKED OR A DEVIATED NOSE
 Causes: Trauma, injuries sustained during birth or childhood
 Correction: Rhinoplasty or septorhinoplasty to correct appearance and
function of the nose

Note: Rhinoplasty and septorhinoplasty aim to correct both the outer appearance
and function of the nose.

NORMAL SADDLE SUPERTIP HUMPED

DEPRESSION
 Crooked nose
Deviated nose

Types of dermoids. (A) Simple dermoid beneath the skin. (B) Dermoid with an external pit or sinus. It lies in front of septum and
deep to nasal bones. (C) Dermoid with an intracranial connection to dura.

TUMOURS

 Congenital Tumours
 Dermoid cysts
 Simple dermoid
 Dermoid with a sinus
 Encephalocele or meningoencephalocele
 Glioma
 Benign Tumours
 Rhinophyma
  Haemangioma
 Pigmented naevus
 Seborrhoeic keratosis
 Neurofibroma
 Sweat gland tumour
 Malignant Tumours
 Basal cell cancer
 Squamous cell cancer
 Melanoma

TUMOURS

 Congenital Tumours
 Dermoid cysts
 Simple dermoid
 Midline swelling under the skin in front of the nasal bones
 No external opening
 Dermoid with a sinus
 Pit or sinus in the midline of the dorsum of the nose
 Hair may be seen protruding through the sinus opening
 Sinus track may lead to a dermoid cyst under the nasal
bone or have an intracranial dural connection
 Treatment: splitting of nasal bones to remove any
extension in the upper part of nasal septum,
neurosurgical-otolaryngologic approach for intracranial
extension
 Encephalocele or meningoencephalocele
 Herniation of brain tissue and meninges through a congenital
bony defect
 Present as subcutaneous pulsatile swelling in the midline at the
root of the nose, side of the nose, or anteromedial aspect of the
orbit
 Treatment: neurosurgical, severing the tumor stalk and repairing
the bony defect
 Glioma
 Nipped off portion of encephalocele during embryonic
development
 Extranasal or intranasal presentations
 Extranasal gliomas are encapsulated and can be easily removed
by external nasal approach
Benign Tumours
Rhinophyma (potato tumour)
 Hypertrophy of sebaceous glands at the tip of the nose
 Presents as a pink, lobulated mass with vascular dilation
 Treatment: paring down the tumour, skin grafting if necessary

 Malignant Tumours
 Basal cell carcinoma (rodent ulcer)
 Most common malignant tumour involving the skin of the nose
 Slow-growing, often remains confined to the skin
 Treatment: cryosurgery, irradiation, surgical excision
 Squamous cell carcinoma (epithelioma)
 Second most common malignant tumour
 Infiltrating nodule or ulcer with rolled-out edges
 Treatment: radiotherapy, surgical excision, plastic repair
 Melanoma
 Least common variety
 Superficially spreading or nodular invasive type
 Treatment: surgical excision

DISEASES OF NASAL VESTIBULE

 Furuncle or Boil
 Acute infection of the hair follicle by Staphylococcus aureus
 Predisposing factors: trauma from picking the nose or plucking nasal
vibrissae
 Treatment: warm compresses, analgesics, antibiotics, incision and
drainage if necessary
 Vestibulitis
 Diffuse dermatitis of the nasal vestibule
 Predisposing factors: nasal discharge, trauma from handkerchief, S.
aureus infection
 Acute form: red, swollen, tender skin with crusts and scales; may involve
upper lip
 Chronic form: induration of vestibular skin with painful fissures and
crusting
 Treatment: cleaning the vestibule, antibiotic-steroid ointment, silver
nitrate cauterization, addressing the underlying cause
 Stenosis and Atresia of the Nares
 Web formation and stenosis of anterior nares due to trauma or
inflammatory lesions
 Young's operation for deliberate closure of nares in atrophic rhinitis
  Congenital atresia of anterior nares is a rare condition
 Correction through reconstructive plastic procedures
 Tumours
 Nasoalveolar cyst: smooth bulge in the lateral wall and floor of nasal
vestibule, excised through sublabial approach
 Papilloma or wart: single or multiple, pedunculated or sessile, surgical
excision
 Squamous cell carcinoma: arises from the lateral wall of the vestibule,
may extend into nasal floor, columella, and upper lip, treatment with
surgical excision or irradiation