Vestibule of Nose

VESTIBULE OF NOSE

• Anterior and inferior part of nasal cavity• Lined by skin • Contain sebaceous gland, hair follicles and

hair(vibrissae)• Upper limit on lateral wall is marked by limen

nasi(nasal valve)• Lined by stratified squamous

epithelium(protective layer)

• A layer of mucus covers the vibrissae• Superior edge of the medial crus of the

greater alar cartilage form the boundary between nasal vestibule and the nasal cavity

• Medial edge of nasal vestibule formed by the mobile septum consisting of the columella in the medial part of the vestibule overlying the medial crura of the alar cartilage

• At the junction of the squamous epithelium of vestibule and respiratory epithelium lies Kiesselbach’s plexus which secretion unsure the nourishment of the cells

• Even a mild trauma could cause bleeding in this region

Diseases of nasal vestibule

• Furuncle or boil

• infection of hair follicle by staphylococcus aureus• Trauma from picking of nose or plucking of nasal vibrissae• Painful and tender• May rupture spontaneously in nasal vestibule• Treatment include warm compresses, analgesics, topical

and systemic antibiotics• Incision and drainage if fluctuant area present• Do not squeez because has danger of infection to

cavernous sinus through venous thrombophlebitis• May complicate into cellulitis of upper lip or septal abscess

vestibulitis

• Diffuse dermatitis of nasal vestibule• Nasal discharge coupled wt trauma of handkerchief is the usual

predisposing factor• S.aureus is the causative organism• Acute form:vestibular skin is red, swollen and tender, crust and

scales cover area of skin erosion. Upper lip may be involved• Chronic form: induration of vestibular skin with painful fissures

and crusting• Treatment consist of cleaning vestibule wt cotton aplicator

soaked in hydrogen peroxide and apply antibiotic steroid ointment

Stenosis and atresia of nares

• Accidental or surgical trauma to nasal tip or vestibule, destructive inflammatory lesions of nose

• Congenital atresia due to noncanalization of epithelial plug is rare

• Corrected by reconstructive plastic procedures

tumors

• Nasoalveolar cyst. A smooth bulge in lateral wall and floor of vestibule. Excised by sublabial approach

Papilloma or wart

• Treated by surgical excison under local anaesthesia

Squamous cell carcinoma

• Arises from lateral wall of vestibule and may extend into nasal floor, columella and upper lip

• Can metastasize to parotid and submandibular nodes

• Treated by surgical excision or irradiation