Ulceration and atrophy of nasal mucosa

Introduction Nodular infiltration under the nasal mucosa, followed by erosion, can lead to scarring adhesions. In the late stage, there was atrophy due to dryness and scarring of the nasal cavity. The anterior nares are narrow. The nasal mucosa is pale and thick, and the secretions increase. There may be purulent sputum and nosebleeds, but the patient may not feel pain.

Cause

1. Nasal mucosal ulcers, erosions: common in the lower part of the nasal septum, mostly caused by chronic inflammation. Chemical gases, high temperatures, and dry air can all be the cause. In addition, nasal septum or rectangular process, nasal septum perforation, atrophic rhinitis, can also cause local nasal mucosal ulcer formation and lead to bleeding.

2. Acute infection of the nose and sinuses.

3. Trauma: nasal mucosa tears in nasal trauma can cause nosebleeds. The nasal stenosis combined with external injury fractures often complicated with anterior ethmoid rupture, which can cause upper nasal bleeding. Skull base fracture can cause the internal carotid artery to rupture, form a traumatic pseudoaneurysm, and severe nasal discharge occurs through the sphenoid sinus. If the anterior cranial fossa fracture has a ruptured anterior cerebral artery, it can cause bleeding at the level of the ethmoid at the top of the nasal cavity

4. Tumor: Tumor-induced epistaxis is caused by surface ulceration of the tumor itself, and the degree of bleeding varies depending on the nature of the tumor. Fatal nosebleeds can occur when a malignant tumor invades a large blood vessel in the late stage.

an examination

Related inspection

Nasal endoscopy olfactory nerve examination

Laboratory examinations must be summarized and analyzed based on objective data learned from medical history and physical examination, from which several diagnostic possibilities may be proposed, and further consideration should be given to those examinations to confirm the diagnosis. Such as: nose, otolaryngology CT examination.

Basic inspection:

1. Front nose examination.

2. X-ray films clearly have no sinus infection.

Further examination:

1. Nasal secretion smear to detect pathogenic bacteria.

2. Nasal secretions bacterial culture + drug sensitivity.

3. If necessary, virus inspection requires special cultivation, separation and identification.

Differential diagnosis

Need to distinguish from nasal congestion, nasal congestion is generally a foreign body sensation in the nasal cavity, nasal obstruction, poor ventilation, often because of mucosal edema or mucus is too thick to block the nasopharynx and nasal passages, resulting in narrowing of the nasal passages. Often occurs in rhinitis, sinusitis, nasal tumors and polyps block the nasal respiratory passages.

Patients with nasal mucosal ulcers and atrophy have nodular infiltration under the nasal mucosa, which in turn can cause scarring adhesions. In the late stage, there was atrophy due to dryness and scarring of the nasal cavity. The anterior nares are narrow. The nasal mucosa is pale and thick, and the secretions are increased. There may be symptoms such as purulent sputum and nose bleeding, which often occur in chronic inflammation, nasal septum or circumflex, nasal septum perforation, atrophic rhinitis, acute infection of the nose and sinuses. Tumor, leprosy, etc.

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