Previous Page      Full Application Library 

Nose (Disorders Of)

Bryan Applications, N

The external protuberance of the nose forms but a small part of the organ. The nose consists of a cavity, opening in front and behind, for the inspiration of air, the upper part of the cavity also being adapted to sub-serve the sense of smell. From front to back the cavity is divided into two by the nasal septum, two openings, therefore, being situated in front and behind, the anterior and the posterior nares respectively.

The protuberance of the nose has a framework of cartilage, except at the bridge, which is formed by the two little nasal bones. The cavity in each side of the septum in this part of the nose is called the vestibule, and from its lining hairs project. The side wall of the vestibule is called the ala.

Beyond the vestibule is the nasal fossa, the cavity proper of the nose. Its inner wall is formed by the septum, which is made up of the plow-share, or vomer, bone behind, the central plate of “the ethmoid bone above, and elsewhere by plates of cartilage. The floor of the cavity is formed by the hard palate, and the top most part of its roof by the cribriform plate of the ethmoid, a thin sheet of bone containing many perforations. The outer wall has three shelves, running from before backwards, and curling downwards into the fossa.

These shelves, known as the turbinated bodies, are covered with mucous membrane, beneath which is erectile tissue, that is, tissue which can become engorged with blood. Thus, the surface area of the lining of the cavity can be increased, though, of course, the space is lessened. When the external air is cold, this engorgement takes place, so that the air is rendered warmer before it passes on into the air-tubes. Besides being warmed in its passage through the nose, air is moistened, and, to some extent, dust is filtered out from it.

The bones forming the basis of the upper two of these bodies, though called the superior and middle turbinated bones, are part of the lateral- mass of the ethmoid bone, but that in the lowest body, the inferior turbinated bone, is a separate bone. The turbinated bodies project inward almost as far as the septum, and thus make a sort of division of the cavity into four passages, the three of these lying beneath the bodies being described as the superior, the middle and the inferior meatus of the nose.

In the middle meatus, that is, the one between the middle and the inferior turbinated bodies, are found the openings of certain important cavities, namely, the antrum of Highmore, the frontal sinus and some of the ethmoidal cells. Into the space above the superior body opens the sphenoidal sinus, into the superior meatus some ethmoidal cells open, while in the inferior meatus is the opening of the nasal duct through which tears are drained from the lachrymal sac into the nose. The antrum may be infected through tooth sockets, or any of the spaces above mentioned may be infected from the nose, and when such infection occurs there may be a persistent purulent discharge into the nose, causing chronic inflammation, or rhinitis, and possibly the formation of polypi.

The lining of the lower part of the nasal fossa is covered with ciliated epithelium, like the lining of the air-tubes; that of the upper part, however, is different, and contains a large number of special cells known as the olfactory cells.

At the end projecting into the cavity, such a cell is stimulate by odoriferous substances in the air inhaled into the nose, while the inner end is prolonged into a nerve which passes through one of the perforations in the cribriform plate of the ethmoid, and on into the olfactory bulb, which lies on the top of the plate. Thence fibers pass back to the parts of the brain concerned with the sense of smell.

Injuries and diseases of the nose:

A blow on the nose may cause a fracture of the nasal bones or septum, and perhaps subsequent deformity and nasal obstruction.

The skin over the nose may be the site of common acne, acne rosacea, lupus vulgaris, lupus erythematosus, or some other eruption. It is also a common site for a chilblain. Rosacea may go on to the development of great thickening of the skin, which may be disposed in folds, a condition described as rhinophyma. Bleeding from the nose or epistaxis, is discussed under the heading Bleeding.

A foreign body is sometimes introduced into the nose. If it can be expelled by blowing the nose or by sneezing, good and well, but if not its removal should be left to a doctor, as unskilled efforts may be dangerous.

Acute inflammation of the lining of the nose, otherwise acute rhinitis, or acute nasal catarrh, is what occurs in a common cold. In some cases of acute rhinitis the discharge is purulent, or at any rate contains a large amount of pus. This may happen, for example, during one of the infectious fevers, or should gonorrheal infection reach the nose. Children who have adenoids may also have such a discharge. A foreign body in the nose is another cause, but then the discharge is likely to be from one side of the nose only. In disease of the antrum a purulent discharge may flow into the nostril, particularly when the patient turns the side of the head with the diseased antrum uppermost. Discharges from diseased nasal sinuses may be constantly swallowed, however, and cause chronic poisoning.

