Raiyyan Tahsan

Raiyyan Tahsan
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ENT Case No 14.Nose Diseases.

1. Nose Symptoms:-

Nasal congestion/blockage – Seen in allergic rhinitis, sinusitis, or nasal polyps.

Nasal discharge (Rhinorrhea) – Clear in allergies, purulent in infections, and bloody in trauma or tumors.

Sneezing – Common in allergic rhinitis.

Loss of smell (Anosmia) – Seen in sinus infections, nasal polyps, or post-viral infections (e.g., COVID-19).

Facial pain/pressure – Associated with sinus infections or sinusitis.

Nosebleeds (Epistaxis) – Can be due to trauma, dry air, hypertension, or bleeding disorders.

2. Nose & Sinus Examination:-

a) External Nose Inspection & Palpation

Look for deformities, swelling, or nasal asymmetry.

Check for tenderness over sinuses (frontal, maxillary) in sinusitis.

b) Anterior Rhinoscopy (Using a Nasal Speculum & Light Source)

Inspect nasal mucosa, septum, turbinates, and presence of polyps.

Look for discharge, bleeding, or foreign bodies.

c) Posterior Rhinoscopy (Using a Mirror or Flexible Nasopharyngoscopy)

Examines the nasopharynx, adenoids, and posterior nasal structures.

d) Smell Test (Olfactory Function Test)

Simple assessment using coffee, peppermint, or alcohol to check for anosmia (loss of smell).

Common Investigations in Otolaryngology:-

1. Laboratory Investigations:-

Complete Blood Count (CBC): To check for infection (elevated WBCs in bacterial infections).

C-Reactive Protein (CRP) & Erythrocyte Sedimentation Rate (ESR): To assess inflammation

Allergy Testing (IgE Levels, Skin Prick Test): For allergic rhinitis.

2. Radiological Investigations:-

X-ray Nasopharynx (Soft Tissue Lateral View): For adenoid hypertrophy.

X-ray Paranasal Sinuses (Water’s View): For sinusitis.

CT Scan (Contrast/Non-contrast),

CT PNS (Paranasal Sinuses): For chronic sinusitis, polyps, or tumors.

4. Endoscopic Examinations:

Flexible Nasopharyngoscopy: For nasal obstruction, adenoid hypertrophy, or vocal cord examination.

Rigid Nasal Endoscopy: For nasal polyps, chronic sinusitis, or epistaxis.

Laryngoscopy (Indirect/Mirror or Direct): For voice disorders, vocal cord lesions, or laryngeal tumors.

Otoscopy & Microscopic Ear Examination: For ear infections, perforation, or cholesteatoma.

  Common Surgeries in Otolaryngology:-

1. Adenoidectomy:

Indication: Chronic nasal obstruction, recurrent otitis media, sleep apnea.

Procedure: Removal of the adenoids through the nasal cavity.

2. Septoplasty:

Indication: Deviated nasal septum causing obstruction, chronic sinusitis.

Procedure: Correction of the septum to improve nasal airflow, usually via a closed technique.

3. Functional Endoscopic Sinus Surgery (FESS):

Indication: Chronic sinusitis, nasal polyps, or other sinonasal disorders.

Procedure: Endoscopic removal of polyps, drainage of sinuses, and correction of sinus pathology.

4. Endoscopic Resection of Nasopharyngeal Tumors:

Indication: Tumors or masses in the nasopharynx, such as benign or malignant growths.

Procedure: Removal of tumors using endoscopic techniques, often through the nose, to avoid external incisions.

 Commonly Used Drugs in Otolaryngology:-Nose Diseases

1. Antibiotics (For Bacterial Infections)

  • Amoxicillin-Clavulanate (Augmentin)
  • Tablet 1.Moxaclav 500 mg(500mg+125mg).(AS A (Amoxicilline+Clavulanic Acid)AS A Broad spectrum penicillins).

Dose: 625 mg TID (three times daily) or 1g BID (twice daily)

  • Cefuroxime (2nd Gen Cephalosporin):-
  • Tablet 1.Cefotil Plus 500mg (500mg+125mg).(AS A Cefuroxime Axetil +Clavulanic Acid),(AS A Second generation Cephalosporins, Vaccines, Anti-sera & Immunoglobulin).

Dose: 500 mg BID

  • Azithromycin (Macrolide, for Penicillin-Allergic Patients)
  • Tablet 1.Zimax 500 AS A Azithromycin Dihydrate AS A Macrolides.

Dose: 500 mg once daily for Day 1, then 250 mg daily for 4 more days

  • Ceftriaxone (Severe Infections, IV Use)

Dose: 1–2 g IV once daily

Injection 1.Ceftron Iv 500mg/vial (AS A Ceftriaxone Sodium AS A Third generation Cephalosporins.).

  • Metronidazole (For Anaerobic Infections, e.g., Peritonsillar Abscess)
  • Tablet 1.Metro 400 (AS A Metronidazole AS A Amoebicides, Anti-diarrhoeal Antiprotozoal).

Dose: 400 mg TID

2. Antihistamines & Decongestants :-

  • Loratadine (Non-Sedating Antihistamine)
  • Tablet 1.Loratin 10 mg (AS A Loratadine AS A Non-sedating antihistamines)

Dose: 10 mg once daily

OR

  • Cetirizine
  • Tablet 1.Alatrol 10 mg (AS A Cetirizine Hydrochloride AS A Sedating Anti-histamine.)

Dose: 10 mg once daily

3. Corticosteroids (For Inflammation & Allergic Conditions)

  • Prednisolone (Systemic Steroid)

Tablet 1.Cortan 20 mg (AS A Prednisolone AS A Glucocorticoids).

Dose: 40 mg once daily for 5 days, then taper

  • Dexamethasone (IV/Oral, Potent Steroid)

Tablet 1.Dexonex 0.5mg (AS A Dexamethasone AS A synthetic glucocorticoid).

Injection 2. Dexonex IM/IV 5mg/ml 1ml Ampoule (AS A Dexamethasone AS A synthetic glucocorticoid).

Dose: 4–8 mg once daily

4. Analgesics & Antipyretics (For Pain & Fever)

  • Paracetamol (Acetaminophen)

Tablet 1.Pyrenol 500 mg AS A Paracetamol.

Dose: 500–1000 mg every 6 hours

  • Ibuprofen (NSAID, Anti-inflammatory)

Tablet 1. Clofenac SR 100MG (Sustained Released) (AS A Diclofenac Sodium AS A Drugs for Osteoarthritis, Drugs used for Rheumatoid Arthritis, Non-steroidal Anti-inflammatory Drugs (NSAIDs)).

Dose: 400–600 mg every 8 hours

  • Diclofenac (Potent NSAID)

Dose: 50 mg twice daily

Nasal spray 1.Fluticasone Nasal Spray (Intranasal Steroid for Allergic Rhinitis)

Nasal Spray 1.Lutisone 50mcg/Spray (AS A Fluticasone Propionate 120metered Spray AS A Fluocinolone & Combined Preparations, Nasal Steroid Preparations).

Dose: 2 sprays per nostril once daily

  • Xylometazoline Nasal Spray (Decongestant for Short-Term Use)

Nasal Spray 1.Antazol 0.1% 15ml Drop (AS A Xylometazoline Hydrochloride AS A Nasal Anti-histamine preparations).

Dose: 1 spray per nostril every 8–12 hours

Raiyyan Tahsan Date:-5-02-2025 Wednesday Time:-2-25-45 Pm

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