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In contact sports & fights Depressed or deviated NB Nonaccidental injury Simple or Compound. NASAL FRACTURES. Deformity, Obstruction& bleeding The deformity is obvious Careful palpation Nasal cavity examination Radiography. NASAL FRACTURES Clinical Presentaion. Reduction of NF - PowerPoint PPT Presentation
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• In contact sports & fights•Depressed or deviated NB•Nonaccidental injury•Simple or Compound
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NASAL FRACTURESNASAL FRACTURES
•Deformity, Obstruction& bleeding•The deformity is obvious•Careful palpation•Nasal cavity examination•Radiography
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NASAL FRACTURESCLINICAL PRESENTAIONNASAL FRACTURESCLINICAL PRESENTAION
•Reduction of NF•Disimpacted bony fragments
•Swinging, reduces the fracture
•Depressed NB is lifted
•External cast
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NASAL FRACTURESTREATMENT
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FRACTURE OF NASAL BONEFRACTURE OF NASAL BONE
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Complicationsof Nasal Trauma
–Septal deviation– Septal hematoma– Septal abscess– Causes of cosmetic defects: • poor initial management • secondary infection
NASAL FRACTURENASAL FRACTURE
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FRACURE NASAL BONEFRACURE NASAL BONE
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*
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NASAL
FRACTURE
NASAL
FRACTURE
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Perichondrium injuryHematoma
necrosis abscess int. sepsis
[”saddle nose”]
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COMPLICATIONS OF NF(SEPTAL HEMATOMA)COMPLICATIONS OF NF(SEPTAL HEMATOMA)
Examination:Thin, firm& swollen septum
Fluctuant swellingNasal obstructionUrgent drainageFirm N packing
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(SEPTAL HEMATOMA)
COMPLICATION OF NF
DS & NASAL DEFORMITYCOMPLICATION OF NF
DS & NASAL DEFORMITY
•DS : “Springiness”•Elective or acutely septoplasty
•Difficult 2ndprocedures
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KEY POINTS IN NFKEY POINTS IN NF
•Common
•Blunt violent injury
•Tripod fracture
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FRACTURES OF THE ZYGOMA&THE BONY ORBITFRACTURES OF THE ZYGOMA&THE BONY ORBIT
•Inspection: Globe level•Palpation: Orbital rim•Depressed maxilla•Parasthesia OR Numbness
•Jaw& Eye movements
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FRACTURES OF THE ZYGOMA&THE BONY ORBIT
•No Treatment•Reduction: OE,DF,ION damage
•Elevation OR Open reduction &wiring
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FRACTURES OF THE ZYGOMA&THE BONY ORBIT
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Isolated Blowout Fracture Isolated Blowout Fracture
– Localized violence --> Orbital contents
– A blow (a fist, a tennis ball, a sq. ball,
a champagn bottle cork, etc )
– Fractures of the orbital bony floor
– Trapping of the orbital contents
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Blowout Fracture SymptomsBlowout Fracture Symptoms
– Enophthalmos
– Double vision
– Limitation of eye movement
– Infraorbital nerve sensation disorders
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Blowout FractureDiagnosis
Blowout FractureDiagnosis
• Radiographs “tear drop”
• Tomograms
• Ophthalmologic examination
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Blowout FractureTreatment
Blowout FractureTreatment
• The antral cavity must be explored: - The bony fragments are exposed - The prolapsed part is replaced - Bridging or stabilization (Lyophilized dura, cartilage or plastic prop)
• Alternative or supplementary measures: - Orbital access - Lyophilized dura, silicone sheet, or teflon - Autologous implant to correct enophthalmos
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Ear Foreign Bodies
– Careful otoscopy– Careful history (nature)– GA in small children– Syringing if TM is intact– Using a hook under otoscopic control– Complication: TM perforation Injury to ossicles
or facial canal
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• Syringing is contraindicated following recent injury or ear surgery and in patients with a history of perforation of the eardrum.
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KEY POINT
• Usually found in children• Beads, coins, peas, pieces of rubber,
paper,metal fragments…Symptoms: -unilateral nasal obstruction -unilateral purulent discharge .RHINOLITH [ca]
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FOREIGN BODIESIN THE NOSE
FOREIGN BODIES IN THE NOSE
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NOSE FOREIGN BODIESNOSE FOREIGN BODIES
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RHINOLITHRHINOLITH
• Diagnosis: -anterior rhinoscopy -radiology -speculum of a fiberoptic auriscope.Treatment: -removal inst.. By probe and tipping - under GA
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FOREIGN BODIESIN THE NOSE
FOREIGN BODIESIN THE NOSE
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REMOVALOF NASALBODY
REMOVALOF NASALBODY
KEY POINT: KEY POINT:
Unilateral, Offensive, Purulent nasal
discharge in a child is usually
due to
Foreign Body.
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