Features
Features:

Product Tour >

Edraw AI >

Paid Plans:

Individuals >

Business >

Eduaction >
Resources
Blog

History

How-tos & Tips

Discovery

Biography

Business Analysis

Examples

AI concept Map

Free AI Mind Map Generator

Onenote Mind Map

Bcg Matrix Examples

Nike Marketing Strategy

Unilever SWOT Analysis

Make Mind Maps in Google Docs

Guide

FAQs

What's New

Resource Center
Templates
All Templates

Brain Storming Templates

Strategy and Planning Templates

Project Management Templates

Product Management Templates

Human Resources Templates

Agile Workflow Templates

Marketing Templates

Education Templates

Fun and Games Templates

User Gallery
Download
Pricing
Enterprise

MindMap Gallery Otolaryngology, Head and Neck Surgery--Rhinology 003

Otolaryngology, Head and Neck Surgery--Rhinology 003

Otolaryngology and head and neck surgery mind map, summarizing nasal septum diseases, Nasal and sinus cysts, nasal cavity and sinus tumors, and more. Welcome to like and collect!

Edited at 2024-03-25 23:22:42

PlotWizard

Recent works View more works>>

Otolaryngology, Head and Neck Surgery--Rhinology 003

PlotWizard

Recent works View more works>>

Recommended to you
Outline

Otolaryngology, Head and Neck Surgery--Rhinology 003

Chapter 4 Nasal septum diseases

1. Deviation of nasal septum

[Definition] Refers to the shape of the nasal septum that deviates to one/both sides/partially protrudes, causing nasal cavity dysfunction/symptoms

[Cause] Uneven development of the nasal cavity, trauma, tumors/nasal polyps

【Classification】

form

C type, S type, bony spine/talar process, bony crest, etc.

parts

Cartilage deflection, bone deflection, high deflection, low deflection

[Clinical manifestations]

symptom

Nasal congestion: the most common; often persistent; if there is alternating bilateral nasal congestion, it usually indicates chronic rhinitis.

Epistaxis: The mucosa at the bony spine/ridge is thin and is prone to erosion and bleeding when stimulated by inhaled airflow.

Reflex headache: The protruding part of the deviation contacts/offsets the inferior turbinate/middle turbinate → reflex headache on the same side

Symptoms involving adjacent structures: such as sinusitis

examine

Anterior rhinoscope: can determine the type and degree of deviation

Nasal endoscopy: can observe the anatomical relationship between the nasal septum, turbinates, and nasal passages and its impact on ventilation and drainage of the nasal cavity and sinuses.

Sinus CT: ①Preoperative and postoperative evaluation; ②Discover whether other diseases exist at the same time

[Treatment] Those with clear diagnosis and obvious symptoms, those with hyperresponsive nasal mucosal disease accompanied by nasal septum deviation but conservative treatment is ineffective, and those with nasal septum deviation affecting the surgical operation and effect during endoscopic sinus surgery should all be treated; classic The method is submucosal resection of the nasal septum, and now septoplasty is often used. If there is still nasal ventilation disorder after correction of the deviation, inferior turbinate externalization/partial inferior turbinate resection can be performed at the same time.

2. Perforation of nasal septum

[Characteristics] It is more common after nasal septum surgery; for small perforations in the front, a whistling sound can be heard when breathing, but there are no obvious symptoms for perforations at the back; patients with large perforations may experience nasal dryness, scabs, and nosebleeds; lymph nodes Perforations caused by tumors, syphilis, tuberculosis, etc. are often accompanied by foul-smelling purulent discharge; surgical treatment is mainly used, such as mucosal displacement suture repair, nasal floor mucosal inversion displacement suture, inferior turbinate free mucosal flap repair, mucosal patch prosthetics

Chapter 5 Nasal and Sinus Cysts

1. Nasal vestibular cyst

[Pathology] A cystic mass that occurs under the skin at the base of the nasal vestibule, anterolateral to the piriform foramen, and in the soft tissue superficial to the alveolar process of the maxilla; it is round in shape, and the adjacent bone may be compressed and absorbed to form a depression.

