ENT Emergencies

Question 1

where does a septal haematoma manifest

Answer 1

between septal cartilage and overlying cartilage

Question 2

how does septal haematoma present

Answer 2

nose feels blocked and obvious red bulge on examination, usually following some kind of trauma

Question 3

list some complications of nasal fracture

Answer 3

epistaxis - typically anterior ethmoidal artery
CSF leak leading to meningitis
anosmia due to cribiform plate fracture

Question 4

list some of the management for epistaxis

Answer 4

external pressure to nose 
cautery
nasal packing 
resuscitate on arrival if required 
topical vasoconstrictor (lidocaine)
cauterise vessel using silver nitrate

Question 5

what is the management of pinna haematoma

Answer 5

aspirate
incision and drainage
apply pressure dressing

Question 6

what is a battle sign bruise and what is it indicative of

Answer 6

bruising round the back of the ear

indicates temporal bone fracture

Question 7

what is the presentation of temporal bone fracture

Answer 7

hearing loss, facial palsy, vertigo, CSF leak

Question 8

what are the two classifications of temporal bone fracture and which one is more common

Answer 8

longitudinal - 80% of cases

transverse

Question 9

describe a longitudinal temporal bone fracture and the type of hearing loss it causes

Answer 9

fracture line parallel to long axis of petrous pyramid

causes ossicular chain dysfunction leading to conductive hearing loss

Question 10

describe a transverse temporal bone fracture and type of hearing loss it causes

Answer 10

fracture line perpendicular to the pyramid

can cross internal acoustic meatus causing damage to auditory nerve – sensorineural hearing loss