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Thursday, September 18, 2014

Examination of Nose and PNS: How to describe.

On examination of osteocartilagenous framework and the skin of the nose, it looks normal in shape and size (Mid face). No gross deformity like hump nose, depressed or deviated nose visible on examination from lateral profile. There is no widening of nasal dorsum. No swelling or lump in the area adjacent to the nose. No scars, sinus, change in color of skin and any ulceration
On palpation of nose, there is no local rise in temperature or tenderness. No fixity of skin, no thickening of soft tissue and No crepitation.

Spatula Test
On performing the spatula test, mist formation is equally present bilaterally suggestive of bilateral nasal patency.
Cotton Wool Test
There is equal movement of cotton on performing cotton wool test.

NASAL VESTIBULE
There is no furuncle, fissure, crusting, and there is no caudal dislocation of nasal septum. No grossly visible pathology with in nasal cavity.

ANTERIOR RHINOSCOPY
The opening of nasal cavity is wide/narrow or adequate. The mucosa looks normal pink and moist. There is no discharge or any other mass. On examination of nasal septum there is no deviation, no perforation, no septal bulging and no any ulceration or growth.
The Mucosa of the nasal turbinate looks pink and moist. The turbinates are not hypertrophied/ atrophied. There is no discharge from the middle meatus.

POSTERIOR RHINOSCOPY
On performing posterior rhinoscopy, the normal structures like opening of ET tube, Choana, posterior end of the septum and turbinates can be visualized. There is no mass on anterior side. There is no post nasal discharge.

PARANASAL SINUS
The area over the soft tissue of cheek, lip, lower eyelid, Upper eyelid, forehead, root of nose, orbital margin and its content look normal. There is no swelling or redness. There is no proptosis.

On palpation over the canine fossa, medial aspect of the root of the orbit and deep to medial canthus, there is no tenderness.


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