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Flashcards in ENT Trauma Deck (23)
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1
Q

Why must a septal haematoma be excluded in a patient with nasal trauma?

A

It may cause infection and septal abscess

It can lead to ischaemia and cartilage death

2
Q

What are the complications associated with nasal fracture?

A

Epistaxis

CSF leak and meningitis

Anosmia (if cribriform plate fracture)

3
Q

Which inherited condition can cause severe epistaxis?

A

Hereditary hemorrhagic telangiectasia

4
Q

How is epistaxis treated?

A

Pinch lower bony part of nose

Lean head forward slightly

(do not put head between legs, this only increases venous pressure in the head)

5
Q

How is a severe epistaxis treated?

A
  1. Resus
  2. Slow blood flow (pressure, ice, topical vasoconstrictor)
  3. Remove clot
  4. Anterior rhinoscopy
  5. Cautery
6
Q

What is a rapid rhino pack?

A

A tool to stop nose bleeding

Inserted into nose and inflated

7
Q

What is a pinna haematoma?

A

Bleeding beneath the perichondrium

May calcify and cause cauliflower ear

8
Q

How is a pinna haematoma treated?

A
  1. Aspirate
  2. Incision
  3. Drainage
  4. Pressure dressing
9
Q

What is Battle’s sign?

A

Indication of fracture of middle cranial fossa of the skull, and may suggest underlying brain trauma

It involves injury to mastoid process leading to bruising

10
Q

How can temporal bone fractures be classified?

A
  1. Longitudinal or transverse
  2. Otic capsule sparing or involved
11
Q

What is the most common type of temporal bone fracture?

A

Longitudinal (80%)

(fracture line parallels the long axis of the petrous pyramid)

12
Q

What is Haemotympanum?

A

Blood in the middle ear space

(a cause of conductive deafness)

13
Q

Why is a transverse temporal bone fracture more likely to damage the auditory and facial nerves versus a longitudinal fracture?

A

The fracture line is at right angles to the petrous pyramid and may cross the internal acoustic meatus

14
Q

Which type of hearing loss may occur with a transverse temporal bone fracture?

A

Sensorineural (damage to CN VIII)

15
Q

Which type of temporal bone fracture is most affected by vertigo?

A

Transverse

16
Q

What are the four types of hearing loss?

A
  1. Conductive
  2. Sensorineural
  3. Mixed
  4. Central
17
Q

What may cause conductive hearing loss?

A
  1. Fluid e.g. effusion, blood, CSF
  2. Tympanic membrane perforation
  3. Ossicular issues
  4. Otosclerosis
18
Q

What is Otosclerosis?

A

A bony growth in the middle ear usually affecting the stapes

19
Q

What may cause sensorineural hearing loss?

A

Cochlear damage

Neura (CN VIII) damage

20
Q

How are most CSF leaks into the ear managed?

A

Most are self limiting (10 days)

Repair may be indicated

21
Q

What are the 3 zones of the neck which can be affeted by trauma?

A

Zone 1 - Lower aspect (root)

Zone 2 - Larynx to carotid arteries

Zone 3 - Upwards from larynx and pharynx

22
Q

What is the classical sign for an orbital fracture on CT?

A

Tear drop sign

(in a blow-out fracture)

23
Q

When will repair be attempted in a blow out fracture?

A
  1. Entrapment
  2. Large defects
  3. Significant enophthalmos