ENT Trauma and plastics

Question 1

What kind of trauma can happen to the ear?

Answer 1

Pinna hematoma
Ear laceration
Temporal bone fracture
Sudden sensory hearing loss

Question 2

How do you treat pinna hematoma?

Answer 2

Aspirate
Incision and drainage
Pressure drainage

Question 3

How do you treat ear lacerations?

Answer 3

Debridement
Closure
LA
AB

Question 4

What should you look for when investigating temporal bone fractures?

Answer 4

Hearing loss
Facial palsy
Vertigo
CSF leakage
Associated injuries
Battles sign
Condition of TM and ear canal

Question 5

What classifications of temporal bone fracture are there?

Answer 5

Longitudinal
Transverse
Otic capsule involved or not

Question 6

Are longitudinal or transverse temporal fractures more common?

Answer 6

Longitudinal

Question 7

What causes longitudinal temporal fractures?

Answer 7

Lateral blows

Question 8

Give some symptoms of a longitudinal temporal fracture?

Answer 8

Bleeding from EOM
Haemotympanum (conductive deafness)
Ossicular chain disruption (conductive deafness)
Facial palsy

Question 9

Give some symptoms of a transverse temporal fracture?

Answer 9

Facial nerve palsy (50%) & Vertigo
Sensorineural hearing loss due to damage to 8th cranial nerve
Can cross the internal acoustic meatus causing damage to auditory and facial nerves

Question 10

What should you do for someone with sudden sensory hearing loss?

Answer 10

Weber test

Steroids

Question 11

What is the Weber test?

Answer 11

Tuning fork in front of ear and bone behind

Question 12

What foreign object should you remove immediately from the ear?

Answer 12

Watch battery

Question 13

What should you look for in nasal trauma?

Answer 13

Bruising, Swelling
Tenderness
Deviation
Epistaxis
Infraorbital sensation
CNs
Septal haematoma

Question 14

How should you manage nasal fractures?

Answer 14

Review in 3-7 days once swelling has gone down

Manipulate <3w

Question 15

What is epistaxis?

Answer 15

Nose bleed

Question 16

What first aid can be administered for epistaxis?

Answer 16

External Pressure to Nose
Ice
Cautery
Nasal Packing

Question 17

What hospital management can be used for epistaxis?

Answer 17

Remove clot: suction, nose blowing
Anterior Rhinoscopy
Cautery / pack
Cauterise vessel: silver nitrate / diathermy
300 rigid nasendoscopy

Question 18

What generally causes CSF leak?

Answer 18

Fracture to the cribriform plate

Question 19

How many zones are there in the neck trauma classification?

Answer 19

3

Question 20

What is included in neck trauma zone 1?

Answer 20

Trachea
Oesophagus
Thoracic duct
Thyroid
Vessels
  Brachiocephalic
  Subclavean
  Common carotid
SC

Question 21

What is included in neck trauma zone 2?

Answer 21

Larynx
Hypoharynx
CN 10,11,12
Vessels 
  Carotids
  Internal jugular
SC

Question 22

What is included in neck trauma zone 3

Answer 22

Pharynx
Cranial Nerves
Vessels 
  Carotids
  IJV
  Vertebral artery
SC

Question 23

What are common places for fractures in facial trauma?

Answer 23

Maxilla
Orbits
le Fort

Question 24

How dangerous are maxilla fractures?

Answer 24

Potentially life threatening

Question 25

How do you diagnose an orbit floor fracture (blow out fracture)?

Answer 25

Tear drop sign

Question 26

Describe a Le Fort I

Answer 26

Break through maxilla under nose

Question 27

Describe a Le Fort II

Answer 27

Maxilla breaks away

Question 28

Describe a Le Fort III

Answer 28

Maxilla and part of temporal break

Question 29

What are the 4 steps in the reconstruction ladder?

Answer 29

Primary closure
Healing by secondary intent
Skin graft
Skin flap

Question 30

What is primary closure?

Answer 30

Suturing

Question 31

What is healing by secondary intent?

Answer 31

Heal naturally but keep clean and covered