V- vestibule, S- septum, IT- inferior turbinate, arrows- mucocutaneus junction.
V- vestibule,, F- floor or nose, S- nasal septum,
IT- inferior turbinate, MT- middle turbinate.
Watch video of normal nasal cavity on endoscopic examination @ YouTube
Topical nasal spray or drops which contains sympathomimetic agent causes vasoconstriction of the underlying vessels typically found abundantly in the inferior turbinates. It improves nasal patency and reduces airway resistance . However, prolonged usage predisposes to rebound congestion and resultant blockage.
Other substances which cause similar decongestant effect include opiods and its derivatives such as cocaine and Co-Phenylcain which are frequently used in otolaryngology procedures and surgery (especially endonasal).
Decongestion improves visibility and appreciation
of anatomical/pathological details and better tolerance by the patient.
[Note middle turbinate anomaly in above figure. The middle turbinate
is not directly seen from this distance in most cases without prior decongestion]
High definition endoscopic view of right nasal cavity.
High definition endoscopic view of left nasal cavity.
Rounded rectangle- olfactory cleft,
PE- perpendicular plate of ethmoid, MT- middle turbinate.
Probable pneumatized superior Normal superior turbinate turbinate
turbinate (star). barey visible (oval).
N- nasopharynx, yellow arrow- eustachian tube opening, white arrows- sphenoid sinus ostium, ST- superior turbinate, MT- middle turbinate, IT- inferior turbinate.
[Left figure- right non-operated, right figure- post-operative view]
Figure showing a widely patent right sphenoid sinus ostium (arrow).
[N- nasopharynx, S- nasal septum]
Arrowhead ball- sphenoid sinus ostium.
OP- optic nerve protuberance, CP- internal carotid artery protuberance,
O- optic nerve, PS- planum sphenidale, SF- sella floor, CL- clivus,
star- intersphenoid septa, arrow- opticocarotid recess.
Stars- internal carotid artery, squares- optic nerve.
The posterior nasal cavity-nasopharynx junction.
Smooth appearance without obvious lymphoid tissue.
Mild lymphoid hyperplasia involving roof and torus tubarius bilaterally.
Corrugated/rugae appearance of posterior nasopharyngeal wall.
Another undulated/wavy appearance of nasopharyngeal mucosa.
Rounded rectangle - favourite site of epistaxis in uncontrolled hypertension. (IT - tail of inferior turbinate, TT - torus tubarius, V - vomer, N - posterior nasopharyngeal wall, SP - rostral surface of soft palate, arrow - Eustachian tube opening)
This is a groove located behind torus tubarius or salpingopharyngeal fold on either side of nasopharynx (ellipse). Nasopharyngeal carcinoma (NPC) formation begins here with fullness, groove obliteration, and eventually becomes obvious tumour with or without ulceration.
[Arrow points to nasopharyngeal Eustachian tube opening]
Close-up view of left nasopharyngeal Eustachian tube opening in a patient irradiated for nasopharyngeal carcinoma. (N - posterior wall of nasopharynx, X - visible cartilage of Eustachian tube opening, arrow -direction leading to middle ear). Compare it with normal below.
1-nasal bone, 2 frontal process of maxilla, 3- lacrimal bone, 4- ethmoid bone,
5- sphenoid bone, 7- zygomatic process of temporal bone, 8- nasal process of frontal bone, blue arrow- optic canal, red arrow- superior orbital fissure, yellow arrow- inferior orbital fissure, green arrow- infraorbital canal.
C- maxillary crest, V- vomer, IM- inferior meatus, IC- inferior concha, MC- middle concha, star rubber marker leading to nasolacrimal duct opening (arrow).
Red arrow- sphenopalatine foramen. Yellow arrow- carotid canal,
V- vomer, MC-middle concha, Black arrow leads to bony eustachian canal.
IC- inferior concha,
MM- middle meatus.