Nasal blockage Flashcards

1
Q

Causes of nasal blockage?

A

Foreign body in the nose
Viral infection - influenza, rhinovirus
Allergic rhinitis
Rhinosinusitis
Nasal polyps
Septal haematoma
Tumours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What to ask in Hx of nasal blockage?

A

Is problem acute (<12weeks) or chronic (>12weeks).
Is it bilateral or unilateral?
Are there associated symptoms? - this helps with diagnosis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What does ‘nasal blockage’ encompass?

A

Nasal obstruction AND nasal congestion problems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Presentation of intranasal foreign body?

A

If an organic object e.g. food, bugs:
Unilateral
Purulent, foul smelling discharge
Nasal obstruction
Facial pain from sinusitis

If an inorganic object e.g. nails, paper, stones:
Asymptomatic usually, unless large enough to cause nasal obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What intranasal foreign body needs emergency removal, and why?

A

Button batteries.

WHY?
- Can cause tissue necrosis through electrolysis at the negative battery pole.
- if negative pole is directed towards the septum = can get septal perforation in 4hrs.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Presentation of intranasal button battery?

A

Purulent discharge
Epistaxis
If have associated necrosis = black discharge, facial swelling, pain, fever.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Management of intranasal foreign object

A

Remove object
Examine nasal cavity
Examine other orifices
Check ears and sinuses - could have associated otitis media or sinusitis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Presentation of nasal polyps?

A

Nasal obstruction
Rhinorrhea
Sneezing
Poor sense of taste and smell
Facial pain or pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What may be in PMH of pt with nasal polyps?

A

Asthma
Aspirin sensitivity
Infective sinusitis
CF
Kartagener’s syndrome
Churg-Strauss syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is Samter’s triad?

A

Association of aspirin sensitivity, asthma and nasal polyposis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Investigations for nasal polyps?

A

Anterior rhinos copy
Nasal endoscopy
CT sinuses
Biopsy
Nasal smear and culture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Differentials for nasal polyps?

A

Neoplasm
Foreign body
Congenital lesion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Management of nasal polyps?

A

Intranasal corticosteroid ( + nasal saline irrigation + doxycycline)
Surgical polypectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Presentation of septal haematoma?

A

Nasal trauma
Sensation of nasal obstruction
Pain
Rhinorrhea

O/E:
bilateral, red swelling arising from the nasal septum.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is a septal haematoma?

A

Development of haematoma between the septal cartilage and the overlying perichondrium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How is nasal septal haematoma managed?

A

Emergency incision and drainage
IV abx

17
Q

Complication of nasal septal haematoma?

A

Irreversible septal perforation
Necrosis —> saddle nose deformity

18
Q

Investigation for nasal septal haematoma?

A

Anterior rhinoscopy - see bilateral cherry-red swelling.

19
Q

Presentation of nasal or sinus cancer compared to nasal polyps?

A

Unilateral
Epistaxis
Vision loss/diplopia
Watering eye
Pain/pressure in one ear
Lump in face, nose, or roof of mouth.

20
Q

Investigations for nasal or sinus cancer?

A

Nasal endoscopy
Biopsy
Fine needle aspiration
Imaging - CT, MRI, PET, USS

21
Q

Risk factors for nasal and sinus cancer?

A

Prolonged exposure to certain substances - wood dust, leather dust, nickel, formaldehyde

Smoking

HPV

22
Q

Management for nasal and sinus cancers?

A

Surgical removal of tumour
Radiotherapy
Chemotherapy
Smoking cessation