Rhinology

Question 1

What are the potential complications of Sinusitis and polyps?

Answer 1

Orbital swelling
Pre- orbital cellulits
These can lead to odema and abcess and are medical emergencies

Question 2

What are the common reason a child might have a blocked/ runny nose?

Answer 2

Forgein body- if unilateral
Enlarge adenoids can increase the risk of blocked nose in children

If bilateral- rhinitis

Question 3

What is choanal atresia?

Answer 3

This is an uncommon congenital abnormality in which the nasal passages don’t open up. If bilateral it can make it very difficult for child to breath particulalry as we mostly breath through our nose until 3 months old.

Question 4

Management of epistaxis

Answer 4

If once of twice used appropriate 1st aid, pinch soft part of nose for 15-20 minutes. DO NOT stuff with tissues or blow nose immediately after

If happens often many cauterised (particularly Little’s area which is densely packed with arteries)

Nasal packing if it won’t stop bleeding

Consider coagulation abnormalities

Question 5

what can be used to cauterise as treatment for epistaxis?

Answer 5

Silver nitrate under local anaesthetic

Diathermy under general anesthetic

Question 6

What is quincy?

Answer 6

Abcess occuring behind tonsil on one side.

May also have trismus/locked jaw.

Treat with IV antibiotics.

Or if it doesnt settle down aspirate under anaesthetic.

Question 7

How would you determine if a neck lump was a thryoglossal cyst?

Answer 7

The lump will be in the midline and move up with swallowing and sticking out of the tongue

Question 8

How is nasal trauma treated?

Answer 8

If seen immediatley- try to reduce under local or general anesthetic
If after a couple of months will need to think about rhinoplasty procedure

Question 9

How is a septal haematoma dealt with?

Answer 9

This is a relative emergency as can form an abcess so needs to be drained.

Question 10

What is a potential complication of septal haematoma?

Answer 10

If you get a necrotic septum you can get a saddle nose, where the middle part of the nose collapses.

Question 11

If someone has nasal polyps what test may you want to do and why?

Answer 11

Sweat test may need to be done as nasal polyps can be associated with cystic fibrosis.

Question 12

why would you not biopsy a poential tumour in the nose?

Answer 12

Is likely an angiofibroma and if it is biopsied they could bleed to death.

The way to treat these is preoperative embolisation of artery to tumour then surgical removal.

These are most commonly seen in young men.

Question 13

What is intermittent in the ARIA classification?

Answer 13

Symptoms
<4 days per week
or
<4 consecuctive weeks

Question 14

What is peristent in ARIA classification?

Answer 14

Symptoms
> 4 days/week
and
>4 consectcutive weeks

Question 15

What qualifies as mild in ARIA classification?

Answer 15

All of the following:

normal sleep
no impairment of daily activites, sport lesiure
no impairment of work and schoo
symptoms present but not troublesome

Question 16

What qualifies as Moderate-severe in ARIA classification?

Answer 16

One or more of:
sleep disturbance
impairment of daily activites, sport lesiure
impairment of school or work
troublesome symptoms