• 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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