Nasal disease in relation to fitness of a pilot

The nasal cavity and sinus system is extensive but its examination is limited. Listening to breathing and respiration can afford useful clues to underlying abnormality. Examination of the nasal cavity may reveal the pale swollen mucosa of allergic rhinitis or the overdeveloped lining seen in perennial rhinorrhoea and hypertropic rhinitis. Localised hypertrophy gives rise to the nasal polyp which usually forms in the region of the ethmoid sinus. Atrophic rhinitis is a destructive condition of the nasal lining. Sinusitis may be open or closed, presenting with localised pain and displacement of the eye in the case of frontal or ethmoidal abscess or mucocoele. Deformities of the external nose or nasal septum are often encountered during examination. Epistaxis may be caused by bleeding simply from Kiesselbach's vessels, or may be an early feature of telangiectasia or cardiovascular diseases. Tumors are rarely found but include papillomata and the mucous membrane melanoma.