Nasal septum

“ Specimens in British Museum collection.
Nose ornaments are not commonly worn in the eastern islands, though the nasal septum is generally pierced by a hole for the appendage which may be of tortoise-shell, bone, shells, &c. Youths keep the hole patent by retaining in it a small piece of wood of the thickness of a lead pencil, and between one and two inches in length. The tip of the nose is frequently pierced by a small hole about half an inch deep, in which a small peg of wood is sometimes placed which projects beyond the nose and gives the face an odd appearance. ”

“ A physician who left the tonsils in any patient was, he felt, foully and ignorantly overlooking his future health and comfort—the physician's future health and comfort. His earnest feeling regarding the nasal septum was that it never hurt any patient to have part of it removed, and if the most hopeful examination could find nothing the matter with the patient's nose and throat except that he was smoking too much, still, in any case, the enforced rest after an operation was good for him. Geake denounced this cant about Letting Nature Alone. Why, the average well-to-do man appreciated attention! ”

“ The relief and treatment of Eustachian catarrh.
5. Facility for treating nasal polypi and affections of the accessory sinuses.
Objections to the operation. (a) That the excision of a large part of the septum may lead to flattening or deformity of the nose. This objection is groundless. A strip of septal cartilage is always left above, beneath the crest of the nose. Falling in of the bridge of the nose could only be consequent on entire removal of this ‘bowsprit’ of cartilage, or from its destruction through the wound becoming septic. ”

“ At a higher level and on a posterior plane is the anterior end of the middle concha or turbinated body, which is of a paler colour than the inferior, and is only visible when the head is tilted backwards. Between it and the inferior turbinated body is the middle meatus, with which communicate the openings of the maxillary sinus, the frontal sinus, and the anterior ethmoidal cells. A considerable area of the anterior part of the nasal septum is also visible by anterior rhinoscopy, and between it and the middle turbinal is a narrow chink—the olfactory sulcus. ”

“ Orifice of anterior nares level with lower end of nasal boss. End of rostrum quite acute, and broader than deep. Rudimentary [51] alveolar groove distinct distally. Proximal end of vomer anchylosed with anterior face of nasals and reaching up to nasal boss, which has a sharp median ridge completing nasal septum superiorly. Anterior face of nasal boss slightly concave on each side of median line. (Pl. 14, fig. 2; pl. 18, fig. 2; pl. 20, fig. 2; pl. 21, fig. 3.)
Rami of mandible anchylosed together at symphysis and suture largely obliterated. Teeth slender, cylindrical, rugose, rather blunt ”

“ It cannot be expected to cease till dead parts have separated, become loose, and fall out, or are removed by art. Portions of the bones, forming the floor of the nostril, can often be removed, when dead, through ulcerated apertures in the palate; whilst others are brought away through the nostrils, there being generally sufficient space allowed for their discharge—the nasal cavities being laid into one by destruction of the columna, and more or less of the septum. Occasionally the ossa nasi, or parts of them, escape through an opening in the superimposed integuments ”

“ The NASAL FOSSÆ, or nostrils, are two irregular, compressed cavities, extending from the nose to the pharynx. These cavities are bounded superiorly by the sphenoid and 390 ethmoid bones; inferiorly, by the hard palate. In the middle line they are separated from each other by a bony and fibro-cartilaginous septum; upon the outer wall of each fossa, in the dried skull, are three projecting processes, termed spongy bones. In the fresh fossa, these are covered by a mucous membrane. ”

“ The cavities of the nose may be partly closed by polpi (tumors) on the upper and middle turbinate bone, a spur on the (septum) partition, deviation of the partition or enlarged turbinate bones, or adenoids in the upper part of the pharynx. These troubles almost close up the nose sometimes and the person is compelled to breathe through his mouth. He not only looks foolish, talks thick, but is laying up for himself future trouble. By correcting the trouble in the nose and removing the adenoids in the upper part of the pharynx the patient can breathe through the nasal passages. ”

“ The lamina perpendicularis is continued by cartilage, especially craniad, in such a way as to make a complete septum separating the two cavities. This septum extends from the septum of the external nose caudad to the lamina cribrosa, and from the internasal suture ventrad to the vomer and the suture of the premaxillaries. All parts of the nasal cavity are lined by mucous membrane. This is continuous at the nares with the integument, while at the choanæ it passes into the mucosa of the pharynx. ”

“ The examiner then elevates the tip of the nose with his left hand, resting the fingers on the forehead of the patient, and lifts the ala away from the septum with a slightly bent probe, when he will be enabled to see a considerable distance into the nasal cavity. It is, however, better to employ a speculum instead of the bent probe, because the parts then are seen in their usual relation to each other, and are not distorted by the forcible traction necessary when the probe or a dilator is employed. ”

“ The frontal sinuses are two irregular cavities extending upward and outward, from their openings on each side of the nasal spine, between the inner and outer layers of the skull, and separated from one another by a thin bony septum. They give rise to the prominences above the root of the nose called the nasal eminences. They are not developed till after puberty, and vary considerably in size, being usually larger in men than in women and young persons, in consequence of the greater prominence of the superciliary ridges in the former. ”

“ Within a few hours of the injury the swelling is often so great as to obscure the nature of the deformity and to render the diagnosis difficult. Subcutaneous emphysema is not a common symptom; when it occurs, it is usually due to the patient forcing air into the connective tissue while blowing his nose. The lateral cartilages may be separated from the nasal bones and give rise to clinical appearances which simulate those of fracture. Sometimes the septum is displaced laterally without the bone being broken, and this causes symptoms of nasal obstruction. ”

