ENT Emergencies

Question 1

Complications from not draining a septal hematoma include:

Answer 1

Saddle-nose deformity
Septal perforation
Septal abscess

Question 2

Basilar skull fractures bones

Answer 2

temporal (most common), occipital, sphenoid or ethmoid bones

Question 3

laryngeal injury Management

Answer 3

ATLS principles
Intubation hazardous
Respiratory distress: Tracheotomy under local anesthesia
Avoid cricothyroidotomies
If no acute breathing difficulties: Detailed history and careful physical examination

Question 4

TM rupture Antibiotic drops

Answer 4

Ofloxicin for 3-4 days
What drops absolutely need to be avoided?
Gentamycin

Question 5

Peritonsillar abscess (AKA Quincy)

Answer 5

Complication of tonsillitis
Can extend into deep neck structures and occlude the airway
Airway occlusion may be more pronounced in children due to the smaller airway size
Severe unilateral throat pain, fever, difficulty swallowing, hot potato voice, halitosis, neck pain, ear pain on affected side, headache, trismus

Question 6

Ludwig’s Angina

Answer 6

Infection of the submandibular space
Rapidly progressive gangrenous cellulitis of the soft tissues of the neck and floor of the mouth
Etiology: odontogenic 90% staph, strep

Question 7

Pott’s Puffy Tumor

Answer 7

Complication of frontal sinusitis or trauma
Most commonly in kids and teens
Osteomyelitis of the frontal bone
Can lead to intracranial abscess or venous sinus thrombosis
Work up: CT

Question 8

Facial Cellulitis

Answer 8

Involves the deeper dermis and subcutaneous fat
Most common Strep and Staph
Can progress rapidly
Treat with antibiotics

Question 9

Erysipelis

Answer 9

Involves the upper dermis and superficial lymphatics
erysipelas lesions are raised above the level of surrounding skin
Usually associated with systemic symptoms
IV antibiotics for Strep and Staph