Nasal obstruction : the diagnosis of the various conditions causing it, and their treatment / W. J. Walsham.

  • William Walsham
Date:
1898
Catalogue details

Licence: Public Domain Mark

Credit: Nasal obstruction : the diagnosis of the various conditions causing it, and their treatment / W. J. Walsham. Source: Wellcome Collection.

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    nose may present a dull blush of redness on one or other s de 01 an erimly just below the bridge. In the so-called, strumous rfaxrt. TZJeL the alee nasi and vestibule are often ^ or edematous, whilst the upper lip may be similarly affected by the irritation of the discharge flowing over it. Snoring is a marked symptom in all forms of nasal obstruction, and is commonly attributed to relaxation of the soft palate, or to weakening of the supports of the palate. Fraenkel, however believes it to be due to the epiglottis falling over the entrance to the larynx as the result of the dropping of the lower jaw and consequent loll- in- back of the tongue. The fact that the snoring of deep chloroform anesthesia, which is no doubt due to lolling back of the tongue and fallin* of the epiglottis, is relieved by pushing up the jaw as well as by drawing the tongue out of the mouth, certainly lends some support to this view. Nightmare and distressing dreams are often complained of, especi- ally when, in connection with obstruction from adenoids, the tonsils are also enlarged. This symptom may be due to inefficient aeration of the blood, and may be caused, like snoring, by the dropping of the lower jaw, and consequent falling back of the tongue and epiglottis. Headache is not an uncommon symptom, especially in the obstruc- tion due to hypertrophic rhinitis, and to a less extent in that due to adenoid growths in the naso-pharynx. The explanation of this symptom is not very clear. It has been attributed to inefficient aeration of the blood, and to some alteration in the vascular inter- change between the nose and base of the anterior fossa of the skull. Vertigo is sometimes complained of in nasal obstruction, and has been attributed to reflex irritation of the fifth nerve, and to vascular disturbance at the base of the brain, accounted for by the free vascular communications between the nose and anterior fossa of the skull established by the anterior and posterior ethmoidal vessels. Aprosexia, or the inability to concentrate the mind on any individual subject, is certainly of common occurrence in some forms of nasal obstruction. It is especially noticeable in children with adenoid growths. The marked improvement in their ability to learn and in their progress at school or college after the obstruction has been removed is familiar to all who have seen many of these cases. Defective development is undoubtedly one of the most marked effects when the obstruction, such as that due to adenoid growths,
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