ENT emergencies Flashcards
what clinical diagnosis indicates a nasal fracture
deviation and altered breathing
how would you manage a deviated nasal fracture
manipulation within 3 weeks
what are some serous complications of a nasal fracture
epitaxies, CSF leak, meningitis and ansomia (if cribriform plate fracture)
what is epitaxis and what blood vessels are involved
acute haemorrhage from the nasal cavity often from trauma - sphenopalatine artery, ethmoid artery, greater palatine artery
how do you arrest flow in epitaxis
pressure and ice, topical vasoconstrictor +/- LA (lignocaine and adrenaline)
what do you do in epitaxis if bleeding is not controlled
admit, arterial ligation, platelet transfusion
what are symptoms of a CSF leak after trauma and what sinuses are usually damaged
clear, thin, runny nose (rhinorrhea), frontal and sphenoid sinus
what is a septal haematoma
build up of blood between nose and nostril - can cause cartilage death and collapse
what is a pinna haematoma and what usually causes it
cauliflower ear - usually from blunt trauma
how do you manage a pinna haematoma
aspirate, incision and drain, pressure dressing
what commonly causes ear lacerations
blunt trauma, avulsion (torn off), dog bites, tissue loss
how do you manage ear lacerations
debridement and closure, LA, topical antibiotics
what can be seen on exam of a temporal bone fracture
battle sign bruise, TM and ear canal, CN VII nerve exam
what is a longitudinal temporal bone fracture
lateral blow and fracture line parallel to long axis of petrous pyramid
what symptoms are associated with a longitudinal temporal bone fracture
bleeding from external canal, hemotypanum (blood conductive hearing loss), ossicular chain disruption (conductive), facial palsy, CSF otorrhoea
what is a tranverse temporal bone fracture
frontal blow, fracture at right angle to petrous pyramid
what symptoms are associated with a tranverse temporal bone fracture
can cross internal acoustic meatus, sensorineural hearing loss from CNVIII, facial nerve palsy and vertigo
how do you manage temporal bone fractures
facial nerve decompression, manage CSF leak, hearing restoration
what exam and treatment is given in sudden sensorineural hearing loss
weber test, steroids
what foreign body in the ear is an emergency
watch/ small battery - can cause severe burns
what is a very common cause of neck laceration
males and knife crome
what urgent investigations and management are done for neck lacerations
CXR for pneumothorax, CT angiogram, urgent exploration, angiography (embolise) and occlude)
what is a deep neck space infection
extension of infection from tonsil/ oropharynx into deeper surrounding tissue
what are symptoms of a deep neck space infection
sore throat, unwell, limited neck movement, febrile and red/ tender neck
how do you manage a deep neck space infection
rehydrate, IV abs (co-amoixiclav and clindaymycin), theatre incision and drainage
what are le fort fractures and what causes them
maxillary face fractures caused by high energy blunt trauma - can be v deadly
what symptoms are seen in le fort fractures
pain, can’t see from swelling, hypoesthesia in infraorbital region, oedema (moon face), enopthalamos (posteriorly displaced eye)
