Rhinology

Question 1

What are the common presenting symptoms in rhinology cases?

Answer 1

Nasal obstruction

nasal discharge

epistaxis (nose bleed)

facial pain

nasal deformity

anosmia

sneezing

Question 2

What are the standard nasal examination techniques?

Answer 2

Nasal endoscopy

Nasal fibroscope

Question 3

What is acute and chronic rhinosinusitis and what are the treatment modalities for these?

Answer 3

Acute Rhinosinusitis:

• Symptoms lasting for < 12 weeks
• Symptoms resolve completely

Chronic Rhinosinusitis:

• Symptoms lasting for > 12 weeks
• Persistent inflammatory changes

Treatment:

Beta Lactams - Penicilin, Cephalosporin

Macrolides - Erythromycin, Clarithromycin

Question 4

What are the most common organisms seen in rhinosinusitis?

Answer 4

H. Influenzae

S. Pneumoniae

Question 5

How is a patient with a nasal fracture assessed and managed?

Answer 5

WHAT IS THE MECHANISM OF NASAL INJURY?

WHAT TREATMENT?

WHAT COMPLICATIONS CAN OCCUR?

Question 6

How are nasal polyps diagnosed and managed?

Answer 6

Investigation:

Sweat test

RAST / skin testing

Nasal smear:

• Microbiology
• Eosinophils (allergic component)
• Neutrophils (chronic sinusitis)

Coronal CT scan of sinuses

Treatment:

Oral & Nasal steroids following surgery

Question 7

How are patients with epistaxis assessed?

Answer 7

1) ABC’s
2) Medical history/medications
3) Vital signs - need IV?
4) Physical exam - rhinoscopy
5) Lab exam