Emergencies in ENT Flashcards
Nasal Bone Fracture
- Make sure no ________
- Avoid contact sports ________
- If not seen by ENT by Day ______, consider septorhinoplasty after _______
Nasal Bone Fracture
- Make sure no septal haematoma
- Avoid contact sports 2/12
- If not seen by ENT by Day 14, consider septorhinoplasty after 9/12
Septal Haematoma
- History of trauma, nasal obstruction
- Post-op nasal surgery
- _____________ swelling on the anterior nasal septum
- Risk of ________
- Leads to ________ of nose
Septal Haematoma
- History of trauma, nasal obstruction
- Post-op nasal surgery
- Spongy/fluctuant swelling on the anterior nasal septum
- Risk of necrosis
- Leads to saddling of nose
Epistaxis: Bleeding from the nose
- Anterior: from _______________
- Posterior: from ___________________
- Investigations/Treatment?
Epistaxis: Bleeding from the nose
- Anterior: often from nasal septum
- Posterior: medial/lateral nasal mucosa
Investigations/Treatment
- Check Coag, FBC
- ANTERIOR: Cauterize with silver nitrate cautery if bleed spot identified
- POSTERIOR: CoPhenylcaine- decongestion and local anesthetic
Complications of Nasal Pack for Epistaxis?
1-Toxic Shock Syndrome (Streptococcus pyogenes and staph aureus)
2 Septal perforation
3 Adhesions
Complications of Acute Sinusitis?
What type of Cellulitis?
Characteristics?
Preseptal Cellulitis (Chandler I)
- Eyelid Oedema
- Erythema, pain, Fever
- No vision impairment
- Normal extraocular muscle movement
What type of Cellulitis?
Characteristics?
Orbital Cellulitis (Chandler II)
- Oedema and inflammation of soft tissue but NO frank abscess formation
- No vision impairment
- Decreased extraocular muscle movement
- Proptosis and chemosis
What type of Cellulitis?
Characteristics?
Subperiosteal Abscess (Chandler III)
- Pus collection between the periorbita and bone
- Orbital contents are displaced (inferolateral)
- Chemosis, Proptosis
- Limitation of ocular movement/ophthalmoplegia
- Impaired visual acuity/colour
What type of Cellulitis?
Characteristics
Orbital Abscess (Chandler IV)
- Pus collection within the orbital tissue
- Often caused by rupture of Subperiosteal abscess
- complete ophthalmoplegia (extraocular paralysis) + vision loss
What type of Cellulitis?
Characteristics/Causes?
Cavernous Sinus Thrombosis (Chandler V)
- Intracranial complication (Not an end result of orbital complication)
- Proptosis//Chemosis
- Bilateral ocular symptoms- VI Nerve palsy (III,IV,V1,V2,VI)
Can be caused by:
- PERIORBITAL CELLULITIS
- Nasal FURUNCULOSIS
- ACUTE RHINOSINUSITIS
Auricular haematoma can cause __________________.
It is treated with _______________________________
Auricular haematoma can cause Avascular Necrosis
It is treated with Immediate Evacuation
________________ is an infection of the tissue lining your ear cartilage. Symptoms include pain, redness and swelling. It is common amongst __________________
Perichondritis is an infection of the tissue lining your ear cartilage. Symptoms include pain, redness and swelling. It is common amongst Immunocompromised/DM
Seen in: Wegner’s
Mastoiditis => _________________________ => Intracranial complications => Neck (______) or Occipital Bone (_____)
- Presentation
- Diagnosis
- Treatment
Mastoiditis => Subperiosteal abscess form => Intracranial complications => Neck (Bezold’s) or Occipital Bone (Citelli’s)
What would result from Trauma to Zone 1?
What would result from Trauma to Zone 2?
What would result from Trauma to Zone 3?
Symptoms of Foreign Body Asphixiation?
Dysphagia
Chest pain
Regurgitate of oral intake including saliva
________________________________;
- “hot potato voice”
- trismus (lockjaw)
- asymmetric tonsils with uvula deviation
Treatment?
Complications?
Quinsy (Peritonsillar Abscess):
- “hot potato voice”
- trismus (lockjaw)
- asymmetric tonsils with uvula deviation
Treatment:
- Use needle and scalpel with plastic guard trimmed to keep penetration ≤1cm. Use headlight with a tongue depressor, Prepare suction.
- Anaesthetize with Lidocaine spray, Wait a few minutes, then make approx. 1cm incision into anterior/medial tonsil over fluctuant spot.
- Use blunt dissection with hemostat inferiorly and laterally to locate abscess. Suction while gently expressing pus.
Complications:
- Airway compromise
- Involvement of carotid sheath
____________________are among the most serious of deep neck infections. They can extend to the mediosteinum.
- Common in ________________
- Adults due to _________________ or ___________________
Retropharyngeal Abscess: among the most serious of deep neck infections. They can extend to the mediastinum.
- Common in Infants/Children
- Adults due to foreign body or Pott’s Disease
Epiglotitis:
- Rarer in children due to _________________ vaccine
- Odynophagia, sore throat, airway obstruction => ______________
- Usually very ill – high ____, _______, ________
Epiglotitis:
- Rarer in children due to H influenza B vaccine
- Odynophagia, sore throat, airway obstruction => inspiratory stridor, cyanosis
- Usually very ill – high WCC, CRP, temp
__________________:Posterior nares blocked due to failure of canalization
Chonal Atresia:Posterior nares blocked due to failure of canalization
- Can be Unilateral ( most common) => Bilateral real emergency
- Infants are obligatory mouth breathers – cyanosis when feeding
- Confirm – MRI/CT
What is CHARGE syndrome?
Coloboma (Missing Structures of the Eye)
Heart defects
Atresia of Nasal Choanae (narrowing of the back of the nasal cavity => difficulty breathing)
Retardation
Gonadal Malformation
Ear abnormalities
