6. Coryza
• It is an acute non specific infective rhinitis.
• Also known as “common cold”.
7. Aetiology
• Causative organism: virus and may be either
influenza virus rhinovirus or adenovirus etc.
• Spread : is by air borne droplet infection or by
direct contact.
• Secondary infection by bacteria may occur
streptococcus staphylococcus pneumococcus
etc.
8. Pathology
• Viral infection of the nasal mucosa
• Acute generalised hyperaemia of the nasal
mucosa
• Engorgement of the secretory gland and
goblet cells
• Profuse secretion involvement of sinus
10. CLINICAL FEATURES
• Incubation period:1-3 days
• Four stages
– Ischaemic stage
– Hyperaemic stage
– Stage of secondary inflammation
– Stage of resolution
11. ISCHAEMIC STAGE
• Raw sensation & irritation in the pharynx.
• Irritation & dryness in the nose.
• Sneezing attack.
• Malaise with chills.
•
12. HYPEREMIC STAGE
• Profuse watery rhinorrhea
• Anosmia
• Blocking of nose
• Fever and malaise with chills.
• Congested nasal mucosa
• Headache and otalgia
13. STAGE OF SECONDARY INFECTION
• Nasal discharge becomes thicker and
yellowish and greenish.
• Fever & malaise with chill.
• Headache
• Otalgia
• Congested nasal mucosa
25. SIGNS
• Anterior rhinoscopy: Hypertrophy of inferior
nasal turbinates.
• Posterior rhinoscopy:Mullbery like appearance
26. TREATMENT
• Removal or treatment of predisposing factors
• Local nasal decongestants drops
• Antihistamine
• Surgical management for turbinate
hypertrophy
• Partial turbinectomy
27. ATROPHIC RHINITIS
• Synonym:ozeana
• It is a chronic inflammatory disease of the
nasal mucosa which characterised by
progressive atrophy of the mucosa and
turbinates', formation of crust and foul smell
from the nose known as ozaena.
29. AETIOLOGY
• Primary:
• Exact aetiology not known but predisposing
factor include:
• Age : common between 15-40 yrs occurs
usually at puberty.
• Sex : more common in female.
• Heredity
• familial
30. • Environmental
• Nutritional
• Hormonal
• Vitamin a deficiency
• Infection
• Secondary :
• Chronic specific infection
• Extensive surgery
• Chronic sinusitis
• DNS
31. PATHOLOGY
• It is a condition characterised by atrophic
changes in all the nasal tissues.
• Mucosa undergoes atrophy and metaplasia
• Cilia and secretory glands also undergo
atrophy with a resultant pale , dry, thin
mucosa with thick scanty secretion dry to
form crust which may bleed on removal.
• Secondary infection usually results in foul
foetid smelling
32. • Turbinates' undergo atrophy resulting in loss
of anatomical landmarks on the nose and a
roomy nasal cavity.
• Blood vessels undergo periarteritis & endaritis
resulting in ischemia .
• Sensory nerves undergo atrophy and hence
the patients may complain of nasal
obstruction as he does not feels the air
passing through the nose.
• Atrophy of the olfactory nerve ending
resulting in anosmia
33. CLINICAL FEATURE
• Nasal obstruction :
– Crust in nasal cavity
– Atrophy of sensory nerves
• Crusting of nose(ozaena)
• Foul smell of nose
• Anosmia
• Epistaxis
• Headache
• dryness of nose and throat
34. SIGNS
• External nasal examination:
– Bridge of nose may be depressed ( saddle shaped)
• Anterior rhinoscopy
– Nasal cavity is roomy
– Causative factors like DNS
– Mucosa is pale shiny dry and atrophy
– Crust are seen
35. • Posterior rhinoscopy
– Diminished sensation of the mucosa due to the
atrophy of sensory nerve ending
41. Aetiology
• The exact etiology is not known.
• Associated with inflammation and granulation
of the lining mucosa.
• There may be erosion of lateral nasal wall
51. Aetiology
• Causative organism: corynebacterium
diphtheria.
• Age :common in children.
• It is of two types
– Primary
– Secondary
52. Primary
• It may affect the nose first without
involvement of other tissues.
Secondary
• It may affect the nose secondary to faucial
diphtheria.
53. CLINICAL FEATURES
• Blood stained watery rhinorrhoea.
• Skin near the nasal vestibule may show
excoriation due to continuous nasal discharge.
• Nasal obstruction
• Greyish white membrane is seen on the
turbinate's or nasal septum, it is difficult to
remove.
• Constitutional symptoms such as fever
malaise etc.
61. SIGNS
• Mucosa
–Acute stage :pale
Chronic stage :bluish purple
– Infection:present
– Polyp :present
– Allergic salute(tip of nose salute like)
– dorrer’s line (crease on dorsum of nose)
62. INVESTIGATION
• Nasal secretion : eosinophilia
• Haemogram
• Stool examination
• History about allergy
• Skin test by intradermal injection
• Inhalation of allergens
• Elimination test for food
• RAST (radio allergosorbant test)
67. PSORA
• Psora-functional changes
• Rhinitis covers the psora miasm; psora leads
to functional disturbances; i.e. in rhinitis there
is inflammation of mucus membrane of nose
leading to ischemic conditions and burning,
irritation like symptoms.
• Sensation of dryness in the nose troublesome
even when the air passes freely.
68. • Epistaxis more or less profusely more or less
frequently.
• Ulcerated nostrils
• Nostrils as if it were stuffed up.
• Disagreeble sensation of dryness in the nose.
69. SYPHILIS
• It also covers the syphilis miasm because of
the nasal discharge.
• Loss of smell.
• Snuffle children.
• The bones of the nose are destroyed.
• Syphilis produce ulceration
• The crust of syphilis are dark greenish black or
brown,thick and not always offensive
70. SYCOTIC
• It also covers the sycotic miasm because t
leads to nasal destruction.
• Sense of smell loss.
• Sycotic has a red nose with prominent
cappilaries
• There is often nasal stoppage due thickening
of the membrane ,there is enlarged turbinated
bones.
71. • New babies of sycotic patient often get
snuffles nose dry stuffed up frequently in
Childs.
• Screams with anger in its attempt with
breathe with its mouth closed