耳鼻咽喉外伤_2课件.ppt

耳鼻咽喉科常见外伤(Trauma to ENT) Nose:：fracture of nasal bone, cerebrospinal rhinorrhea Throat: Blunt trauma of larynx, open injury Ear: traumatic perforation of ear drum, fracture of temporal bone Trachea and esophagus: burn, caustic injury Neck: Open or closed wounds 鼻骨骨折（Fracture of the nasal bone) Clinical features Deformity of external nose Swelling Pain and tenderness Nosebleed Co-existed nasal septum trauma Diagnosis Clinical diagnosis X-ray diagnosis Treatment Manipulation needed only in case of cosmetic deformity 喉挫伤(contusion of the larynx) Concept: Blunt injury Etiology: external violence from front Co-existed trauma of the other organs in neck Clinical features Sore throat Hoarseness/dysphonia Bleeding/hemoptysis Dyspnea/laryngeal obstruction dysphagia Examination PE：Swelling, subcutaneous emphysema, tenderness, deformity of laryngeal cartilages Laryngoscopy X-ray/CT Treatment Tracheotomy Open replacement of laryngeal cartilage and repair of mucosal tears Stent ABC’s 外伤性鼓膜穿孔(traumatic perforation of the tympanic membrane) Concept Etiology： direct trauma Explosion iatrogenic Clinical features Hearing loss Otalgia Bleeding (rare) Tinnitus/vertigo Otoscopy Audiometry Treatment Avoid irrigation Avoid ear drops Avoid water into the ear No blowing Antibiotics Tympanoplasty if necessary * * Applied anatomy Applied anatomy Anatomy Anatomy *