2: Nasal Injury and Foreign Bodies Flashcards
What are 3 possible MOA for nasal fracture
- Direct Blow
- Clash Heads
- Fall
What is the most common mechanism of nasal fracture
Direct Blow (eg. punch)
What are 4 clinical features of nasal fracture
- Black Eye
- Facial Swelling
- New deformity
- Septal haematoma
How will a septal haematoma present
Boggy swelling cause nasal obstruction
How is a septal haematoma managed
I+D
What needs to be excluded in nasal fracture
Head and C-Spine Injury
How should nasal fracture initially be managed
Treat epistaxis
Ice
When should nasal fractures be re-assessed
5-7d, one swelling has decreased.
If needed, when should manipulation under anaesthesia for nasal fracture be performed
10-14d
What is CSF Rhinorrhoea
Leakage of CSF caused by disruption ethmoidal bone
What are two possible causes of CSF rhinorrhoea
- Trauma
- Tumour
If CSF rhinorrhoea, what will nasal discharge test positive for
Glucose
B2 Transferrin
What is gold-standard level B2 transferrin in CSF rhinorrhoea
B2 Transferrin more than 0.5mL indicates CSF
How is traumatic CSF rhinorrhoea managed
- Antibiotics
- Pneumococcal vaccine
- Bed-rest for 7-10d, with head at 15-30’ angle
In which population are foreign bodies in the nose more common
Children
How will organic foreign intra-nasal bodies present clinically
Unilateral purulent discharge
How will in-organic foreign nasal bodies present clinically
Asymptomatic
What is used to examine the nose for foreign bodies
Auroscope
What is first-line management for foreign nasal body
Parental kiss - parent blows in child’s mouth whilst occluding other nostril
If parental kiss is unsuccessful, what is second line
Crocodile forceps
What is the most common cause of septal perforation
Septal surgery
What is septoplasty
reconstruction of deviated septum
What is septorhinoplasty
aims to straighten and re-fasten nose for cosmetic reasons or to improve breathing
What are other causes of septal perforation
- Trauma
- Inhalants
- Infection (TB, Syphilis)
- Churg strauss
