Ear, Nose and Throat - U.S.A.  (ENT USA)  
Nose (Nasal) Photographs and Pictures
Nasal (Nose) Pictures
Pictures of the Inside of the Nose

Allergic  Rhinitis:  The inside of the nose is swollen and there is thick secretions.  The turbinates are pale wit clear secretions.  Pictured in these photographs is the space between the nasal septum and inferior turbinate.

Pale Nasal Mucosa in a Patient with Allergic Rhinitis   Inferior Turbinate and Septum in a Patient with Allergic Rhinitis   Allergic Rhinitis  


Search PubMed for Allergic Rhinitis 
Search PubMed for Fungal Sinusitis
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Picture of Polyps in NosePicture of Nasal PolypsNasal Polyp:  A nasal polyp is a mass of gelatinous tissue which usually forms from allergy. If only on one side, one must rule out a carcinoma or cancer.  Allergic nasal polyps can be treated by topical nasal steroids or by surgical removal.  Often endoscopic sinus surgery is needed for their removal. 
Search PubMed for Nasal Polyps


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Photograph of Polyps in NosePicture  of Polyps in Right Nasal CavityThe pictures shown to the right are of a patient's CT Scan (far right) and of her polyps in the left (middle picture) and right (far left picture) nasal cavities.  The CT Scan shows polyps "*" and opacified maxillary sinus "MS" and an opacified posterior ethmoid sinus "ES". 

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The nasal polyps on the below and to the right are from a 65 year old patient who has had four previous sinus operations.  The last one was twelve years ago.  The polyps fill his nasal cavity.  On CT Scan there was erosion of the posterior table of the frontal sinus and intracranial air.

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Nasal PolypsNasal Polyps

Rhinophyma is a chronic end-stage skin condition caused by hypertrophy of the skin's sebaceous (oil) glands.  The skin thickens and becomes filled with cysts and pustules.  Treatment is surgical excision and shaving the thick skin in layers with CO2 laser, dermabrasion or electrocautery.      Click Here To:  View Stages in Operation and Post Operative Result

Medical treatment to prevent progression has been targeted at the treatment of sebaceous hypertrophy.  Rosacea has been implicated as a causative factor.  For this reason topical antibiotics such as metrogel have been prescribed and to keep the skin pores open, soaps, moisturizes, gels, sun screen may also be recommended.   Rhinophyma is NOT related to alcohol consumption but an end-stage presentation of sebaceous hypertrophy. 


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Mucocele:  A mucocele is a collection of mucoid fluid from a blocked sinus which forms an expansile mass.  The lining of the sinus continues to secrete mucus which places a mild continuous pressure on the surrounding sinus walls.  This pressure over many months to years slowly expands the sinus and may impinge upon important structures.   

The patient below is a 31 year old patient who sought medical attention for double vision and facial numbness.  The patient's face was asymmetrical (left hand picture below) and on CT Scan a large mass was seen in the Maxillary Sinus (middle picture below).  On nasal endoscopy the sinus was entered and abundant thick fluid was removed from the sinus a septoplasty to straighten the nasal septum was also performed.  Post operative result is show in the right hand CT Scan below.

Click Here To: 
CT Scan after drainage of a large maxillary sinus mucoceleCT Scan of a large maxillary sinus mucocele Mucocele - Appearance of Patient
View Flash CT Scan Presentation

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Five Month Post-Op
Septal Spur:
  This patient had chronic headaches which were relieved with intranasal hurricane spray (numbing solution).  It was felt that the large septal spur impinging upon the middle turbinate may be contributing to the headaches.  A septoplasty was performed.  The headaches disappeared after the operation.
  Spur on Nasal SeptumNasal Septal Spur
CT Scan of Septal Spur(Left Photo:  CT Scan of Septal Spur, Middle Photo:  Septal Spur- Pathological Specimen;  Right Photo: Septal Spur Pre-Operative Appearance.)
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Nasal Septal SpurAlthough some patients have reported headache relief from the removal of
septal spurs, the results are variable and cannot be guaranteed. View Article  Headaches are caused by a wide range of etiologies.  Before surgery, it is best to anesthetized (numb) the nose to see if the headache is relieved.

