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ENT > 2.4: ENT Trauma > Flashcards

2.4: ENT Trauma Flashcards

1
Q

What is the most common ENT Trauma?

A

Nose Trauma

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2
Q

Describe some of the mechanisms of nose trauma?

A

Fighting
Sports
Falls

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3
Q

Describe breakage of the nose bone?

  • Children
  • Adults
A

Uncommon for children to break their nose bone

As they grow older, the nose bone ossifies and is more likely to break in adults

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4
Q

Some of the signs/symptoms of nose trauma?

A

Bleeding
Swelling
Bruising
Deviation

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5
Q

What is a septal haematoma?

  • How does it feel?
  • Importance?
A

This is an accumulation of blood underneath the lining of the septum
Feels boggy and soft when touched
Can lead to penetrating infection in the brain and also prevents cartilage (which is avascular) receiving nutrients leading to death (of cartilage) and deformity

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6
Q

How is nasal fracture diagnosed?

- Repeat appointment?

A

Clincially - X-Rays are unnecessary
Based on appearance, functionality, tenderness and ability to breathe
Should come back 5-7 days later once swelling has reduced to allow bones to be looked at

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7
Q

Management of nasal fracture?

A

Nothing (heals on it)

May need realigned

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8
Q

Complications of nasal fracture?

A

Epistaxis (Nose Bleed)
CSF Leak
Meningitis
Anosmia

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9
Q

Why does Anosmia occur in nasal fracture?

A

Loss of smell

Cribriform plate fracture shears off the olfactory nerves that go to the olfactory mucosa

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10
Q

What is Epistaxis?

- Common?

A 
Nose bleeding
Very common (5-10% of the population get this)
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11
Q

Management of Epistaxis?

A

Simple first aid

  • Rapid Rhino Pack
  • Remove clots/blood using suction
  • Arterial ligation (if needed)
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12
Q

Management of CSF leak?

A

Often resolves spontaneously
If they haven’t settled within 10 days, consider surgery
Role of antibiotics unclear

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13
Q

What is pinna haematoma?

  • Caused by?
  • What does this lead to?
A

Accumulation of blood in the external ear
Caused by blunt trauma
Causes deformity of the cartilage –> Cauliflower ears

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14
Q

Treatment for pinna haematoma?

A

Aspiration OR Incise and Drain
FOLLOWED BY:
Pressure Dressing

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15
Q

Describe ear lacerations?

What causes them?

A

Deep cuts or tears in the ear skin

These can be caused by blunt trauma, dog/human bites or avulsion (pulling away)

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16
Q

Treatment for ear lacerations?

A

Debridement
CLosure - Either primary or reconstruction
Antibiotics (Germs could have got into the wound)

17
Q

Describe temporal bone fracture in terms of:

  • Important history questions?
  • Complications
  • Difficulties in history?
A

Important to find out the mechanism of injury
Complications include:
- CSF leak
- Hearing Loss
- Facial Palsy
- Vertigo
Hard to get history due to associated injuries that will most likely be present - relies on bystanders

18
Q

What is the battle sign?

A

This is bruising behind the ear

Suggest middle cranial fossa fracture and may indicate underlying brain trauma

19
Q

Important things to examine in ENT trauma (temporal bone trauma)?

A

Tympanic membrane and rest of Ear
Facial Nerve (CN VII)
Hearing Test

20
Q

Types of temporal bone fracture?

A

Longitudinal vs Transverse

  • Including otic capsule
  • Sparing otic capsule
21
Q

Describe a longitudinal temporal bone fracture?

A

Most common (80%)
Caused by lateral blows
Battle sign

22
Q

Describe a transverse temporal bone fracture?

A

Less Common

Associated with blows to the frontal bone or occiput

23
Q

What are the four types of hearing loss?

A

Conductive
Sensorineural
Mixed
Central

24
Q

Describe conductive hearing loss?

Examples of causes?

A

This is when sound is unable to reach the inner ear and cannot be conducted
Can be caused by fluid in the ear - Eg: Blood, CSF
May be caused by tympanic membrane perforation (Acute or Chronic)
Ossicular Disruption/Fixation
Stapes Fixation

25
Q

What is Otosclerosis?

A

Otosclerosis is an overgrowth of bone in the middle leading to hearing loss

26
Q

Describe sensorineural hearing loss?

A

This is when sound is able to reach the inner ear however cannot be transmitted to the brain
Sensor = Cochlea
Neural = Auditory nerve

27
Q

Management of temporal bone fracture?

- Treatment may be delayed - why?

A

Often delayed due to polytrauma
May require repair of CSF leak
May require repair due to hearing loss
May need facial nerve decompression

28
Q

What are the two types of neck trauma?

A

Penetrating

Blunt

29
Q

Give some examples of penetrating neck trauma?

A

Car Accident
Knife Wound
Gun shot
Industrial Accident

30
Q

Give some examples of blunt neck trauma?

A 
Car accident
Sports Injury (Clothesline)
31
Q

Describe knife injury (neck trauma)

A

Most common in young males
Glasgow most common area
Zone 1 = Highest mortality
Some won’t make it past scene

32
Q

Describe facial trauma?

- Cause?

A

High energy blunt force

Can be life threatening and disfiguring

33
Q

Describe orbital floor fractures?

- Radiology sign?

A

Second most common facial fracture

Teardrop sign on CT

ENT (17 decks)

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