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Head and Neck > Rhinology > Flashcards

Rhinology Flashcards

1
Q

What is parosmia?

A

‘bad smell’ in nose, sign of chronic infection

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2
Q

How does aspirin trigger the airways?

A

Aspirin metabolites break down to leukotrienes, triggering a huge inflammatory response

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3
Q

What endoscopy is used for the nasal passage?

A

Flexible endoscopy

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4
Q

When should a nasal poly be removed?

A

When it actively impedes breathing

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5
Q

What investigations can be performed in a patient with nasal symptoms?

A 
Blood tests 
CT 
MRI
Skin tests
Rhinomanometry
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6
Q

What blood tests can be performed in patients with nasal symptoms?

A 
FBC
ANCA
ESR
ACE
RAST
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7
Q

What is the treatment for nasal polyps?

A

Give steroids/surgery with steroids (improves efficacy)

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8
Q

How is septal hematoma treated?

A

Drainage to prevent deformity

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9
Q

What is Samter’s triad?

A

Asthma
Aspirin Intolerance
Nasal polyps

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10
Q

What is the cause of nasal polyps?

A 
Idiopathic
Chronic inflammation
Autonomic NS dysfunction
Genetic predisposition
Allergic/non-allergic
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11
Q

Nasal polyps are commonly comorbid with what allergic conditions?

A

20-50% asthma
Allergic rhinitis
8-26% aspirin intolerance
50% alcohol intolerance

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12
Q

Nasal polyps are commonly comorbid with what non-allergic conditions?

A

Cystic fibrosis 6-48% have polyps
AFS 85% have polyps
Churg-Strauss syndrome

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13
Q

What investigations should be performed on a child with polyps?

A 
Sweat test - CF
RAST/Skin Testing
Nasal smear 
Coronal CT
Flexible nasendoscopy
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14
Q

What investigations should be performed on someone with polyps?

A

RAST/Skin testing
Nasal smear
Coronal CT
Flexible nasendoscopy

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15
Q

What should be tested for on a polyp nasal smear?

A

Microbiology
Eosinophils (allergy)
Neutrophils (chronic sinusitis)

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16
Q

What is the pharmacological treatment for nasal polyps?

A

Oral/nasal steroids
(high dose prednisolone, 20 days, eliminated 50% of polyps)
Immunotherapy

17
Q

What is the surgical treatment for nasal polyps?

A

Traditional polypectomy
Microdebrider
Endoscopic sinus surgery

18
Q

What are the positives of sinus radiographs?

A

Able to find air-fluid levels
Mucosal thickening
Sinus opacification
Less expensive

19
Q

What are the negatives of sinus radiographs?

A

Poor visualisation of osteomeatal complex/ant. ethmoid sinuses
High rate of false positives
Less accurate

20
Q

How is acute sinusitis classified in adults?

A

Acute symptom onset
Duration <12 weeks
Symptoms resolve quickly

21
Q

How is recurrent acute sinusitis classified in adults?

A

> 1 to <4 episodes of acute rhinosinusitis per year
Complete recovery between episodes
Symptoms free >8wks (absence of Rx)

22
Q

How is chronic sinusitis classified in adults?

A

Symptomatic >12wks

Persistent inflammatory changes on imaging >4wks

23
Q

How are acute exacerbations ofchronic sinusitis classified in adults?

A

Worsening of existing symptoms
Appearance of new symptoms
Complete resolution of acute symptoms between episodes

24
Q

What are the microbial causes of acute rhinosinusitis?

A

S. pneumoniae (31%)

H. influenzae (21%)

25
Q

When are antibiotics indicated for acute rhinosinusitis?

A

Purulence from the nose

26
Q

What are the minor symptom factors in rhinosinusitis?

A 
Dental pain
Halitosis
Fatigue
Fever
Headache
27
Q

What are the major symptom factors in rhinosinusitis?

A 
Facial pain/pressure
Hyposmia/anosmia
Congestion
Purulent postnasal drain
Olfactory disturbance
28
Q

What are the antibiotics used for rhinosinusitis?

A

Beta-lactams

Macrolides

29
Q

Why are macrolides used for rhinosinusitis?

A

Penetrate well into the linings of the sinuses

30
Q

What is the management for a child with acute periorbital swelling secondary to rhinosinusitis?

A 
(emergency referral)
ENT consult
CT Scan
IV Antibiotics
Emergency surgery
31
Q

What is frontal sinusitis?

A

Potts puffy tumour - inflammation and swelling of the frontal sinus

32
Q

How is frontal sinus treated/

A

Frontal sinus surgery and drainage

33
Q

What are the most common causes of epistaxis?

A 
Trauma
Iatrogenic
Infection
Allergy
Hypertension
34
Q

What are the most common surgeries for epistaxis?

A

Arterial ligation (of different arteries)

35
Q

How does Hereditary Haemorrhagic Telangiectasia present?

A

Profuse epistaxis

Red spots on lip

36
Q

How is Hereditary Haemorrhagic Telangiectasia treated?

A

Laser coagulation
Young’s Procedure
Septodermoplasty

37
Q

What is angiofibroma?

A

Highly vascularised benign tumour of the nose presenting almost always in males

38
Q

How is angiofibroma treated?

A

Preoperative Embolisation

Surgery

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