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Ebook Self assessment and review ENT (7/E): Part 2

Part 2 book "Self assessment and review ENT" has contents: Granulomatous disorders of nose, nasal polyps and foreign body in nose, granulomatous disorders of nose, nasal polyps and foreign body in nose, anatomy of pharynx, tonsils and adenoids, pharynx hot topics, lesions of nasopharynx and hypopharynx including tumors of pharyn,. and other contents. | 17 chapter Granulomatous Disorders of Nose, Nasal Polyps and Foreign Body in Nose GRANULOMATOUS DISEASES OF THE NOSE Bacterial Fungal Unspecified/Causes yySyphilis yyRhinosporidiosis yyWegener’s granulomatosis yyTuberculosis yyAspergillosis yyLupus yyMucormycosis yyNon-healing midline granuloma yyRhinoscleroma yyCandidiasis yySarcoidosis yyLeprosy yyHistoplasmosis yyBlastomycosis BACTERIAL INFECTIONS LUPUS VULGARIS yy It is an indolent and chronic form of tuberculous infection. yy Female: Male ratio is 2:1 yy Most common site is the mucocutaneous junction of the nasal septum, the nasal vestibule and the ala. yy Characteristic feature is the presence of apple-jelly nodules (Brown gelatinous nodules) in skin. yy Cutaneous lesion involving external nose has a typical butterfly appearance. yy Lupus can cause perforation of cartilaginous part of nasal septum yy Confirmation is by biopsy. yy T/t = ATT. SYPHILIS (FLOW CHART 17.1) Flow Chart 17.1:  Types and clinical feature of syphilis 210 SECTION II  Nose and Paranasal Sinuses RHINOSCLEROMA (MIKULCIZ DISEASE) It is chronic, progressive granulomatous disease commencing in the nose and extending into the nasopharynx and oropharynx, larynx (subglottic area), trachea and bronchi. Organism Klebsiella rhinoscleromatis (Gram-negative Frisch bacillus). Features yy Scleroma can occur at any age and in either sex. yy The disease has following stages: Atrophic Stage Resembles atrophic rhinitis and is characterized by foul smelling purulent nasal discharge and crusting. Granulomatous Stage yy Proliferative stage yy The stage is characterized by granulomatous reactions and presence of ‘Mikulicz cells’ yy Painless nodules are formed in nasal mucosa. yy Subdermal infiltration occurs in lower part of external nose and upper lip giving a woody feel. yy Severe cases may lead to broadening of nose due to thickening of the skin with characteristic “Hebra-nose”. Diagnosis yy Biopsy shows submucosal infiItrates