Nose pathology Flashcards
What has to be excluded in nasal septal fracture?
septal haematoma
Symptoms of nasal septal fracture…
brusing swelling tenderness deviation epistaxis
tx for nasal septal fracture…
manipulation under anaesthetic
complications of nasal septal fracture…
haematoma
CSF leak/meningitis
anosmoia
What can a septal haematoma lead to…
separation of perichondrium, de-vascularisation of cartilage which can lead to necrosis and infection
Tx for mild epistaxis…
lean forward
external compression
ice
Tx for moderate epistaxis…
silver nitrate cautery or electrocautery
Tx for severe epistaxis…
packing
topical vasoconstriction
possible arterial ligation
Describe acute sinusitis…
symptomatic inflammation of mucosal lining of nasal cavity
symptoms of acute sinusitis…
purulent nasal discharge
nasal obstruction
facial pain/pressures over sinuses
tx of acute sinusitis if immunosuppressed…
immediate antibiotics
referral to ENT
Tx for acute bacterial sinusitis…
1st line - penicillin
2nd line - doxycycline
Tx for acute viral sinusitis…
analgesia decongestants intranasal corticosteroids ipratropium mucolytics
How long does sinusitis need to last before it is classed as chronic?
more than 12 weeks
What surgical Tx can be done for chronic sinusitis?
FESS (functional endoscopic sinus surgery)
What are the 2 types of rhinitis?
allergic
non-allergic
What type of allergic reaction is allergic rhinitis?
type 1
IgE mediated
What Ix is carried out for allergic rhinitis?
skin prick test
RAST test
Tx for allergic rhinitis…
1st line- oral/intranasal antihistamine, intranasal corticosteroid
2nd line - leukotrine receptor antagonist
What are the 2 types of non-allergic rhinitis?
vasomotor
NAR eosiniphillic syndrome
How is non-allergic rhinitis diagnosed?
negative skin prick test
Tx for non-allergic rhinitis…
ipratropium nasal saline irrigation intranasal antihistamine and corticosteroid oral decongestant surgical - CO2 laser turbinectomy
What is the most common sinus for nasal polyps to appear in?
ethmoidal sinuses
What is associated with nasal polyps?
asthma
EGPA
When do nasal polyps require further Ix?
if in children or unilateral
Tx for nasal polyps…
corticosteroids
surgical polypectomy
What virus are inverting papillomas associated with?
HPV
Are papillomas malignant?
No but can change into something malignant
Sx of inverting papillomas…
anosmia
irritation
bleeding
occlusion
Tx for inverting papillomas…
removal
radiotherapy if malignant
What is the most common nasal cancer?
SCC
What are the 2 types of nasal carcinoma?
SCC
adenocarcinoma
Sx of nasal carcinoma…
unilateral obstruction
nose bleeds
mucus
hyposmia
Tx for nasal cancers…
complete surgical resection
adjuvant radiotherapy
