Nose Conditions Flashcards
what conditions are assocciated with nasal polyps
allergic and non-allergic rhinitis, non-allergic asthma, aspirin allergy, CF
what is the presentation of a nasal polyp
congested, discharge, sneezing, snoring, not painful
what is the management of a nasal polyp
TOP CCS betamethasone, if fails surgical removal ESS
what benign lesion can affect the nasal vestibule
squamous papilloma
what is the commonest malignant lesion of the nose
nasopharyngeal carcinoma
what type of cancer is nasopharyngeal carcinoma
squamous cell carcinoma
what are risk factors for nasopharyngeal carcinoma
epstein barr virus infection
how is EBV linked to malignancy
subclinical infection, infects epithelial cells (NPC) & B cells (lymphomas)
what must be done on examination of a suspected nasal fracture
look up nose to check fro boggy septal haematoma
how is a nasal fracture diagnosed
clinically; deviation/ cosmesis. no XR
what is the management of a nasal fracture
nothing/MUA
review at ENT clinic 1wk later
what are complications of a nasal fracture
epistaxis
CSF leak
meningitis
anosmia
what is the management of epistaxis in a nasal fracture
pressure, vasoconstrictor, adrenaline, co-phenylcaine
what vessel is most likely to be causing epistaxis in a nasal fracture
anterior ethmoidal
what is battle sign
bruising behind ear in temporal bone fracture
how are temporal bone fractures classified
if spare or involve the otic capsule
are longitudinal or transverse temporal bone fractures more common
longitudinal
what are complications of temporal bone fractures
ossicle disruption, CHL, SNHL, VII palsy, CSF leak
where is a le fort 1 fracture
horizontal above teeth
where is a le fort 2 fracture
pyramidal, through nasal bridge, maxilla frontal process, lacrimal, inferior orbital floor, zygoma, pterygomaxillary fissure, pterygoid plates
where is a le fort 3 fracture
transverse, craniofacial disjunction
what is the risk in cribriform plate fracture in le fort 2 and 3
infection spreads form nose/sinus to cranium
investigations of facial trauma (suspected fracture)
CT and C spine XR
what is the cause of acute sinusitis
nasopharynx organism spread to sinus
which sinus is most commonly affected by sinusitis and why
maxillary since drains against gravity
why are the cold and smoking risk factors for sinusitis
affect cilia (their job is to waft mucus towards ostia)
what are the common infecting organisms in acute sinusitis
98% viral URTI
secondary bacterial infection: s. pneumoniae, h. influenzae, s. pyogenes, Moraxella
what is the presentation of acute sinusitis
runny nose, discomfort on frontal/maxillary sinuses, tooth pain
why can acute sinusitis present with tooth pain
referred pain from CNV1/2 shared sensory supply
how is acute sinusitis diagnosed
clinical Dx
what is the general management of acute sinusitis
nasal decongestant, analgesia
when are antibiotics indicated for acute sinusitis
if persists longer than 10 days
which antibiotics can be used for acute sinusitis
1st penicillin, 2nd doxycycline (not in child)
what is a complication of ethmoidal sinusits
orbital cellulitis
what is vasomotor rhinits
non-allergic
what allergic tests are useful for allergic rhinitis
serum IgE, mast cells, skin prick
what is the classification of allergic rhinits
intermittent or persistent
what is intermittent rhinitis
symptoms <4day/wk or for <4wk
what is persistent rhinitis
symptom >4day/wk + >4wk duration
what is the management of allergic rhinitis
avoid allergen + antihistamine
TOP CCS
TOP CCS + antihistamine
IgE immunotherapy
