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Flashcards in ENT Trauma Deck (23)
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1

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

It may cause infection and septal abscess

It can lead to ischaemia and cartilage death

2

What are the complications associated with nasal fracture?

Epistaxis

CSF leak and meningitis

Anosmia (if cribriform plate fracture)

3

Which inherited condition can cause severe epistaxis?

Hereditary hemorrhagic telangiectasia

4

How is epistaxis treated?

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

How is a severe epistaxis treated?

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

6

What is a rapid rhino pack?

A tool to stop nose bleeding

Inserted into nose and inflated

7

What is a pinna haematoma?

Bleeding beneath the perichondrium

May calcify and cause cauliflower ear

8

How is a pinna haematoma treated?

  1. Aspirate
  2. Incision
  3. Drainage
  4. Pressure dressing

9

What is Battle's sign?

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

How can temporal bone fractures be classified?

  1. Longitudinal or transverse
  2. Otic capsule sparing or involved

11

What is the most common type of temporal bone fracture?

Longitudinal (80%)

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

12

What is Haemotympanum?

Blood in the middle ear space

(a cause of conductive deafness)

13

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

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

14

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

Sensorineural (damage to CN VIII)

15

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

Transverse

16

What are the four types of hearing loss?

  1. Conductive
  2. Sensorineural
  3. Mixed
  4. Central

17

What may cause conductive hearing loss?

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

18

What is Otosclerosis?

A bony growth in the middle ear usually affecting the stapes

19

What may cause sensorineural hearing loss?

Cochlear damage

Neura (CN VIII) damage

20

How are most CSF leaks into the ear managed?

Most are self limiting (10 days)

Repair may be indicated

21

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

Zone 1 - Lower aspect (root)

Zone 2 - Larynx to carotid arteries

Zone 3 - Upwards from larynx and pharynx

22

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

Tear drop sign

(in a blow-out fracture)

23

When will repair be attempted in a blow out fracture?

  1. Entrapment
  2. Large defects
  3. Significant enophthalmos