Atrophic-Rhinitis-slides-050330

Biology microbiology klebsiellaozenae

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Unformatted text preview: rior and middle turbinates. Pace-Balzan, Shankar, Hawke. J Otolaryngol 1991; 20:428-32. Biopsy Findings Biopsy Findings Normal Mucosa Pseudostratified Columnar Presence of serous and mucous glands Atrophic Rhinitis Squamous metaplasia Atrophy of mucous glands Scarce or absent cilia Endarteritis obliterans Microbiology Microbiology Klebsiella ozenae May be found in almost 100% of primary AR No predominance in secondary AR Staphylococcus aureus Proteus mirabilis Escherichia coli Corynebacterium diphtheriae Current Therapies Current Therapies Goals of therapy Restore nasal hydration Minimize crusting and debris Therapy options Topical therapy Saline irrigations Antibiotic irrigations Systemic antibiotics Implants to fill nasal volume Closure of the nostrils Local therapy Local therapy Irrigations Saline Mixtures Antibiotic solution Moore: Gentamycin solution 80mg/L Anti­drying agents Sodium bicarbonate Shehata: Sodium Carbonate 25g, Sodium Biborate 25g, and Sodium Chloride 50g in 250ml water. Glycerine Mineral Oil Paraffin with 2% Menthol Other Acetylcholine Pilocarpine Systemic therapy Systemic therapy Oral antibiotics Medication avoidance Vasoconstrictors Topical steroids * Other Ciprofloxacin Aminoglycosides Streptomycin injections Vitamin A (12,500 to 15,000 Units daily) Potassium Iodide (Increases nasal secretions) Vasodilators Iron therapy Estrogen Corticosteroids * Vaccines Antibacterial (Pasturella, Bordetella) Autogenous Surgical therapies Surgical therapies Young procedure Modified Young procedure Turbinate reconstruction Volume reduction procedures Denervating operations Nasal Closure Nasal Closure Young’s procedure Advantages Circumferential flap elevation 1 cm cephalic to the alar rim. Sutures placed in center of elevated flap to close the nostril Staged second side in 3 months Often provided relief of symptoms Disadvantages Difficult to elevate circumferential flap Breakdown of central suture area common Does not allow for cleaning Did not allow for periodic exam...
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