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Consists of osteo-cartilaginous
framework covered by muscles and
skin1
Upper 1/3rd bony and lower 2/3rd
cartilaginous
1
Diseases of the Nose, Paranasal Sinuses, and Face. In: Probst R, ed. Basic Otorhinolaryngology. New
York. Thieme.2006. 1 - 7
Nasal Mucosa in Various Parts of the
Nasal Cavity
Olfactory region
Upper 1/3rd of lateral wall (up to
superior concha), corresponding
part of the nasal septum and the
roof of nasal cavity form the
olfactory region
Mucous membrane is paler in
Respiratory
colour region
Lower 2/3rd of nasal cavity
Mucous membrane shows
variable thickness
Lined by pseudostratified
ciliated columnar epithelium
Serous and mucous, glands are
located in the submucosa
1
External Nose. In: Dhingra PL. ed. Diseases of ear nose and throat. New Delhi. ELSEVIER.129-132
Paranasal Sinuses
Air-filled cavities that communicate
with the nasal cavities
mucus production,
congestion, sneezing Chronic
Acute rhinitis rhinitis
paroxysm, watery eyes, < 4 days/ > 4 days/week
and nasal and ocular week or < 4
weeks duration
or
> 4 weeks
pruritus.1 duration
1
Quillen DM, Feller DB. Diagnosing Rhinitis: Allergic
vs. Nonallergic. Am Fam Physician. 2006;
73(9):1583-1590
2
Kradjan W. Acute and Chronic Rhinitis. Dr Ted
Williams.
RINOSINUSITIS
Rinosinusitis (termasuk polip hidung) didefinisikan sebagai :
inflamasi hidung dan sinus paranasal yang ditandai dengan adanya dua atau lebih
gejala, salah satunya : Hidung tersumbat/ obstruksi/ kongesti atau pilek (sekret hidung
anterior/ posterior):
nyeri wajah/ rasa tertekan di wajah
penurunan/ hilangnya penghidu
Etiology 2
Signs and symptoms 1
Diagno
Painful pressure in the cheeks and forehead
Thick yellow-green nasal discharge
Postnasal drip, often with a bad taste
Examination of nasal
Cough passages - Rhinoscopy or
sis
Congestion Nasal endoscopy
Toothache MRI or CT scan
Fever
Phenylpropanola
Oxymetazoline Xylometazoline
mine
Oxymetazoline
1
Tripathi KD. Essentials of Medical Pharmacology.
New Delhi: Jaypee Brothers Medical
Publishers;c2013:125-137
Overview of Nasal Decongestants
Naphazoline Xylometazolin Oxymetazol Pseudoephedr Phenylpropanola
e ine ine mine
Mode of Selective 2 Selective 2 Selective 2 Alpha- Directly stimulate
action agonist) agonist) agonist) Adrenergic adrenergic
Agonist. receptors but
probably indirectly
stimulates both -
and -adrenergic
receptors
Duration Longer duration Longer duration Long
of action of action (12 of action (10 duration of
hours) hours)2 action (12
hours)
Dose 0.1% topical in 0.050.1% 0.0250.05% 30- 60 mg three 2550 mg daily
nose topical in nose topical in times a day
nose
Adverse Impairs mucosal Impairs Impairs Rise in BP can Rise in BP
effects ciliary function mucosal ciliary mucosal occur,
causing Atrophic function ciliary especially in
rhinitis and causing function hypertensive,
anosmia, CNS Atrophic rhinitis causing CNS effects
depression and and anosmia, Atrophic
rise in BP, initial CNS depression rhinitis and
1
Tripathi KD. Essentials of Medical Pharmacology.
stinging and rise in BP anosmia,
New Delhi:Jaypee Brothers Medical
sensation CNS
Publishers;c2013:125-137. depression
2
SUDAFED 0.1% NASAL
SPRAY. MHRA. and rise in
http://www.mhra.gov.uk/home/groups/par/docume
BP
Nasal Decongestants
Two main types are used:
Adrenergics (largest group)
Constrict dilated blood vessels
Nasal mucosa
Corticosteroids
Reduce inflammation