Nasal trauma Flashcards
what are the important features of a nasal trauma history
when it occurred, mechanism of injury(eg sport, fight), loss of consciousness, epistaxis, breathing
what are the different clinical features that can be seen on exam of nasal trauma
bruising, swelling, tenderness, deviation, epistaxis, infraorbital sensation, CNs
why is it important to exclude the presence of a septal haematoma with nasal trauma
septum can lose its blood supply and get infected, also risk of infection spreading to the brain
what pathology is it important to exclude with nasal trauma
septal haematoma
what is the diagnosis of nasal fracture based on
clinical diagnosis based on deviation/cosmesis, breathing
describe the management of nasal fractures
review in ENT 5-7 days after incident, then consider digital manipulation in <3 weeks
what are the complications associated with nasal fracture
epistaxis, CSF leak, meningitis, anosmia
what arteries are involved in epistaxis, and what one is especially involved
sphenopalatine artery, Ethmoid arteries and Greater palatine arteries
esp. anterior ethmoid artery
describe the first aid measures involved in the management of epistaxis
pinch nasal cartilage quite hard and high up for 5-10mins if doesn’t settle get help, ice, cautery, nasal packing
describe what is involved in the management of epistaxis in A+E
resuscitate on arrival if necessary, arrest flow/pressure, remove clot, anterior rhinoscopy, cautery/pack, 30degree rigid nasendoscopy, cauterise vessel
what further treatment is required for epistaxis if doesn’t stop bleeding in A+E
consider arterial ligation of causative artery
what is involved in the systemic management of epistaxis
reversal of effect of anticoagulant, correction of clotting abnormalities, platelet transfusion, treatment of hypertension
describe the healing of CSF leaks
often heal spontaneously, if not within 10 days then need treatment
what is a possible cause of CSF leak
if site of fracture is the cribriform plate