Chronic rhinitis may be either of the hypertrophic or the atrophic variety. Hypertrophic rhinitis may follow a repetition of acute attacks. It may also occur in persons much exposed to irritating vapors or sudden changes of temperature, or who have some chronic source of irritation within the nose, such as discharges from an infected sinus, or a spur or prominence on the septum. Changes occur in the turbinated body so that it ceases to contract properly to normal dimensions. The effect of this kind of rhinitis is to obstruct the passage of air through the nose. There is also a mucopurulent discharge from the nose. In some cases of hypertrophic rhinitis, however, there is a disagreeable dryness of the lining.

Atrophic rhinitis is also known as ozena, a name derived from a Greek word meaning a stench, because crusts form in the nose, and, decomposing, emit an extremely foul odor. The turbinated bodies are shrunken, and the airway through the nose is unduly wide. The interior of the nose is very dry, and dryness and crusts may affect the naso-pharynx also. The patient has usually lost the sense of smell early, and is therefore unconscious of the smell, but this makes the vicinity of the patient so objectionable to other people that his society is shunned. The patient is troubled with a hacking cough and constant hawking in an attempt to clear crusts out of the throat.

Extension of infection from the nose to the throat takes place, more or less, whenever the former is affected, and as the lower opening of the Eustachian tube lies just behind the posterior opening of the nose, extension to the ear also may readily occur.

The treatment of acute catarrhal rhinitis is discussed under the heading of Colds. Before suppurative rhinitis can be treated it is necessary to determine the precise cause. When chronic rhinitis occurs, it will generally be necessary to improve the general health of the patient by a sufficiency of open-air exercise, proper ventilation of the bedroom, a sufficiency of good, mixed food, avoiding an excess of carbohydrate substances, and, possibly, by giving tonics.

The nose should be cleansed once or twice a day, and lotions for this purpose can be used as a spray or douche.

In hypertrophic rhinitis, however, it may be necessary to have an operation in order to relieve obstruction or remove sources of irritation. This may mean the cauterization of the turbinated bodies, or removal of portions of them by a snare or otherwise, straightening a deflected septum, removing septal spurs, or cleaning out a diseased nasal sinus.

A nasal polypus denotes disease of the bone underlying its site. These growths are usually multiple in the nose, and come from the outer wall. They cause more or less obstruction and discharge, with loss of smell, and often impairment of hearing. The voice loses its resonant quality. Polypi should be removed, this being accomplished usually by means of a wire snare, and the part from which they spring should be cleaned up.

Tuberculosis may occur in the nose, usually in people who have the disease in the lungs, but in rare instances as an independent infection. More frequently lupus (q.v.) is found, and this may cause much destruction. Syphilis of the nose may occur, both in the inherited and the acquired disease. It is responsible for the catarrhal condition in the nose referred to as snuffles, which is found in infants born suffering from syphilis, and for the sinking of the bridge of the nose which appears later on. Acquired syphilis may be found in the nose in any of three stages. It may cause much destruction in the nose, and also of the external protuberance; it is the commonest cause of the perforation of the hard palate.

Progressive nasal obstruction may be caused by a rare disease called rhinoscleroma, in which chronic inflammation of the nose is accompanied by the formation of much scar-tissue, in which bone is ultimately developed. This condition may involve the pharynx and the larynx also. The cause of the disorder is not known. X-rays and radium have produced some benefit, but the removal of obstructing masses and the divisions of strictures are often necessary.

Other simple tumors besides polypi occur in the nose, osteomata and chondromata, for example: malignant tumors are very rare, however. Rough spherical concretions, usually of phosphate and carbonate of lime, may be found in the nose. They are known as rhinoliths, and are formed round a nucleus of blood-clot or dried mucus. They act as foreign bodies, and should be extracted by suitable means. In the tropics maggots may be found in the nose, and should be dislodged by douching with a solution of common salt. See: Acne.. Adenoids.. Colds.. Lupus..

Application and treatment:

For the majority of problems of the nose, no special pad placement is usually required, and the standard treatment regimen via water pans is suggested. A stuffy nose which leads people to gape and breathe through their mouth or to snore when sleeping can cause facial pain and even forgetfulness. Sometimes colds, lack of sleep, allergies, other indigestion problems and polarity problems can cause it to run or for the nose to be dry. The sense of smell is impaired.

Nose (Disorders Of)

Stress or injury may cause the nose to bleed. Hold head back, on the headrest of a chair if necessary, and remain still until bleeding abates. Cool the nose with ice pack.

Nasal infections use 727, 787, 880 Hz at low output 5 minutes 2 to.3 times daily.
Itching in nose: apply positive polarity to both sides of nose for 5 minutes or longer twice daily.
Stoppage of nose: to dissolve use negative polarity on both sides of nose for 10 minutes, 2 times daily. Alternate with positive.