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DISEASES OF OLFACTORY
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DISEASES OF OLFACTORY See also:SYSTEM See also:External Affections and Injuries of the See also:Nose.—Acne rosacea is one of the most frequent nasal skin affections. In an See also:early See also:stage it consists of See also:dilatation or congestion of the capillaries, and later of a See also:hypertrophy of the sebaceous follicles. This may be accompanied by the formation of pustules. In an exaggerated stage the sebaceous glands become overgrown, forming large protuberant nodular masses over which the dilated capillaries are plainly visible. This See also:condition is termed lipoma See also:nasi (rhinophynia or See also:hammer nose), though there is no increase in fatty See also:tissue. Nasal See also:acne occurs mainly in dyspeptics and See also:tea drinkers, and the more advanced condition, lipoma nasi, chiefly in elderly men addicted to al- coholism. The treatment of acne is the removal of the See also:dyspepsia with the See also:local application of See also:sulphur ointment or of a lotion of perchloride of See also:mercury. Un- sightly capillaries may be destroyed by an application of the galvano-cautery or by See also:electrolysis. See also:Free See also:dissection of the re- dundant tissue from around the nasal cartilages is necessary in lipoma nasi, skin being grafted on to the raw See also:surface. The nasal bones are frequently fractured as the result of See also:direct violence, as by a See also:blow from a See also:cricket See also:ball or stick. The fracture is usually transverse, and may be communicated, leading to much deformity if See also:left untreated. The treatment is the immediate reposition of the bony fragments. The old-See also:standing cases where there is considerable depression Cerebral wiring the fragments may be resorted to. 'hemi- In numerous cases the subcutaneous See also:sphere injection of See also:paraffin may improve the shape of the See also:organ. Deflection of the septum may also result from similar injuries, and lateral displacement may cause subsequent nasal obstruction and require the straightening of the septum. Lesions involving considerable loss of substance due to injury or to syphilitic or tuberculous disease have led to many methods being devised to See also:supply the missing See also:part. In the See also:Indian method of rhinoplasty a flap is cut from the fore-See also:head, to which it is left attached by a pedicle; the flap is then turned down-wards to See also:cover the missing portion of the nose; when the parts have See also:united, the pedicle is cut through. In the See also:Italian operation devised by Tagliacotius (See also:Tagliacozzi), a flap was taken from the patient's See also:arm, the arm being kept fixed to the head until the flap has united. Diseases of the Interior of the Nose.—Epistaxis or bleeding of the nose may arise from many conditions. It is particularly See also:common in See also:young girls at the See also:time of See also:puberty, being a See also:form of vicarious menstruation. It also occurs in cerebral congestion, See also:heart disease, See also:scurvy, haemo- phylia, or as a sign of local disease. The treatment will depend upon the cause. In patients with high arterial tension epistaxis may be of direct benefit. In other cases See also:rest on the back may be tried, with the local application of tanno-gallic See also:acid or hazelin or adrenalin, either in a spray or on absorbent See also:cotton. If these should not stop the See also:haemorrhage the nose must be plugged. In cases which arise from specific forms of ulceration, such as See also:tuberculosis and syphilis, the See also:area should be rendered anaesthetic by See also:cocaine, the bleeding points found, and the vessels obliten ted by the electrocautery. Polypi in the nasal passages are also a frequent cause of epistaxis.
Rhinitis, or inflammation of the mucous membrane of the nose, occurs both in acute and chronic forms. Of the acute he See also:simple catarrhal form termed "coryza " forms the widely known See also:cold in the head." The tendency of acute coryza to affect entire families, and to be communicable from one See also:person to another, points to its infectious nature, though probably some predisposing condition of See also:health is necessary for its development. It is considered proved that the symptoms are due to the presence and development of
Mesencephalon
See also:Eye
Globular See also:process
Prosencephalon
IV
Lateral nasal process
Olfactory See also:pit
Mesial nasal process
Globular process
the two globular processes, the intervention of the olfactory pits between the mesial and lateral nasal processes, and the approximation of the maxillary and lateral nasal processes, which, how-ever, are separated by the oculo-nasal sulcus (from His).
IV. Transverse See also:section of head of embryo, showing the deepening of the olfactory pits and their relation to the hemisphere vesicles of the fore-See also:brain.
