Upper Respiratory Tract
Differentiate the following:
Deviated septum – separates the external nares, 80% of population have deviated
septum, could result in difficulty breathing through the nose, can result in
recurrent infection, can be present at birth due to trauma
treatment of deviated septum – initially manage the s/s of the condition, use
decongestants to reduce nasal congestion, antihistamines to prevent cold and
allergy symptoms, nasal cortisone spray to reduce inflammation and runny nose,
medications are only a temporary fix. Surgical repair – septoplasty cure
symptoms such as nosebleeds and nasal congestion but NOT nasal or sinus
conditions that are related to allergies.
Septoplasty is preferred surgical treatment but can not be done on those under 18
years old due to continued growth of cartilage.
Nasal fracture – can be broken during sports, accidents, fights and falls, swelling
makes it difficult to tell if the nose is actually broken, after swelling decreases a
broken nose may appear crooked and possibly broken. Nasal fracture is the most
common site specific bone injury of the facial skeleton. Morbidity includes airway
obstruction due to dorsal nasal collapse, septal deviation, vavlular collapse,
epistaxis or poor cosmetic outcome.
s/s nose pain, swelling, crooked or bent appearance, bruising around the eyes,
runny nose or nosebleed, grating sound or feeling when the nose is touched or
rubbed, blocked nasal passages
Epistaxis – 90% arise in anterior nasal septum due to the location of arterial
vessels, susceptible to trauma, nose picking, drying, and infection
Posterior usually secondary to blood disorders – dyscrasias, hypertension or
Results from trauma, foreign bodies, topical corticosteroid use, nasal spray
abuse, street drug use, anatomic malformation, allergic rhinitis, tumor
What does Lewis state about infection in relation to a deviated septum?
“There is conflicting evidence to support that severely deviated septum may block
drainage of mucus from the sinus cavities, resulting in infection or sinusitis.”