Common ENT Emergencies:
- Foreign Bodies
- Trauma
- Complications of ENT Infections
EAR:
Foreign body, Auricular hematoma (Topic 1)
Traumatic TM perforation (Topic 3)
Temporal bone fracture
Etiology: blunt head injury
Clinical picture:
- Longitudinal → facial nerve paralysis, conductive hearing loss,
- Transverse→ sensory neural hearing loss
- Disequilibrium
- Battles sign (bluish discolouration of postauricular region)
- Racoon eyes & dizziness, CSF otorrhea
Diagnosis: CT
Acoustic trauma
Etiology: Sudden exposure to Noise
Clinical picture: Sensory neural hearing loss & tinnitus
Treatment:
- Avoidance/ear Protection
- Corticosteroids w/ hypobaric oxygen therapy to stop inflammation
- Vasodilators, Diuretics
Otitic Barotrauma
Inability to ventilate middle ear → abnormal dysfunction of Eustachian Tube
Etiology: Scuba diving, Flight
Symptoms: Hemotympanum
Sudden Hearing Loss
Mechanism: SNHL > 30 dB over 3 contiguous frequencies within 3 days or less
Etiology: Viral, Infectious, Vascular, Autoimmune, Neurologic
Otogenic complications (Topic 6)
Complication are caused by expansion and infection and can include
I. Extracranial complications
- Extratemporal
- Intratemporal
II. Intracranial complications
NOSE:
Foreign Bodies:
Usually Stuck on the floor of anterior or middle third
Etiology: Small toys, Buttons / beans, Food items
Symptoms: Purulent unilateral Rhinorrhea
Treatment:
- Alligator forceps to remove cloth, cotton or paper
- Kelly clamp/ Bayonet forceps for hard Foreign bodies
- Vasodilators, Diuretics
Barotrauma
Injury or damage to body tissues caused by changes in pressure
Etiology: Repeated Valsalva Maneuver
Treatment:
- Topical Nasal decongestants
- Myringotomoy / Pericentesis tube insertion
Nasal Fracture & Epistaxis (Topic 7)
Septal Hematoma/ Abscess
Complication of nasal fracture, it’s a soft fluctuant swelling of septum
Treatment:
- Needle aspiration
- Bilateral nasal packing > several days
- Prophylactic antibiotics
Orbital complications (Topic 7) →