NOSE - Epistaxis

NOSE - Epistaxis

Bleeding from Littel`s area

Compression of the nasal alae

Chemical cautery 

Bipolar cautery

Anterior nasal packing

  Expandable sponge nasal pack

  

Merocel nasal pack - with airway tube 

Posterior nasal pack 

Epistaxis nasal balloons with integral airway

Posterior nasal pack with foley`s catheter 

 Arterial embolisation 

Endoscopic arterial ligation

NOSE - Congenital

NOSE - Congenital

Posterior choanal atresia

Choanal atresia is a congenital disorder where the back of the nasal passage (choana) is blocked, due to persistence of bucco-nasal membrane (between the nose and nasopharynx(. 

Catheter not passed

Mirror test

Post nasal view of bilateral choanal atresia

Post nasal view of unilateral choanal atresia

 Airway 

Airway in place

Airway in place as seen in newborn with choanal atresia (X-ray)

CT scan

 Axial view bilateral choanal atresia

 Axial view unilateral choanal atresia 

  

 Axial view unilateral choanal atresia 

 Axial view bilateral choanal atresia

  Axial view unilateral choanal atresia 

 Axial view bilateral choanal atresia

Sagittal view posterior bony choanal atresia

Treatment

 Perforation of the plate

Widening of the opening

Bilateral choanal atresia. A view from the nasopharynx using 120° telescope.

 

Widening the choanal opening using a diamond burr.

 Bilateral choanal stents prepared from reinforced endotracheal tubes.

Videos

http://www.youtube.com/watch?v=2gndjh7ZWBU

choanal atresia repair

http://www.youtube.com/watch?v=7UyLHqFgggc

Endoscopic Choanal Atresia repair

NOSE - Examination

NOSE - Examination

 Examination of the vestibule

How to use nasal speculum 

Endoscopic examination

CT scan

CT Axial image shows sphenoid sinus (SpS) and the sphenoethmoidal recess marked by the (*). (AE: anterior ethmoid, PE: posterior ethmoid, CC: carotid canal, NS: nasal septum(. 

CT coronal image shows ethmoid bulla air cells superior to uncinate processes. The (*) highlight the hiatus semilunaris. Ethmoid bulla air cells are part of the anterior ethmoid sinuses and make up the superior border of the hiatus semilunaris. (EB:ethmoid bulla, U: uncinate process, MT: middle turbinate).

 CT scan coronal image demonstrating frontal recess (arrows), hiatus semilunaris (*) and middle meatus (arrowheads). (EB: ethmoid bulla, MT: middle turbinate, MS: maxillary sinus(

CT scan coronal image with arrows demonstrating overly pneumatized frontal sinuses. Also note enlarged ethmoid bulla air cells (arrowheads(. 

CT scan coronal image showing pneumatized lateral recesses of sphenoid sinus (SpS) and foramen rotundum (FR) bulging into the sinus. Arrows point to optic canals superior to sphenoid sinus and medial to anterior clinoid processes. 

Videos

http://www.youtube.com/watch?v=d8eS9eSoVrI

Endoscopic Examination of Normal Nasal Cavity

http://www.youtube.com/watch?v=ppnUwvR9x6I

The Nasopharynx as Seen Using Transoral Nasopharyngoscopy Technique

http://www.youtube.com/watch?v=G7tv-K9YSyg&feature=endscreen&NR=1

Pediatric Video Nasal Endoscopy (HD)