Nasal Obstruction

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Nasal Obstruction
Walsham, William Johnson, 1847-1903
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The swelling readily yields to the probe, but does not disappear or shrink to any extent under the influence of cocaine. In addition to the obstruction, the patient complains of a slimy, sanguinolent discharge, occasional attacks of epistaxis, and, it may be, of parosmia, or of trouble about the fauces or palate. On posterior rhinoscopy, a purplish mass is seen projecting at the posterior nares, and on examination with the finger a sharply-cir- cumscribed, soft, resilient swelling is felt on th...e affected side, free all round except at the situation of the posterior end of the inferior turbinal body. It is probably turbinal varix.
Turbinal varix may occur on one or on both sides. When the swelling is excessive, nothing may be seen on looking into the nostril from the front but a purplish-red mass, more or less completely blocking the passage. It may then be mistaken for a deflected septum, erection of the turbinal, or a new growth. The introduction of a probe between the septum and the swelling will show that it is not connected with the septum at all; its non-disappearance under cocaine will distinguish it from mere erection; while its general outline, which is that of the anterior end of the turbinal body, and the facts that it dimples on being probed, that it does not change its position on forcible respiration, and that it presents the characters above 1 stated when examined posteriorly, should serve to distinguish it from a polypus or other new growth.* § 72.


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