Surgery for "sinus headaches" is also debated and results cannot be guaranteed.  Shields has shown the there was no correlation between the severity of pain and the severity of sinus symptoms.  This brings into question whether sinus disease is causing the symptoms at all.  One explanation is that most head pain is caused by tension headaches and migraines.  The patients just assume the pain is from sinus disease because of the mass marketing of sinus medications they see on television.   View Article

Picture of Nasal PapillomaCT Scan Nasal Papilloma
Nasal Adenoma:  The pictures on the right shows a large nasal mass in a 60 year old patient.   The far left hand picture shows the patient's preoperative CT scan.  The adenoma was removed in the office. 


Ethmoidectomy - Fess - Functional Endoscopic Sinus SurgeryaPost Op Ethmoidectomy - Fess - Functional Endoscopic Sinus SurgeryaThe mass was removed with and endoscopic intranasal anterior ethmoidectomy.   The post-operative cavity is shown in the right hand picture.  The final pathology reveled a benign nasal
papilloma.  The picture on the left shows the four month post operative result.  Endoscopic removal of papillomas has a high rate of cure without producing a cosmetic defect (Kraft 2004). View Abstract
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Axial CT Scan of Inverted Papilloma of the Nasal CavityCoronial CT Scan of Inverted Papilloma of the Nasal CavityTheses photographs shows patient with an adenoma
of the nasal cavity.  On CT scan, the center of the adenoma can be seen to be calcified. 

The pictures below show the appearance of the papilloma before (left) and during (far right) surgical removal.  Note that the preoperative appearance of the papilloma resembled a normal turbinate.  Endoscopic removal of papillomas has a high rate of cure without producing a cosmetic defect (Kraft 2004).
View Abstract   However, inverted papillomas are locally invasive and patients must be followed for recurrence.

Picture of Nasal adenoma in left nasal cavity    Nasal Adenoma - Surgical Specimen    Nasal Adenoma - Surgical Specimen

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Nasal Polyp in Oral-PharynxThis photograph shows a huge
nasal polyp in a 10 year old white female extending into the oral pharynx.  In a young Caucasian patient cystic fibrosis should be ruled out.

Appearance of Nasal Cavity After Functional Endoscopic Sinus Surgery - FESSPost Endoscopic Sinus Surgery:   This is a picture of the middle meatus, the space between the middle and inferior turbinate.  Large openings can be seen into the maxillary and ethmoid sinuses.  The mucosa is moist and without significant drainage.

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Chronic Allergic RhinitisChronic Allergic RhinitisChronic Rhinitis:  This is a picture of chronic rhinitis secondary to smoking.  The secretions are dry and the turbinates are whitish.  Unfortunately, quitting smoking often does not reverse the symptoms since permanent damage has been done to the nose.  After quitting, nasal secretions may worsen as the goblet cells recover, but the ability to clear secretions does not. Search PubMed for Vasomotor Rhinitis  Search PubMed for Smoking and Rhinitis

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Picture of Normal Nasal Mucosa and Ostea of Maxillary SinusNormal Nasal Mucosa and Ostea of Maxillary Sinus:

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Foreign Body in the Nose:
  This picture shows a plastic "hot wheels" toy in the right naris of a 5 year old.  The foreign body is wedged below the middle turbinate.  Attempts at removal in the emergency room was unsuccessful and the child was taken to the operating room for removal. 

Plastic Toy Wheel Deep in the Nasal CavityPlastic Toy Wheel Wedged Between the Middle Turbinate, Inferior Turbinate and Nasal SeptumNasal Foreign Body - Plastic Wheel from a Hot Wheel Toy

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Picture of a Foreign Body in the NosePicture of Wood Chip Nasal Foreign Body
This picture shows a wood chip foreign body in the nose.  It is located under the middle turbinate, deep in the middle meatus.  It was removed in the doctor's office under local anesthesia. 

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Search PubMed for Epistaxis

Nasal Septal Vessels Which Cause Nose BleedsThis picture shows prominent anterior (up-front) septal vessels which will bleed easily.  This type of nose bleed (epistaxis) usually occurs in children.

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Nose Bleed in Kiesselbach's plexusProminent Anterior Nasal Septal Vessels.
  In young children
nasal bleeding is often caused by chronic nasal inflammation and rupture of small blood vessels located on the anterior nasal septum.   The picture on the far right shows prominent vessels on the nasal septum.  This vascular formation is often called Kiesselbach's plexus.  The same child was seen a week later just after a nose bleed.  The picture on the left shows the source of bleeding.   Learn More About Epistaxis

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Picture of Posterior Nasal Cavity Nose BleedThese pictures show a
posterior nosebleed (epistaxis) with a large clot on the floor of the nose.  This type of nose bleed usually occurs in adults with high blood pressure.  Note the blood coming out from under the middle turbinate.

