HTHSCI 2F03 Lecture Notes - Lecture 19: Post-Nasal Drip, Rhinorrhea, Hematoma
26 Dec 2020
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Upper 3rd of nose has bony support. Cartilaginous injury won"t show and radiographs don"t alter mx. Reduction under ga c post-op splinting best w/i 2wks. Septal necrosis + nasal collapse if untreated. Needs evacuation under ga c packing suturing. May be sign of rare but sinister pathology. Overgrowth of tissue on little"s area due to irritation or hormonal factors. Coagulopathy: warfarin, nsaids, haemophilia, plats, vwd, etoh. If bleeding not controlled remove clots c suction or by blowing and try to visualise bleed by rhinoscopy. Bleeds can be cauterised c silver nitrate sticks. Persistent bleeds should be packed with mericel pack. Refer to ent if this fails or if you can"t visualise the bleeding point. They may insert a posterior pack or take pt. to theatre for endoscopic control. Pass 18/18g foley catheter through the nose into nasopharynx, inflate c 10ml water and pull forward until it lodges. Admit pt. and leave pack for ~48hrs.
