ENT trauma Flashcards
What is the common mechanisms of injury for nasal trauma ?
- Fight
- Sports
- Falls
What are the signs of nasal trauma ?
- Bruising
- Swelling
- Tenderness
- Deviation of the nasal bone
- Epistaxis (nose bleed)
- Facial tenderness
How are nasal fractures diagnosed ?
- On clinical findings
- They do not warrant investigation
What is the management of nasal fractures ?
- Conservative
- Unless - narrowing of nasal passage sufficient enough to warrant (MUA - manipulation under anaesthetic)
What are some of the complications of nasal fractures ?
- Epistaxis
- CSF leak
- Ansomia (loss of smell)
What is the management of epistaxis ?
- 1st line = anterior nasal septal pressure + vasoconstrictor spray (oxyductazoline)
- 2nd line = rhino packing
- 3rd line = nasal cauterisation if bleeding point seen (try avoid in kids)
If there is CSF leak due to nasal trauma what bone is most likely to have been fractured?
Cribriform plate - note CSF will contain transferrin
What are the main types of trauma which occur to the ear ?
- Pinna haematomas
- Lacerations
- Temporal bone fractures
What is a pinna haematoma ?
'’cauliflower ear’’
What is the treatment of pinna haematomas ?
- Say day assessment by ENT
- 1st line = Incision and drainage
What is the management of laceration injuries to the ear ?
- Debridement and closure by either primary or reconstruction
- Also give antibiotics
What are the signs of a temporal bone fracture ?
- Brusing - ‘battle sign’ this is post-auricular bruising
- Bleeding from ear
- Can involve middle or inner ear structures so can get vertigo, hearing loss, balance problems and facial palsys
What are the 2 main classifications of temporal bone fractures ?
Longitudinal or transverse
What are the features of a longitudinal temporal bone fracture ?
- Spares the otic capsule
- Results in conductive hearing loss due to blood in middle ear or disruption of the ossicles
- Due to lateral head blows
Describe the typical features of transverse temporal fractures
- Affects the otic capsule
- Results in sensorineural hearing loss
- Can damage facial and vestibular nerves
- Due to frontal head blows