[Clinical manifestations] Most common in women aged 30 to 50 years old; cysts grow slowly and are asymptomatic in the early stage. In the late stage, nasal congestion and swelling in the nose/upper lip may occur; in the event of concurrent infection, they can rapidly increase in size and worsen local pain; puncture of fluid can confirm the diagnosis

[Treatment] If the cyst is large and causes nasal facial deformity, nasal congestion, or infection, it should be surgically removed. 2. Cyst of nasal sinus

【Classification】

1. Mucocele cyst of nasal sinus: the most common; mostly seen in the ethmoid sinus and often unilateral, but can become more destructive after infection; develops slowly, and seek medical attention only when pharyngeal symptoms often occur

2. Mucosa cyst of nasal sinus/sinus serous cyst: more common in the maxillary sinus, unilateral/bilateral; grows very slowly and can rupture naturally to a certain extent, with cyst fluid flowing out from the sinus ostium; often asymptomatic , often discovered accidentally during sinus X-ray/CT examination

[Clinical manifestations]

symptom

It grows slowly and may not cause any discomfort/only headache when it is limited to the sinus; corresponding symptoms may occur when the cyst enlarges and compresses/destroys the bone wall of the sinus and invades the orbit/intracranium; symptoms worsen when secondary infection occurs.

Eye symptoms: eyeball displacement, tearing, double vision, headache, eye pain, apex syndrome ①

Apical syndrome: The cyst compresses the optic nerve and superior orbital fissure, causing dysfunction of the II, III, IV, V, and VI cranial nerves, causing symptoms such as vision loss, ophthalmoplegia, ocular sensory disturbance, and pain.

Facial symptoms: local bulge, ping pong ball/eggshell shape to touch, and may appear undulating when bone is absorbed and disappears

Nasal symptoms: spontaneous intermittent rhinorrhea, nasal congestion, hyposmia

examine

CT: Used for the diagnosis and localization of cysts; it appears as a round mass with uniform density and smooth edges, with compression and absorption of adjacent bone and a thin bone shell, which can show invasion into the orbit and intracranium.

[Treatment] After the diagnosis is clear, surgery is the only treatment method. The principle is to establish a permanent passage between the cyst and the nasal cavity; however, small asymptomatic cysts can be followed up for observation.

Chapter 6 Tumors of the Nasal Cavity and Paranasal Sinuses

Section 1 Benign tumors of the nasal cavity and paranasal sinuses

1. Hemangioma

[Pathology] The most common benign tumor of the nasal cavity; divided into capillary hemangioma (more common, more common in the nasal septum), cavernous hemangioma (more common in the inferior turbinate and maxillary sinus)

[Clinical manifestations] More common in young adults

symptom

Nasal symptoms: progressive nasal congestion, recurrent epistaxis

Compressive symptoms: facial deformity, eyeball displacement, double vision, headache

Systemic symptoms: anemia, hemorrhagic shock

examine

Red, soft, elastic tumors

Imaging, pathology biopsy

[Treatment] Mainly surgical treatment (endoscopic sinus surgery is preferred) to completely remove the mucosa including the tumor and the root.

2. Papilloma

[Pathology] The most common locations are nasal vestibule, nasal septum, middle turbinate, ethmoid sinus, and maxillary sinus; they are divided into the following two types:

1. Hard type: The tumor is small, hard, gray in color, localized and solitary; mainly composed of squamous epithelium

2. Soft type: The tumor is larger, soft, red in color, and grows diffusely; it is mainly composed of transitional cells and columnar cells. It can grow inward and concave in the subepithelial matrix (inversion type), but does not break through the base. membrane; prone to recurrence after surgery, malignant transformation after multiple surgeries, and tissue destruction when multiple invasive growths occur

[Clinical manifestations]

symptom

Mostly unilateral, the main symptoms are progressive nasal congestion, mucopurulent discharge with blood, accompanied by sinusitis and nasal polyps.

Signs of malignant transformation: rapid recurrence after resection, invasion of adjacent paranasal sinuses, repeated bleeding, intractable headache

examine

Tumors are divided into hard and soft types, and they bleed easily when touched.

