Rhinology Flashcards
Anosmia
loss of sense of smell
presenting complaints of nose problems
sneezing, facial pain, discharge, epistaxis, obstruction, deformity
PMH, OH and SH of nasal problems
trauma, previous nasal surgery, asthma, aspirin allergy
woodworker
cocaine, alcohol, smoking
Examination of anterior nose
otoscope, anterior rhinoscope, profile of nose
Examination of posterior nose
endoscopic or fibroscopic
Investigations of nasal problems
bloods - FBC, RAST
CT/MRI
skin test
rhinomanometry
What are x-rays used for in nasal problems?
facial trauma
Septal haematoma treatment
drained to prevent infection
Septal perforation causes
cocaine, trauma, previous rhinoplasty, cauterisation
Nasal polyps causes
unknown, genetic, chronic inflammation, autonomic nervous system dysfunction
Allergic conditions causing nasal polyps
asthma, aspirin and alcohol intolerance
Non allergic conditions causing nasal polyps
cystic fibrosis and AFS
3 investigations for nasal polyps
sweat test - CF
RAST/skin test
microbiology - nasal smear
Imaging done for nasal polyps
CT coronal
treatment for nasal polyps
oral/nasal steroids
immunotherapy
surgery for nasal polyps
endoscopic sinus surgery, microdebrider, polypectomy
Acute sinusitis treatment
nasal decongestants, antibiotics, steam inhalation, steroid spray, antihistamine
Rhinosinusitis in sinus radiographs - negatives
poor visualisation of osteomeatal complex and anterior ethmoidal sinus
false positives
50% sensitivity of sinus opacification
Acute sinusitis classification
<12 weeks, resolve without treatment and completely
recurrent - break of 8 weeks between, 1-4 times a year
Chronic sinusitis classification
> 12 weeks, inflammation after treatment
flares - new, worse symptoms
2 causative main organisms of sinusitis
Strep pneumonia and H influenza
Symptoms of sinusitis
facial pain, nasal discharge, nasal blockage, loss of sense of smell, congestion
headache, malaise, fever, halitosis
Halitosis
bad breath
2 antibiotic classes used for sinusitis
macrolides and beta lactams
Peri orbital swelling treatment
IV antibiotics and drainage
CT and emergency surgery
Frontal sinusitis presentation and treatment
large swelling , fever, discharge
frontal sinus surgery
Common causes of epistaxis
infection, trauma, blood disorders, allergy, tumour, hypertension, congenital
Epistaxis surgery?
sphenopalatine (main blood supply), anterior ethmoid - most easily damaged by finger trauma, posterior ethmoid and ECA ligation and embolization
Epistaxis, lip vascular lesions- what is connection?
blood vessel abnormality
HHT
What MUST be done before surgery with angiofibroma?
embolization
