ENT trauma & airway obstruction Flashcards
Management of suspected nasal fracture
Review in ENT 5-7 days post injury
No intervention or MUA
Complications of nasal fracture
Epistaxis
CSF leak
Meningitis
Anosmia (cribriform plate fracture)
Treatment of pinna haematoma
Incision @& drainage
What is the battle sign?
Haematoma or bleeding in post auricular area
Sign of mddle cranial fossa fracture
What are 80% of temporal bone fractures?
Longitudinal (lateral blow)
How can a temporal bone fracture cause conductivedeafness?
Haemotympanum
Ossicular chain disruption
Which type of temporal bone fracture is more likely to cause nerve injury?
Transverse (frontal blow)
What is the second most common facial fracture?
Orbital floor fractures
What is the week point for fractures of the orbital floor?
Infraorbital groove
Presentation of orbital floor fractures
Pain Decresed visual acuity Hypoaesthesia in infraorbital region Periorbital ecchymosis Oedema Enopthalmos Restriction of ocular movement Bony step in orbital rim
Investigation finding on CT of sinuses in orbital floor fracture
Tear drop sign
What would merit surgery in an orbital floor fracture/
Entrapment
Large defect
Significant enopthlamos
What view on x-ray is useful in Le Fort fractures?
Waters view
What physiologically causes a hoarse voice?
If vocal chords don’t come back together
What predisposes babies to airway obstruction?
Large head Small nares Neonates are obligate nose breathers Relatively large tongue Small, soft larynx Higher position (C1) Weak neck muscles (floppy head) Narrow subglottis
Causes of airway obstruction
Inflammatory/ infective causes/allergy Foreign bodies Physical compression/invasion of airway Trauma/iatrogenic trauma Neurological causes Neoplastic causes Burn Congenital airway pathology
What is stertor?
Snoring
What signs of airway obstruction?
SOB Coughing Choking Inability to complete sentence Sternal/subcostal recession Tracheal tug Dusky colou of skin Dysphagia Dysphonia Pyrexia Cyanosis
What causes recurrent respiratory papillomatosis?
HPV infection of the larynx (benign but can become cancerous)
How does recurrent respiratory papillomatosis present?
Obstruction/collapse after progressive breathing difficulty over months
What is the commonest cause of adult subglottic stenosis?
Vasculitis