Imaging, pathological biopsy (confirmed diagnosis)

【Treatment】Inverted papilloma should undergo radical resection

3. Osteoma

[Pathology] The most common benign sinus tumor; more common in the frontal sinus and ethmoid sinus; divided into dense type (slow growth, more common in the frontal sinus), cancellous type (fast growth, more common in the ethmoid sinus), mixed type (external hardness) Internal loosening, more common in the frontal sinus)

[Clinical manifestations] More common in young men

symptom

Growth is slow; small cases are asymptomatic, while large cases can cause local pain and pressure on surrounding structures (proptosis, diplopia, headache, nausea and vomiting)

examine

Nasal CT: round high-density shadow

[Treatment] Surgical resection is the main method (especially for those with large tumors, obvious symptoms, craniofacial deformities, intracranial spread, and intracranial complications)

Section 2 Malignant tumors of the nasal cavity and paranasal sinuses

[Pathology] Primary malignant tumors in the nasal cavity are rare; malignant tumors in the paranasal sinuses are most common in the maxillary sinus and the least common in the frontal sinus; histologically, squamous cell carcinoma is the most common

[Clinical manifestations]

symptom

Malignant tumors of the nasal cavity: In the early stage, there are often unilateral progressive nasal congestion, bloody discharge, foul-smelling purulent discharge/flesh-colored watery discharge, accompanied by headache, hyposmia/loss of sense of smell; in the late stage, symptoms of sinus malignant tumors are manifested due to invasion of the sinuses and orbits.

Sinus malignancy

Malignant tumor of maxillary sinus

Early stage tumors: small, mostly limited to the inner and upper area of the maxillary sinus

With the development of tumors, there may be

Pulmonary discharge: multiple sides; late stage may have a foul odor

Cheek pain and numbness: caused by invasion of infraorbital nerve; has early diagnostic value

Nasal congestion: progressively worse on multiple sides

Pain and looseness of molar teeth: often misdiagnosed as dental disease, but symptoms remain after tooth extraction

In the late stage, the sinus wall can be destroyed and invade adjacent tissues.

Cheek bulge: destroys the front wall; infringes the soft tissue of the cheek and can cause fistulas and ulcers

Eye symptoms: tearing (oppression of nasolacrimal duct); eyeball upward movement, ophthalmoplegia, limited eye movement, diplopia

Hard palate and alveolar deformation

Backward invasion into the pterygopalatine fossa and medial pterygoid muscle: intractable neuralgia and difficulty opening the mouth; indicating late stage and poor prognosis

Infringement of skull base: medial canthus mass, difficulty opening mouth, temporal bulge, headache, earache

Cervical lymph node metastasis: indicates advanced stage, more common in ipsilateral submandibular lymph nodes

∎ Ethmoid sinus malignant tumors may be asymptomatic in the early stages; if they invade the nasal cavity, they will cause unilateral nasal congestion, bloody discharge, headache, and smell disturbance; then they are most likely to grow into the orbit, and may also invade the retrobulbar and orbital apex (proptosis (nasal tumors) most likely to cause), oculomotor nerve palsy), intracranial, lymph node

Malignant tumors of frontal sinus and sphenoid sinus: rare

examine

Anterior and posterior rhinoscopy: Most of the new organisms in the nasal cavity are cauliflower-shaped and broad-based, with ulcers and necrotic tissue often present on the surface and prone to bleeding. Posterior rhinoscopy is required in every case, with special attention to the choanal area and nasopharynx. The condition of the top, Eustachian tube and pharyngeal opening Nasal endoscopy: can enter the sinuses for observation

Pathological biopsy

Videography

[Differential diagnosis] Hemangioma, papilloma, nasal polyps, benign hemorrhagic neoplasms of maxillary sinus, maxillary sinus cyst

【treat】

in principle

Many advocates early comprehensive therapy based on surgery, including preoperative radiotherapy, complete surgical resection of the primary tumor, unilateral/bilateral lymph node dissection if necessary, and postoperative radiotherapy and chemotherapy; the first treatment is the key to the success or failure of the treatment. The essential

radiotherapy

Radical radiotherapy alone: only suitable for malignant tumors that are sensitive to radiotherapy (such as sarcoma, undifferentiated carcinoma)

Palliative radiotherapy alone: suitable for advanced and incurable tumors

Preoperative radiotherapy: surgical resection after 6 weeks

Surgical treatment

Lateral rhinotomy: suitable for removal of malignant tumors in the nasal cavity

Total maxillectomy: suitable for malignant tumors of the maxillary sinus and ethmoid sinus

Extended total maxillary resection: suitable for patients with extensive maxillary malignant tumors that have invaded the infratemporal fossa; advantages: good hemostasis (the maxillary artery can be ligated during the operation), prevention/relief of mouth opening difficulties, and easy treatment of the pterygopalatine fossa and temporal fossa. inferior fossa tumor

Chemotherapy

Used as appropriate, variable pressure chemotherapy can improve efficacy