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Fracture of nasal boneEtiologyTraffic accidentPhysical combat.Sports injuryNasal bone-Upper end:thickLower end:thinSymptoms&Signs：Pain,epistaxis,nasal deformity or deviation,bruising.Diagnosis：X-ray in lateral view.Septal hematoma?punctureTreatment：Hemostasia,cleaning&suturing wound,restoring alignmentReduction of nasal boneBefore soft tissue edema57 days after injuryWalshan forcepsNasal packing for 2-3dDeal with septal hematoma&abscessSeptal hemotoma drainage as early as possible.“L”incision on septum.Postoperative nasal packing.Adequate antibiotics.Fracture of frontal bonePathology：Often combine with fracture of naso-fronto-ethmoido-orbital complex.Front wall Front&back wallBase fracture(frontonasal fracture)Stringy,sunken and smashed fracture Symptoms&Signs：Epistaxis,edema or sunken front.front wall fracture front&back wall fracture(sunken fracture凹陷型)(smashed fracture 粉碎型)Diagnosis：Frontal palpation,X-ray,CT scansTreatment：According to the situation:1、stringy fracture2、sunken fracture3、smashed fracture4、front&back wall fracture 5、base fracture(frontonasal fracture):restore the function of frontal sinus.Principle：To isolate the communication between frontal sinus and cranial cavity,to prevent rhinogenic complications,to keep the frontal part from deformation.Fracture of naso-fronto-ethmoido-orbital complexFracture of ethmoidal bonePathology：Often combine with fracture of naso-fronto-ethmoido-orbital complex.Symptoms&Signs：Edema of eyelid or nasal root,increase in the intercanthal distance.sunken front，vision disorder,Diagnosis：X-ray film,CT scanTreatment：Vision disorderdepression of optic canalNosebleednasal pack or arterial ligation(ligation of ethmoidal artery)Cerebrospinal fluid rhinorrhea(CSF)surgical reparation Blow-out fractureSymptoms&Sign：Swelling and bruising involving all eyelids,lid and infraorbital emphysema.diplopia，restricted movement of the eyes；vision disorder.击出性骨折(眶底暴折)Diagnosis：Clinical manifestation,X-ray,CT scans Treatment：Reduction after 710d post-wound.Operation approach:via infraorbit,via maxillary sinus and external ethmoidectomyBlow-in fractureRelatively rare.Symptoms&Sign：Protruding eye,swelling eyelids and zygoma,Palpation:infraorbital edge-“stairs-like”.Diagnosis：Clinical manifestation,X-ray,CT scansTreatment：Reduction after 710d post-wound.Midface fractureLe Fort,Le Fort,Le Fort Cerebrospinal fluid rhinorrhea(CSF)Etiology：Traumatic:Iatrogenic,and external trauma.Intracranial or extracranial surgery.Cribriform plate,sphinoid,frontoethmoidal complex.Nontraumatic:Spontaneous(or primary),direct erosion or increased intracranial pressure(tumors,congenital or acquired hydrocephalus,or infections.Diagnosis：History,laboratory test,endoscopic examination,ascertain the nature,fix the precise location Treatment：1、Conservative treatment：To prevent from infection,to prevent from high cranial pressure2、Surgery：Intracranial approach：Extracranial approach：nasal external approachnasal endoscopic surgeryVestibulitis of noseEtiology：Irritation of rhinorrhea and dust；secondary to skin infectionSymptoms&Sign：Red,swelling and ulcerative skin，crusting inside the vestbule,tenderness of the nasal tip or alae.Treatment：Acutethermotherapy or infrared Chronic3%H2O2,antibiotic ointment Furuncle of noseEtiology：Secondary to chronic vestibulitis.Diabetics and weaklings will be subject to the disease.Symptoms&Sign：Redness,swelling,heat,and pain；matureulcerate.Serious cases:Phlegmon Complications：Thrombosis of cavernous sinus and cranial infectionTreatment：Unmature：antibiotic，physiotherapyMature：drainage，Dnot crash and pressUlcerate：drainage，antibioticComplications：antibiotics，call ophthalmologist and neurologist for assistanceAcute&chronic inflammations of the nasal cavitiesAcute rhinitisEtiology：Rhinoviruses,adenoviruses,coronaviruses,influenza¶influenza viruses.Common cord(coryza)Causes:general factors,local factorsSymptoms&Sign：Sneezing,nasal obstruction,malaise,fever.Nasal mucosa congestion,swelling,secretion in meatus.Complications：1、Sinusitis2、Acute ototitis media infection pass through the Eustachian tube to middle ear3、Acute pharyngolaryngitis,trachitis&bronchitisDifferential Diagnosis：1、Influenza2、Allergic rhinitis3、Vasomotor rhinitis4、Acute infectious diseaseTreatment：General treatmentLocal treatmentChronic rhinitisEtiology：Local causes：1、Acutechronic，2、Chronic diseases of nose&sinus，3、Infective focus around nasal cavity，4、Iatrogenic:misuse nasal dropsProfessional and environmental causes：dusts，harmful chemical gas，physical changes General factors：1、chronic diseases，2、malnutrition，3、endocrinic dysfunction，4、cigarette and alcoholPathology：Simple chronic rhinitisno hyperplasiaHypertrophic chronic rhinitisnasal mucosa,submucosa,even periosteum&os:limited or extensive hypertrophySymptoms&Sign：Nasal obstruction,rhinorrhea,hypertrophied inferior turbinate Treatment：1、Pathogenic treatment2、Local treatment1)Simple chronic rhinitis：Vasoconstrictor sympsthomimetics,acupuncture2)Hypertrophic chronic rhinitis：Vasoconstrictor sympsthomimetics,electric coagulation,laser,microwave,radiofrequancy.Partial inferior turbinectomy.Atrophic rhinitisEtiology：Primary：Endocrine imbalance,functional disorders of autonomic nerve,infection,（coccobacillus foetidus ozena,diphtheroid bacilli）,poor nutrition,hereditary factors,autoimmunophathy？Secondary：1)Infection:chronic inflammation;2)Iatrogenic:excessive surgical destruction of mucosa(empty nose syndrome);3)Irritant:4)Special infection:tuberculosis,syphilis.Pathology：Endarteritis and periarteritis of terminal arterioles,metaplasia of the epithelium,atrophy of the mucosa,glands,periosteum.Symptoms&Sign：1)Nose,nasopharynx is dry 2)Nasal obstruction(detached crusts)3)Epistaxis 4)Anosmia 5)Foul or fetid odor 6)Headache Treatment：1、Local management：nasal irrigation by worm water,liquid paraffin 2、General management：vitaminB2、C、E 3、Surgery：
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