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Inverted Papilloma of the Nasal CavityThis patient presented with left sided
epistaxis and was found to have a mass in her nasal cavity.  The mass was an inverted papilloma.  This is a locally invasive tumor which is treated with surgical resection.  Endoscopic sinus surgery can be used to remove this growth.  In this procedure fiberoptic scopes are placed in the nose and the growth is resected without any external surgical incisions.  The overall success rate has been reported to be as high as 94%   View Article

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Necrotic turbinate mucosa from insertion of pills into the nose.Nasal Necrosis from Drug Abuse:  The appearance of the inside of the nose from inserting a pill into the nose.  The robin egg blue is characteristic of narcotic abuse.  The picture on the right shows necrosis of mucosa on the medial portion of the inferior turbinate and the inferior portion of the middle turbinate.  The lower septal mucosa is also white and necrotic.   Click on pictures to enlarge !!!   
Go To ENT Manifestations of Drug Abuse Page.

CT Scan of a RhinolithPicture of a Removed RhinolithRhinolith:  A rhinolith is a rock which forms in the nose.  It occurs from the solidification of mucus and nasal debris.  As shown on the CT Scan x-ray, the rhinolith was displacing the inferior turbinate superiorly and had to be removed under general anesthesia. 

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Nasal Septal Mass:  Shown in this photograph is a pyogenic granuloma on the nasal septum.  This mass is benign and is not a true neoplasm.  In the nose, it usually presents as bleeding.  Treatment is by surgical removal.  Unfortunately, recurrences are common.

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Nasal Septal PerforationNasal Septal PerforationPerforation of Nasal Septum:  A perforation of the nasal septum can be caused by a complication of surgery, nasal trauma, autoimmune diseases, chronic use of nasal steroids, use of topical nasal decongestants or cocaine abuse.  The perforation can cause crusting, nasal bleeding and whistling when the patient breaths.  Treatment involves the use of nasal wetting agents, placement of a plastic button over the perforation, and surgical repair.  Repair with surgery is very difficult and failure to close the perforation is common.
Search PubMed for Septal Perforation
Articles on Repair of Nasal Septal Perforations:   View Abstract   View Abstract

Nasal Septal PerforationNasal Septal Perforation DiagramPerforations of the
nasal septum can also be caused by drug abuse.  To the right is a photogra ph of a large nasal septal perforation, the margin of which is shown in blue (click on pictures to enlarge).  Note the nasal synechiea (scaring shown in green) between the nasal septum and right inferior turbinate.  The specks through out the nasal cavity are a whitish dust which has been inhaled or snorted.

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Nasal Septal PerforationThe perforation shown on the right in in a 5 year old.  The hole was produced from a button battery which the child inserted.  This type of foreign body should be removed immediately.  Prior to removal, the use of nose drops of any kind is absolutely contraindicated.  The electrical charge of the battery will produce electrolysis of any electrolyte-rich fluid.  This produces hydroxides which will cause a severe alkaline burn. Healing took several weeks and damage to the to the nose which produced a
nasal septal perforation occurred.  In children, there is some evidence that damage to the nasal septum
may cause failure to the mid-face to grow.
        Learn More About Button Battery Foreign Bodies:   
***View & Read Article - Adobe Acrobat 4.0***

Wegener's Granulomatosis:  This patient is a 62 year old with a two year history of Wegener's Granulomatosis.  This is an autoimmune disease which attacks the blood vessels of the body, causing a vasculitis.  The disease often damages the nasal septum and sinuses.  It can also attack the eyes and kidneys, causing visual loss and renal failure.  This patients was treated with methotrexate ( an immunosuppressant ), bactrum and folic acid.  The picture on the right shows a very large perforation of the patient's nasal septum.  There is also almost complete loss and scaring of the left middle turbinate and middle meatus (see arrow) which is blocking the drainage of the ethmoid sinus cavities. 

