Nose

External Appearance

Saddle nose

Destruction of the tissue of the external nose

Flaring nostrils during normal respiration

erosion of the bony portion of the nose

Seen in congenital syphilis

caused by

Gummas of late syphilis

Basal cell carcinoma

diseases of the chest

abdominal conditions touching on the diaphragm

Internal Appearance

Nasal Septum

Perforation

causes

tuberculosis

infected intranasal hematoma

chromium poisoning

syphilis

trauma

cocaine or heroin inhalation

connective tissue diseases

Cerebrospinal Fluid Rhinorrhea

Whatever the etiology, the connection between the subarachnoid space and the nose predisposes the patient to meningitis and may require surgical intervention

Often mixed with blood, which does not clot. Such nasal secretions should be evaluated by placing a drop on a piece of filter paper (or paper towel) to see whether it separates into a central red spot with a clear, strawcolored outer ring or “halo.” (The halo is due to CSF.) Never place a nasogastric tube in a patient with this sign because it may end up in the cranial vault

The presence of beta-2 transferrin in the fluid is diagnostic

Loss of Smell

Bilateral anosmia

Unilateral anosmia

always accompanies hypogonadotropic hypogonadism (Kallmann syndrome).