several distinct micro-organisms. Of these the most important is the micrococcus catarrhalis described by See also: One attack of coryza conveys no See also:immunity from subsequent attacks, and some persons seem particularly susceptible. The treatment is directed towards increasing the See also:action of the kidneys, skin and bowels, A brisk See also:mercurial purgative is indicated, and See also:salicin and aspirin are useful in many cases. Considerable See also:relief may be obtained by washing out the nasal cavities several times a See also:day with a warm lotion containing boric acid. Those who are unusually prone to catch cold should habituate themselves to an open See also:air See also:life by day and an open window by See also:night, See also:adenoids or enlarged tonsils should be removed, and the See also:diet should be modified so as not to contain an excess of starchy foods. An acute croupous inflammation occasionally attacks the nasal mucous membrane when the Klebs-Lofffer bacillus is not See also:present, but the nasal membrane often shares in true See also:diphtheria, or it may be the only organ to be infected thereby. The diagnosis is of course bacteriological. As a result of frequent catarrhal attacks the nasal mucous membrane may become the seat of a chronic rhinitis in which the turbinals become swollen with oedema, and congested and finally thickened by increase in the fibrous tissue. There is an excessive muco-purulent discharge, and the patient is unable to breathe through the nose; deafness and adenoid vegetations may be the result. In the early stages the nasal cavity should be washed out night and See also:morning with an alkaline lotion, such as bicarbonate of soda, or a See also:caustic, such as chromic acid, should be used in swabbing over the affected part. The application of the galvano-cautery here is useful, but when the areas are much hypertrophied the hypertrophied portion of the inferior turbinals may have to be removed under cocaine. A See also:special form of recurrent hypertrophic rhinitis is See also:hay See also:fever (q.v.). Rhinitis Sicca is a form of chronic rhinitis in which there is but little discharge, crusts or scabs which may be difficult to remove forming in the nasal cavities; the pharynx may be also affected. Atrophic rhinitis or ozaena usually attacks See also:children and young adults, following on See also:measles or See also:scarlet fever. Crusts form, and favour the retention of the purulent discharge. The disease may extehd to the nasal sinuses and septic absorption take See also:place. The treatment is to keep the nasal cavity clean by See also:irrigation with See also:solution of permanganate of potash or carbolic acid lotion, the nose then being wiped and smeared with See also:lanolin or partially plugged with a tampon of cotton-See also:wool, the process being repeated at frequent intervals, the See also:general treatment being that for See also:anaemia. Disease of the See also:middle turbinated See also:bone is also a cause of an offensive nasal discharge, and rhinitis occurring in infants gives rise to the obstructed respiration known as " the snuffles." Three forms of nasal polypi are described, the mucous, the fibrous and the See also:malignant. The general symptoms of nasal See also:polypus are a feeling of stuffiness in one or both nostrils, inability to breathe down the nose and a thin watery discharge. A nasal See also:tone of See also:voice, together with cough and See also:asthma, may be present, or there may be partial or See also:complete loss of the sense of See also:smell (anosmia). The treatment of mucous polypi is their removal by the forceps or the snare, the See also:base of the growth being afterwards carefully examined and cauterized with the galvano-cautery. Fibrous polypi are usually very vascular, and may be a cause of severe epistaxis as well as of obstruction of breathing, " dead voice," sleepiness and deafness. The increasing growth may See also:lead to expansion of the See also:bridge of the nose and deformity of the facial bones, known as " See also:frog-See also:face." The tendency of fibrous polypi to take on malignant sarcomatous characters is specially noticeable. Extirpation of the growth as soon as its nature is recognized is therefore urgently demanded. The See also:chief diseases of the nasal septum are abscesses, due to the breaking down of haematomata, syphilitic gummata (leading to deep excavation and bony destruction), tuberculous disease in which a small yellowish See also:grey See also:ulcer forms and what is known as perforating ulcer of the septum, which is met with just within the nostril. The latter tends to run a chronic course, and the detachment of one of its crusts may cause epistaxis. Rhinoscleroma was first described by F. Hebra in 187o, and is endemic in See also:Russian See also:Poland, See also:Galicia and See also:Hungary, but is unknown in See also:England, except amongst See also:alien immigrants. The infecting organism is a specific bacillus, and the disease starts as a chronic smooth painless obstruction with the formation of dense See also:plate-like masses of tissue of stony hardness. Treatment other than that of excision of the masses has proved useless, though the See also:recent See also:plan of introduction of the injection of a vaccine of the bacillus may in future modify the progress of the disease. The See also:accessory sinuses of the nose are also prone to disease. The maxillary antrum may become filled with muco-pus, forming an See also:empyema, pus escaping intermittently by way of the nose. The condition causes See also:pain and swelling, and may require the irrigation and drainage of the antrum. The frontal sinuses may become filled with mucous, owing to the swelling of the nasal mucous membraneover the middle turbinated bone, or an acute inflammation may spread to the frontal sinuses, giving rise to an empyema in that locality. There is severe frontal pain, and in some cases a fulness on the forehead over the affected See also:side, the pus often pointing in this site, or there may be a discharge of pus through the nose. The treatment is that of incision and irrigation of the sinus (in some cases scraping out of the sinus) and the re-See also:establishment of communication with the nose, with free drainage. The ethmoidal and sphenoidal sinuses are also frequently the site of empyemata, giving rise to pain in the See also:orbit and the back of the nose, and a discharge into the nasopharynx. In the See also:case of the ethmoidal sinus it may give rise to exophthalmus and to strabismus (See also:squint), with the formation of a See also:tumour at the inner See also:wall of the orbit and fever and See also:delirium at night. In the young the condition may become rapidly fatal. Suppuration in the sphenoidal sinus may lead to See also:blindness from involvement of the sheath of the optic See also:nerve, and dangerous complications such as septic basal See also:meningitis and thrombosis of the cavernous sinus may occur. Acute ethmoiditis and sphenoiditis are serious conditions demanding immediate surgical intervention. (H. L. Additional information and CommentsThere are no comments yet for this article.
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