“ The discharge from the nose adheres to the nostrils and upper lip, and the infiltrated nasal lining, impeding breathing, causes snuffling and frequent snorting. The lymphatic vessels of the face are often involved and appear as painful subcutaneous “cords” passing across the cheek. These vessels sometimes present nodules which break and discharge a glutinous pus. As the disease progresses, the ulcers on the nose increase in number, enlarge or become confluent, extend in depth and sometimes completely perforate the septum. ”

“ Examination showed the entire nasal mucous membrane greatly engorged, as it always is during an attack. On the right side of the septum, near the floor, was a sharp septal spur, projecting at right angles about three-eighths of an inch, prodding the tumefied lower turbinated body. The removal of this spur under cocaine anæsthesia 188greatly modified the symptoms immediately, but a grateful frost, following in a few days, prevented an exact estimate of the benefit to be ascribed to the removal of this offending appendage. ”

“ Great care should be exercised, when introducing the speculum, not to scratch the mucous membrane of the septum, for this will give rise to pain and start hemorrhage, both of which are to be avoided as much as possible. When applications are to be made to the mucous membrane of the septum or turbinated bones, or when operations are to be performed within the cavity, it is best to employ an instrument called a nasal dilator, of which there are a large number of different forms, the most satisfactory of which is shown in Fig. ”

“ The accessory sinuses of the nose are also prone to disease. The maxillary antrum may become filled with muco-pus, forming an empyema, pus escaping intermittently by way of the nose. The condition causes pain and swelling, and may require the irrigation and drainage of the antrum. The frontal sinuses may become filled with mucous, owing to the swelling of the nasal mucous membrane over the middle turbinated bone, or an acute inflammation may spread to the frontal sinuses, giving rise to an empyema in that locality. ”

“ Further, it is of great importance to bear in mind “that the resonance of the nasal cavity also plays a part in the formation of non-nasal articulate sounds,” appearing here as a mere reinforcement of the resonance of the cavity of the mouth, and free from the nasal twang. Indeed, paradoxical as it may seem, an infallible way to make our speech sound “nasal” is to keep the air out of the nose by clasping it tightly; whereas if the nasal passage remains open the nasal twang is replaced by an agreeable resonance. What could more forcibly illustrate the importance of a well-developed nose? ”

“ The nostrils should be dilated as much as possible, as a free, wide, open nose gives a free, well-rounded tone, while a contracted nostril induces the nasal tone so much dreaded. A proper training of the facial muscles makes this dilation possible. Lifting the upper lip and projecting it forward aids the action to a great degree.
There is a strong tendency to unity of action between the nostrils and the lips and the soft palate. ”

“ First, you must realize that so-called "talking through the nose" is not talking through the nose at all, but rather failure to do so—that is, instead of letting the tone flood into the nasal cavity, to be reinforced there by striking against the walls of the cavity, which act as sounding-boards for the tone confined within that cavity, we shut off the cavity, and refuse the tone its natural reinforcement. It takes on, as a result, a thin, unresonant quality which we call nasal, although it is thin and unpleasing because it lacks true nasal resonance. ”

“ This deformity, due to whatever cause, rarely affects the base or inferior part of the nose, owing undoubtedly to the greater protection and stability offered by the lower lateral and sesamoid cartilages and the dense cellular tissue making up the alæ. Except in such cases where violence of an extreme nature has been exerted in early life, or where ulcerative disease has broken down most of the cartilage of the septum, the point of the nose is usually normal in size and shape. ”

“ Again, as showing that our knowledge of the tactile field is precise, there is the well-known fact that when a piece of skin is transplanted from the forehead to the nose, in the operation for removing a deformity of the nose arising from lupus or other ulcerative disease, the patient feels the new nasal part as if it were his forehead, and he may have the curious sensation of a nasal instead of a frontal headache. ”

“ The steel should be left in each nostril several minutes, and gently moved back and forth from time to time, for the tonic “penciling” or “ironing” effect. The curative influence of this on chronic nasal catarrh or other pathological conditions of the nose is sometimes quite remarkable. ”

“ The hair is worn very long, rolled into little curls and plentifully oiled. A most peculiar deformation is applied to the nose and results in extreme ugliness: the septum is perforated, and instead of merely inserting a stick, a springy spiral is used, which presses the nose upward and forward, so that in time it develops into an immense, shapeless lump, as if numberless wasps had stung it. ”

“ To rebuild such a nasal defect without dissection, except in such instances where the skin is quite elastic, is not to be advised, since the injected mass would be flattened, more or less, antero-posteriorly, giving the nose a broad and ugly appearance after the connective-tissue formation has been attained. ”

“ The operations herein described apply particularly to the correction or reduction of an overprominent nasal tip due to an excessive growth of congenital malformation of that part of the nose, giving the organ undue prominence and a hooklike appearance, usually associated with a narrow, sharply upward inclined upper lip.
Pozzi Method.—The same operation, on a larger scale, can be readily employed for the correction of hyperplasia nasi and rhinophyma. ”

“ To me, a turned up nose, a long thin nose, a very small nose, a nose with small nostrils, or a nose that is flat between the eyes, are the ugly forms, and every one of these may result from nasal obstruction. A few words of description as to how these various deformities of the nose are produced will help you to guard against letting your daughters grow up with deformed noses.
The turned-up nose is very common and when well marked is exceedingly ugly. People who cannot breathe easily through the nose are very fond of sniffing, and this of itself tends to produce a "snub nose." ”

“ The interior is a large and complicated chamber divided into the right and left nares, or nostrils, by the partition called the septum. This, like the external part, consists of cartilage in front, attached to bone at the back.
The Nostrils, opening on the face in front, run backward for about two inches and open into the pharynx behind. But the single canal is divided into three separate passages some distance inward. This division is effected by the turbinated bones which jut out into the nostril and thus form the upper, middle, and lower air-channels. ”