《耳鼻喉科学 Otolaryngology》课程教学课件（PPT讲稿）nose_2 Trauma of nose and nasal cavity inflammatory disease

Trauma of nose and nasalcavity inflammatory diseases

Trauma of nose and nasal cavity inflammatory diseases

Trauma of nose1.Fracture of nasal boneBecause of its prominent position andprotruding, delicate skeleton, the nose ispredisposed to soft-tissue injury and fracture.50% trauma of nose is external nose traumacaused by impact, fall, bullet and blast. Most ofthem is lacerating wound and nasal bonefracture. Tape of fracture is relatived todirection and size of violence

Trauma of nose 1.Fracture of nasal bone ◼ Because of its prominent position and protruding, delicate skeleton, the nose is predisposed to soft-tissue injury and fracture. 50% trauma of nose is external nose trauma caused by impact, fall, bullet and blast. Most of them is lacerating wound and nasal bone fracture. Tape of fracture is relatived to direction and size of violence

Fracture of nasal boneEtiologyTraffic accidentPhysical combat.Sports injuryNasal bone---Upper end: thickLower end: thin

Fracture of nasal bone Etiology Traffic accident Physical combat. Sports injury Nasal bone- Upper end: thick Lower end: thin

ClinicalFeaturesMost common symptom is nose bleed andnose pain. Serious patient can lead to shock1.Simple contusions show external nose swellingand ecchymoma. Appears within few hours and mayobscure details of examination.2.Periorbital ecchymosis3.Tenderness4.Fracture of nasal bone can cause displacementand deformity, show bridge of the nose collapse anddeviation and saddle nose

Clinical Features Most common symptom is nose bleed and nose pain. Serious patient can lead to shock. 1.Simple contusions show external nose swelling and ecchymoma. Appears within few hours and may obscure details of examination. 2.Periorbital ecchymosis 3.Tenderness 4.Fracture of nasal bone can cause displacement and deformity, show bridge of the nose collapse and deviation and saddle nose

ClinicalFeatures5.Nasal septum fracture can cause nasal obstructionmucosa dilaceration, cartilage or bone reveal. If havehematoma of nasal septum, we can see bulging in oneor two side of nasal septum.6.If nasal root collapses obviously, X-ray or CT should betaken so fracture of sinuses and skull base can be foundearlier. Nasal discharge flood just like water, we shouldthink about cerebrospinal fluid rhinorrhea. Final diagnosiscan be get by chemical examination.7.Open fractures often are comminuted fractures. Besideshave soft tissues injury ,always have foreign bodies

Clinical Features 5.Nasal septum fracture can cause nasal obstruction, mucosa dilaceration, cartilage or bone reveal. If have hematoma of nasal septum，we can see bulging in one or two side of nasal septum. 6.If nasal root collapses obviously, X-ray or CT should be taken so fracture of sinuses and skull base can be found earlier. Nasal discharge flood just like water, we should think about cerebrospinal fluid rhinorrhea. Final diagnosis can be get by chemical examination. 7.Open fractures often are comminuted fractures. Besides have soft tissues injury ,always have foreign bodies

ClinicalFeaturesAlthough these injuries do not often appear to besevere, the mistake of undertreating nasal traumacan lead to significant long-term problems. Externaldeformity, nasal obstruction, septal perforation andother complications (e.g., chronic sinusitis) oftenpersist and sometimes worsen months or years afterthe original insult. Thoughtful assessment andproper management of nasal injuries can reduce therisk of these sequelae, thereby reducing the needfor delayed corrective septorhinoplasty

◼ Although these injuries do not often appear to be severe, the mistake of undertreating nasal trauma can lead to significant long-term problems. External deformity, nasal obstruction, septal perforation and other complications (e.g., chronic sinusitis) often persist and sometimes worsen months or years after the original insult. Thoughtful assessment and proper management of nasal injuries can reduce the risk of these sequelae, thereby reducing the need for delayed corrective septorhinoplasty. Clinical Features

DiagnosisDiagnosis is best made on physicalexamination. X-ray may or may not showfracture. Patient should not be dismissed ashaving no fracture because X-rays did notreveal it.X-rays should include Waters' view, right andleft lateral views and occlusal view. We cansee fracture line and sclerotin sag

Diagnosis Diagnosis is best made on physical examination. X-ray may or may not show fracture. Patient should not be dismissed as having no fracture because X-rays did not reveal it. X-rays should include Waters’ view, right and left lateral views and occlusal view. We can see fracture line and sclerotin sag

Diagnosis: Frontal palpation, X-ray, CT scansfront wall fracturefront & back wall fracture(sunkenfracture凹陷型）(smashedfracture粉碎型）

front wall fracture front & back wall fracture (sunken fracture凹陷型) (smashed fracture 粉碎型) Diagnosis：Frontal palpation, X-ray, CT scans

Tang Wan You M/038YLIFFORDHOSPITALPID:52233CT01 OCOACC:151796Apps305.4_H3.1M42008-06-1710:07:2893.800003SER:102IMA.99FracturedNasal boneKVP:120mA.260SNUM

Fractured Nasal bone

TangManYou M/038YCLIEFORB-HOSPITATCA522TASTOLCMA8C1417960i)LightSpeedApps305r41H32tM42008-06-1710g7.28.3cmBORE102/0SER:145IMA.4Fracturednasalbone0.2/kv120203120nA22600./5:17c.6sp-22.0SNM20AMIP2816411

Fractured nasal bone