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2. Palpation of the nasal bones for tenderness and cripitus in fracture of the nasal bones

3. This examination is called ……….
This examination is called anterior rhinoscopy
The srtuctures seen by this examination are the anterior part of:
1-Floor of the nose
2-Inferior turbinate & meatus
3-Middle turbinate & meatus
4-Nasal septum
This examination is called ……….
The srtuctures seen by this examination are the anterior part of: 1- 2- 3- 4-

4. Nasal Air Flow Test
The metal tongue depressor is held below the nostril during quiet respiration
The area of fogging gives an idea about the patency of the nasal airway

5. Rigid endoscope Endoscopy can be carried out in the out-patient clinic
Provide good illumination & visualization
Allows examination of difficult-to-examine areas
Many therapeutic procedures in the nose and sinuses can be done by this instrument
An optical telescope
Used for direct visualization of the nose (and also ear & throat)
What is the Value of this instrument ?

6. Flexible fibro-optic naso-pharyngo-laryngoscope
To examine
Nasal cavity
Pharynx
larynx

7. Hump Nose

8. Bifid Nose

9. Nasoalveolar cyst The arrow points to flaring of the ala

10. The arrow points to………
It is used for………………..

11. What is your diagnosis?
Treatment?

13. Foreign Body (Bead) in Left Nasal Cavity

14. Rhinolith

15. Saddle Nose

16. 25-year-old man complains of midfacial pain, fever, and general malaise of about 48 hours' duration. He denied having a cough, rhinorrhea, or nasal congestion. The patient reported being hit in the nose about 10 days earlier. The patient's temperature was 38.1° C orally and he had no frontal or maxillary sinus tenderness. Nasal examination (see accompanying figure).
What is the most likely diagnosis?

17. The answer : septal hematoma
The answer : septal hematoma. The midline swelling of the septum is typical of septal hematoma and is consistent with the patient's history of facial trauma.
Typically soft and fluctuant when compressed, a septal hematoma is a collection of blood between the nasal mucosa and the cartilaginous septum.
It may occur unilaterally or, more commonly, bilaterally following nasal trauma with or without associated nasal fracture.
This urgent condition warrants immediate referral to an otolaryngologist.

18. Incision and drainage of septal abscess

19. Vestibulitis

20. This child presented also with foul odor from the right nasal side
You should suspect……………
FB in the right nasal cavity

21. Orbital abscess

22. The black arrow points to frontal mucocele
The red arrow points to the orbit which is displaced downwads and laterally

23. Picture 1(left). A male with orbital cellulitis with proptosis, ophthalmoplegia, and edema and erythema of the eyelids. The patient also exhibited pain on eye movement, fever, headache, and malaise
The same patient (right) exhibited chemosis and resistance to retropulsion of the globe

24. The cardinal signs of an orbital cellulitis are decreased eye movements, proptosis, decreased vision. The conjunctiva may be injected in either periorbital or orbital cellulitis

25. Rhinophyma

26. Frunculosis In this patient
1- incision and squeezing the lesion is a proper treatment
2- The causative organism is strptococcus pnumonia
3- diabetes millitus should be considered especially if the lesion is bilateral
4- cavernous sinus thrombophlebitis is never a complication of this lesion
Answer : 3

27. Acute ethmoiditis complicated by orbital infection
This child presented with fever, , pain in the eye, edema of the right lids, limitations of eye movements and gave a history of recurrent attacks of nasal obstruction and discharge.
Examination of the nose revealed right yellowish nasal discharge but no masses
Acute ethmoiditis complicated by orbital infection
1-Orbital cellulitis
2-Subperiosteal
abscess
3-Orbital abscess

28. Patient undergoing Caldwell-Luc surgery, involving removal of the diseased lining of the maxillary antrum

29. Oral-Maxillary Fistula. 
This patient presented with left nasal offensive discharge, and left nasal regurgitation of fluids ??

30. Oro-maxillary
fistula
The patient shown on the right has a small hole in the middle of a tooth socket.  A tooth had been pulled and a hole was made into the maxillary sinus.  The hole did not fully heal and a small fistula was left in the middle of the upper alveolar ridge

31. Rhinoscleroma
Bilateral reddish non ulcerating firm nodules which firstly appear at the muco-cutaneous junction
As seen below the nodules spread and coalesce to fill the nasal cavity and broaden the nose

32. Atrophic Rhinitis
A 20 years old female presented with crusty nose and anosmia. Examination revealed roomy nose, greenish crusts and pale atrophic nasal mucosa

33. Anterior nasal packing
A traditional ribbon gauze pack,
Prefabricated expandable packs,
Intranasal balloons
A traditional ribbon gauze pack,
Prefabricated expandable packs,
Intranasal balloons applied to an identified or unidentified bleeding site

35. Epistaxis Ballon for anterior and posterior nasal packing
Balloon packs for epistaxis have become more available and varied than the first Foley catheter balloon used
The concept is the same as traditional nasal packing;