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Sinusitis (Acute)
Published in Charles Theisler, Adjuvant Medical Care, 2023
Inflammation or infection of any of the sinuses surrounding the nose is sinusitis, or rhinosinusitis. Inflammation causes nasal passages to become swollen with nasal obstruction due to a mucus buildup. There are acute and chronic types of sinusitis. Most cases will resolve without treatment.1
Management of Ballistic Face and Neck Trauma in an Austere Setting
Published in Mansoor Khan, David Nott, Fundamentals of Frontline Surgery, 2021
The face is rarely the site of torrential haemorrhage sufficient to be the sole contributor to hypovolaemic shock. Bleeding from the nose may represent oral (such as a mandible fracture) or nasal injury. Similarly, oral bleeding can represent injuries at both sites. All conscious patients should be sat up and, in extremis, rolled onto their front. Cauterisation of severe nasal haemorrhage is usually challenging unless a clinician is well trained, has good light, and ideal magnification. Instead, nasal bleeding should be managed first by insertion of a haemostat into each nostril such as Merocel® or Rapid Rhino®. Should this fail, anterior packing of each nostril should be performed with a ribbon-type haemostatic dressing; if this fails, then additional posterior packing should be performed. Oral bleeding is far more challenging and may require intubation. Although bite props can be used to impact the maxilla, this can displace fractures and should be performed by an experienced clinician. Oropharyngeal bleeding that cannot be arrested requires careful packing that cannot be properly performed without a definitive airway. Blind clamping of external areas of facial bleeding should be avoided because critical structures, such as the facial nerve or parotid duct, are susceptible to injury. Ligation of the external carotid artery to stop facial bleeding is rarely successful due to collateral circulation and is not recommended.
Paper 4
Published in Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw, The Final FRCR, 2020
Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw
A CT and MRI have been performed for an ear, nose and throat clinic patient with chronic sinus symptoms. The MRI confirms a mass centred on the right maxillary sinus. This is low signal on T1 and high signal on T2 sequences. There is peripheral enhancement. On CT the mass is slightly hyperdense and no air is visible within the sinus. The bony walls of the sinus are thinned. The mass passes through a widened maxillary ostium into the nasopharynx.
Multi-resistant Enterobacter cloacae dacryocystitis and preseptal cellulitis: case and review of literature
Published in Orbit, 2023
Michael Kvopka, Ezekiel Kingston, Daniel D.H. Nguyen, Jessica Y. Tong, Hayden L. Kirk, Claudia M. Whyte, James D. Dalgliesh, Jennifer J. Danks
A 61-year-old male presented to general emergency with a 2-day history of right eye (RE) irritation, pruritis, conjunctival injection and new periorbital pain, erythema, and oedema that persisted despite topical chloramphenicol 1% treatment. RE conjunctival bacterial and viral swabs had been collected the day prior. Ophthalmic history included bilateral pseudophakia. Best-corrected visual acuity (BCVA) was 20/20 in both eyes (BE). He had no pain on extra-ocular movements and slit-lamp examination was limited due to RE periorbital oedema. Blood tests demonstrated elevated white cells (13.2 x 109/L), neutrophils (9.5 x 109/L), and c-reactive protein (25 mg/L). Orbital CT with contrast showed right preseptal soft tissue thickening and fluid with no retro-orbital involvement – consistent with preseptal cellulitis (Figure 2). Images were reviewed by the ear, nose, and throat (ENT) team who identified bilateral maxillary and ethmoid opacification and provisionally diagnosed chronic sinusitis. Previous RE conjunctival swabs returned positive for Streptococcus dysgalactiae, which was sensitive to penicillin and clindamycin, and Coliform spp. (no sensitivities); viral PCR was negative. He was treated with a single dose of intravenous (IV) flucloxacillin 2 g and discharged home with oral amoxicillin-clavulanic acid 875 mg/125 mg twice daily (BD).
Orbital Complications of Chronic Rhinosinusitis: Two Years’ Experience in a Tertiary Referral Hospital
Published in Ocular Immunology and Inflammation, 2023
Dina Tadros, Mohamed O Tomoum, Heba M. Shafik
We included patients with orbital manifestations of complicated rhinosinusitis (e.g., proptosis, limitation of ocular motility, periorbital swelling and pain, and visual acuity affection). All patients were diagnosed with rhinosinusitis according to the European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS) 2020 criteria7 which stated that diagnosis of rhinosinusitis requires two or more symptoms, one of which should be either nasal blockage or nasal discharge: ± facial, pain/pressure ± reduction or loss of smell. In addition to endoscopic signs of nasal polyps, mucopurulent discharge, and mucosal obstruction of the middle meatus. The diagnosis of RS was confirmed by computed tomographic scan of the nose and paranasal sinuses. We excluded patients with orbital inflammation that did not fulfill the EPOS diagnostic criteria of RS.
Application of the FACE-Q rhinoplasty module in a mixed reconstructive and corrective rhinoplasty population in Finland
Published in Journal of Plastic Surgery and Hand Surgery, 2021
S. Pauliina Homsy, Mikko M. Uimonen, Andrew J. Lindford, Jussi P. Repo, Patrik A. Lassus
Rhinoplasty is only available in the Finnish public healthcare system in cases where obstruction to airflow exists or the aesthetics of the nose are affected by a congenital condition, a previous trauma or a tumour. Reflecting this, the only PROM suitable for rhinoplasty patients validated in Finnish is the SNOT-20, an instrument focusing on sinusitis symptoms [11]. With an increasing focus on incorporating the patients’ own views in the evaluation of plastic surgery procedure outcomes in both clinical practice and research, a true need exists for a validated PROM in Finnish on the aesthetic aspects of nasal surgery [12]. The FACE-Q Rhinoplasty module was selected for translation due to the perceived ease of use that the modularity of the scale conveys as well as the rigor of its development.