Nasal Granulomas
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Transcript Nasal Granulomas
Nasal Granulomas
A
granuloma is a tumour like
mass of nodular granulation
tissue with actively growing
fibrobasts and capillary buds
due to chronic inflammatory
process
It may occurs locally as a mass,
an isolated process or
it may be local manifestation of a
generalized disease.
Classification
Bacterial
Fungal
Non specific
Bacterial
Syphilis
Tuberculous
Leprosy
Histiocytosis
Lupus vulgaris
Anthrax
Fungal
Rhinosporidiosis
Aspergillosis
Actinomycosis
Candidiasis
Histoplasmosis
mucormycosis
Non Specified
Wegeners granuloma
Stewarts midline granuloma
Sarcoidosis
Fungal granulomas
Grow by budding
Commonly affects males
Immunocompromised,diabetics,leukemia,malign
ancies,AIDS,burns ,organ transplant
,malnutrition
more susceptible
Biopsy,serology
antifungal
Rhinosporidiosis
Rhinosporium Seeberi
In mucosa of upper&lower rt
Bleeding polyp
Friable strawberrry like,white dots
Biopsy
Excision,diathermy,antifungal
Lupus Vulgaris
Indolent,localized and chronic form ofTB
Common in females
Mucocutaneous junctions
Epitheloid and langhans giant cellsules
Red ,firm nod,blanching leads to apple
jelly nodules
ATT,Vit D
Leprosy
Chronic, laprae Bacillus
Clinical types tuberculoid,borderline
&lepromatous
Nasal involvement in lepromatous type
Anosmia,crusts,atrophic rhinitis,bleed
Dapsone,clofazimine,rifampicine
Tuberculosis
Usually secondary wit a rapid course
Nodular,ulcerative or polypoidal
Nasal septum,lateral wall
No pain
Mucosa bright red ulcerative
AFB,Bacteriology,biopsy
Alkaline douches,ATT
sinonasal sarcoidosis
The clinical symptoms are usually nonspecific.
Nasal obstruction, postnasal drainage, headache, and recurrent
sinus infections are common Sarcoidosis patients usually present
with symptoms in other systems, particularly the lungs.
Other associated findings in the head and neck, such as xerostomia
(dry mouth), xeroophthalmia (dry eyes), or parotid gland
enlargement increase the clinical suspicion for sarcoid
the diagnosis of sinonasal sarcoidosis is established only after
appropriately directed biopsy and histopathologic examination.
Rhinoliths
They are calcareous concretions that are formed by the deposition
of salts on an intranasal foreign body.
The foreign body, which acts as the nucleus for encrustation, can be
either endogenous or exogenous. Dessicated blood clots, ectopic
teeth, and bone fragments are examples of endogenous matter.
Exogenous materials include fruit seeds, plant material, beads,
cotton wool, and dental impression material.
Although the pathogenesis remains unclear; a
number of factors are thought to be involved in
the formation of rhinoliths. These include entry
and impaction of a foreign body in the nasal
cavity, acute and chronic inflammation,
obstruction and stagnation of nasal secretions,
and precipitation of mineral salts. Development
and progression are believed to take a number
of years.
Most patients complain of purulent
rhinorrhea and/or ipsilateral nasal
obstruction. Other symptoms include fetor,
epistaxis, sinusitis, headache and, in rare
cases, epiphora. In some patients,
rhinoliths are discovered incidentally
Rhinoliths
Nasal obstruction and discharge
Destruction of mucosa leading to
sequestra of bone and cartilage with
unpleasant odour
Diagnosis is clinical
Treatment surgical removal with pnasal
packs for 24 hours
Wegener’s granuloma
A systemic disorder
Lungs,Kidneys, upper respiratory tract
Necrotizing giant cell with vasculitis
Wegener’s ganuloma
Septal perforation unilateral discharge
Raised ESR,
multinodular and cavitating lesions of
lungs
Haematuria
cANCA
Renal failure within one year
Sex equal age incidence is 4th -5th
decade
Wegener’s granuloma
Treatment
Corticosteroids
Cyclophosphamide
Azathioprine
Stewart’s granuloma
Indurated mass of the nose or nasal
vestibule
Leading to progressive ulceration of the
cartilage and bone
as a variant of lymphoma
Surgical excision and radiotherapy