Nasal Septal Hematoma
Septal Hematoma:  This picture shows a unilateral left septal hematoma which has been present for over one week.  This condition requires immediate medical attention.  The septal cartilage has no blood supply and receives all of its nutrients and oxygen from the perichondrium.  If the hematoma is bilateral, the cartilage can die within 24 hours, resulting in a saddle nose deformity.  Treatment consists of surgical drainage, packing and antibiotics.   Search PubMed for Nasal Septal Hematoma

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The pictures below are from a 5 year old male who sustained a blow to his nose four days prior to his visit.  Note the bilateral swelling of his
nasal septum (picture to the extreme right).  The child was taken to the operating room where a septal hematoma and abscess was drained.  The vast majority of the septal cartilage had liquefied, turning yellow and translucent (see middle picture).  The nasal cartilage is important both for the support of the nose and in children for mid-facial growth.   This child is at risk for developing a saddle nose deformity, and mid-facial hypoplasia (flat cheeks and poor occlusion with a maxillary under bite).  Two weeks out (left picture) the nose is starting to show a mild saddle deformity.

Nasal Septal HematomaNasal Septal Hematoma With Necrotic Nasal Septal CartilageSaddle Deformity of the Nose Caused by Nasal Septal Hematoma

Frontal Sinus Osteoma X-Ray
Frontal Sinus Osteoma:  An osteoma is a benign slowly growing bone tumor.  It is commonly found in the frontal sinus.  Removal is recommended if the osteoma shows significant growth, is blocking the sinus or is very large and threatening to produce an acute sinus blockage.  The picture to the right shows a very large frontal osteoma (located between and above the orbits).

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X-Ray of Undifferentiated Carcinoma of the Nasal Cavity and SinusesUndifferentiated Carcinoma of the sinus.  This is a 33 yr old male who presented with three months of deep facial pain and recently developed unilateral nasal bleeding and airway obstruction.  He was a woodworker and exposed to sawdust.  These tumors can be successfully treated with a combination of chemotherapy and radiation therapy   View Abstract
Search PubMed for Nasal Neoplasms

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Squamous Papilloma of The Anterior Nasal Septum;  This growth is a benign locally invasive and destructive lesion.  It was found in a 62 year old male with a 37.5 pack year history of tobacco use.  Treatment is with surgical excision.

Squamous Papilloma of the Nasal SeptumSquamous Papilloma of the Nasal SeptumSquamous Papilloma of the Nasal Septum

verrucous valgarisVerrucous Vulgaris:  Shown in the picture on the right is a verrucous vulgaris or wart which is on the inside of the nose.  This is a skin growth which is caused by a virus.  In this case, it may have been implanted in the nose by nose picking. 

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Ossifying Fibroma of Ethmoid Sinuses
Ossifying Fibroma of the Ethmoid Sinuses:  This is a rare condition caused by a slowing growing benign process which can cause serious problems by placing pressure on important structures as the mass expands.  Often the sinus lining protrudes into the nasal cavity and nasalpolyps can form. Treatment is surgical excision or debulking.  Shown in the pictures is the patient's CT Scan and a photograph of a mass (NM) in the patient's nose.  Search PubMed for Fibrous Dysplasia  Search PubMed for Ossifying Fibroma        

Nasal Hemangioma
Nasal Hemangioma:  This patient presented with nasal bleeding.  A mass was found growing from the inferior edge of the middle turbinate.  The mass was surgically removed.   The pathological diagnosis was a hemangioma.

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Tornwaldt CystLarge Nasopharyngeal Cyst in an 89 year old who presented with serous otitis media.  Always check the nasopharynx for masses in adults with an otitis media.  Congenital cysts in the posterior wall of the nasopharynx are called Tornwaldt cysts.   Theses cysts are thought to form from a remnant of the notochord. 

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Mucocele of the
Anterior Ethmoid Air Cells:  The CT scan and intranasal photographs shows a large mucocele of the anterior ethmoid sinus air cells.  The cyst is expanding the surrounding bone and can be seen in front of the middle turbinate (photograph second from the left).  The post-operative drainage photograph is shown far right.  

Post-Operative Appearance of  Ethmoid Sinus MucoceleCT Scan Ethmoid Sinus MucoceleEthmoid Sinus MucoceleEthmoid Sinus Mucocele  

Jacobson's Organ - Vomeronasal Organ and PitJacobson's Organ - Vomeronasal Organ and Pit
Jacobson's Organ ( vomeronasal organ and vomeronasal pit ) :
  In many patients, if one looks closely, a small pit can be seen at the bottom of the anterior nasal septum.  This pit is felt to be a vestigial organ used in lower vertebrates to detect traces of chemicals and in humans it may act as a pheromone receptor.  

Search PubMed for Jacobson's Organ
View Abstract    View Abstract

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