ENT emergencies Flashcards
subperichondrial hematoma d/t shear force trauma
auricular hematoma
cauliflower ear is seen with _____
auricular hematoma
how do you treat auricular hematoma
I/D or aspiration (if <2cm and 1-2 days old)
abx
ear discomfort d/t pressure changes, eustachian tube blockage or ear infection
barotrauma (airplane air)
on exam the TM bulges out/in slightly and you can use insufflation to see if liquid build-up behind ear
barotrauma
how is barotrauma tx (3)
yawning, chewing gum
decongestants
abx if infection
blood in tympanic cavity of middle ear d/t basilar skull fracture
hemotympanum
how do you tx hemoptypanum
address underlying condition
pt has ear pain or fullness, difficulty hearing, tinnitus, discharge/odor. Normal ear exam but cannot see TM. what is the likely cause?
cerumen impaction
two things that can cause acute tympanic membrane perforation
infection (including otitis)
direct trauma (q-tip, etc)
which medication should be avoided with acute tympanic membrane perforation? which should you use?
avoid corticosporin
use oflaxacin or ciprofloxacin
how do you treat acute TM perforation? (2)
heals spontaneously but large ones need surgery
oral or drop abx if infected
most common location for epistaxis
Kiesselbach’s plexus (anterior)
what do you do if after 10mins of pressure, the epistaxis doesn’t stop? (5)
if you can see it cauterize it
topical vasoconstrictor (oxymetaxoline)
hemostatic agents
nasal packing
arterial ligation
what must you do if packing an epistaxis
give prophylaxis abx and remove packing a week later
minor epistaxis patient education (including 4 things to avoid)
use nasal saline spray
avoid hard nose blowing/sneezing
avoid digital trauma
avoid hot showers or hot/spicy foods
avoid NSAIDs
5 ways to remove nasal foreign bodies
positive pressure (farmers blow, mothers kiss)
alligator forceps or hooked probe
lido jelly + balloon catheter
suction
glue
2 imaging for facial fractures
CT for facial bones
Xray for nasal bones
frontal fracture management (1)
immediate neurosurgery consultation
orbital fracture management (2)
support + convo w/ ophtho or oral maxillo-facial surgery
if it involves sinus, should get prophylaxis abx
zygomatic fracture management (1)
surgery
maxillary (Le fort) fracture management (2)
often surgery
if CSF rhinorrhea then consult neurosurgery
nasal fracture management (4)
reduce if severely angulated
control epistaxis and support w/ analgesics
wait 10-14 days for surgery
abx for open wounds
mandible fracture management
fixation w/ admission
abx (PCN or clindamycin)
