Rhinology Flashcards
(43 cards)
Red flag nasal signs
Unilateral, bleeding, numb face, neck lump
Red flags of eye symptoms
Unilateral, proptosis, double vision, eye displacement
What to check if patient has sense of horrible smell, blocked nose and discharge
Teeth as roots of teeth may be causing infection in sinus (odontogenic sinusitis)
What is forehead swelling due to
‘Potts puffy tumour’ which is osteomyelitis of frontal sinus
What is a red flag for a polyp
Unilateral or from septum
Displacement od eye due to
Mucocele: mucus cyst in sinus with mass effect
What other investigations to do If someone presents with a fractured nose
A&E management
Check for head injury: Loss of consciousness, N+V, amnesia, panda eyes (bruising under both eyes signifies damage to head)
Signs of facial fractures: diplopia, facial numbness
What nasal symptoms would you check in suspected nasal fracture
OBStruction
Nose bleeds- should have stopped after a bit
CSF leak- clear fluid dripping out when they lean forward
Cosmetic changes
Septal haematoma
IS any imaging required for a nose
NO
Acute management of fractures nose
Epixtaxis intervention
Treat septal haematoma
When to refer to ENT for follow up for broken nose
5-7 days post injury maximum
Difference between septal haematoma and inferior meatus
Septal heameatoma arises from the septum whereas the other from the other side
Management of septal haematoma
Drainage by ENT and IV abx
Complication of a septal haematoma that isn’t delt with
Saddle horse deformity (looks like a wave)
What predisposes to epistaxis
Trauma/foreign body
URTI
Anticoagulants
Systemic disorders e.g. hereditary haemorrhage telangiectasia
Management of epistaxis
Pressure on soft fleshy part of nose
Ice
Lean forwards
Resus
FBC
CLotting
Group and save
What is usually the area called which causes an anterior nose bleed
Kiesselbach’s area- ‘Littles area’
Where do posterior bleeds originate from
Sphenopalatine artery
How to examine nose with an anterior bleeding point
Local anaesthetic and adrenaline on cotton ball
Cauterise with silver nitrate stick or bipolar diathermy in theatre
Give an anterior pack if not settled: MErocel (rough tampon) or rapid rhino (gentler)
Management of posterior bleeding point
POsterior balloon pack
However SP artery ligation is better for most
Correct clotting and consider tranexamic acid
Epistaxis management ladder
1) holding nose
2) cuarterise
3) SPA ligation
4)balloon pack
5) embolisation (rare)
Presentation of vestibulitis and treatment
Crusting at the front of the nose
Mupirocin ointment or naseptin cream (contains mpeanuts)
Types of rhinitis
Infective: systemically unwell, viral URTI
Allergic rhinitis
Occupational
Gustatory (on eating)
MEdicamentosa (decongestant abuse)
Hormonal (pregnancy)
Non allergic rhinitis (also sometimes called vasomotor): in older people when the weather changes e..g from going inside to outside.
What is the nasal cycle
One nostril blocks then this switches. This is a normal phenomenon
