Nose Injuries Research Articles

Assessment of Knowledge and Attitude of First Aid Management of Epistaxis among the General Population in Najran Region: A Cross-Sectional Study

Background: Nasal bleeding, epistaxis, is a common emergency. Few Saudi studies exist on epistaxis awareness and first aid management. We aimed to assess knowledge and attitude of adults in Najran, Saudi Arabia towards epistaxis first aid management, as well as their association with sociodemographic factors.Methods: A cross-sectional web-based survey was carried out involving general adults of Najran, Saudi Arabia, using a snowball sampling method. A pretested questionnaire was utilized for data collection. Knowledge and attitude scores were categorized as good/positive or poor/negative. Both descriptive and inferential statistics were carried out with odds ratio (OR), 95% confidence intervals (CIs), and logistic regression analysis to investigate factors associated with knowledge and attitude towards epistaxis first aid management using SPSS Software.Results: The study included 518 participants with 58.9% experienced nosebleeds. Common causes were hypertension (24.5%) and nose injuries (23.7%). Factors as nasal dryness, blood thinner use, and tumors/nasal polyps were also identified. Around 60.2% believed first aid was necessary and 59.5% had good knowledge about epistaxis first aid management. Participants with university/higher education, employed in health sector, and with previous experience with nosebleed were more knowledgeable, more likely to have positive attitudes, and showed significantly higher ORs for knowledge and attitude scores compared to others.Conclusion: The study showed fair knowledge and attitude of Najran adults towards epistaxis first aid management with sociodemographic variables showing varying associations. Educational initiatives are needed especially for those with lower education, non-health sectors, and not experienced nosebleeds, to improve public first aid knowledge and attitudes.Keywords: Epistaxis; Knowledge; Attitude; First aid management; Saudi Arabia

Pediatric Epistaxis-Effectiveness of Conservative Management.

Epistaxis is an emergency medical condition that sometimes requires admission to the emergency department. Pediatric epistaxis differs from epistaxis in the older population in terms of etiology, severity, and management. Our objective was to identify the distinctive features of pediatric epistaxis and determine the appropriate management. This was a retrospective study of 231 medical records of children (<18 years old) with epistaxis of a total of 1171 cases in the general population who presented to our medical center's emergency department between 2013 and 2018. Among 231 admissions, 10 children (4.3%) presented more than once. Male patients accounted for the majority of cases (64.5%), and the average age was 9.4 years. Two children were treated with aspirin because of cardiac valve disease. Anterior bleeding was detected in 101 cases (43.7%), whereas posterior origin was observed in 8 cases (3.5%). In 122 cases (52.8%), there was no active bleeding observed. Nose injury was the cause of epistaxis in 24 cases (10.4%), and 16 admissions (6.9%) followed nasal surgical interventions. Nineteen children (8%) had abnormal coagulation tests, and 7 patients (3%) received blood transfusions. Chemical cauterization was performed in 89 cases (39.3%), and anterior packing was needed in only 9 cases (3.9%). Nine children required hospitalization (3.9%), and 2 needed surgical intervention to control bleeding. Compared with the adult population, there were significantly fewer cases of active bleeding, recurrent epistaxis, anterior packing, or need for hospitalization in the pediatric population. Epistaxis is significantly less severe in the pediatric population, with only a few cases requiring major intervention. Endoscopic examination of the entire nasal cavity and routine coagulation tests are not mandatory unless there is a history of recurrent epistaxis, known coagulopathy, antiplatelet/anticoagulation therapy, or a suspicion of juvenile idiopathic angiofibroma. We suggest using absorbable packs, which offer advantages over cauterization or nonabsorbable packs.

ОСНОВНЫЕ ПРИЧИНЫ И ФАКТОРЫ РИСКА РАЗВИТИЯ ОЛЬФАКТОРНОЙ ДИСФУНКЦИИ У ВЗРОСЛЫХ ПАЦИЕНТОВ

Pathology of smell is an interdisciplinary problem. Olfactory disorders are polyetiological and occur in a wide variety of diseases. However, with these complaints, patients first turn to otolaryngologists. The article describes the etiopathogenetic mechanisms of olfactory disorders, identifying the following main causes and risk factors for the development of olfactory dysfunction in adult patients: diseases of the nose and paranasal sinuses; acute respiratory viral diseases; head and nose injuries; consequences of surgical treatment in the nasal cavity and paranasal sinuses, intracranial operations; diseases of the nervous system; diseases of the endocrine system and internal organs; intoxication; taking medications; smoking; alcohol and drug addiction, age over 65 years, metabolic disorders. The mechanism of disturbance of the olfactory function is determined by the level of damage to the olfactory analyzer and is conductive, sensorineural, central and mixed. Chronic diseases of the nose and paranasal sinuses are the most common cause of olfactory dysfunction. Timely detection of olfactory disorders is fundamentally important for early diagnosis of the diseases that cause them. Determining the causes and risk factors of olfactory disorders is an important task, as it helps determine treatment tactics for patients.

Nose Injury

Nose Injury

Symptoms and Physical Exam Findings in Sexual Assault-related Non-fatal Strangulation.

ObjectiveOur goal was to investigate the frequency of specific signs and symptoms following sexual assault-related non-fatal strangulation (NFS) and to explore the interaction between assault characteristics and physical exam findings.MethodsThis retrospective observational study included all adults (>18 years) reporting strangulation during sexual assault who presented for a forensic sexual assault exam at one of six urban community hospitals contracted with a single forensic nurse agency. Demographic information, narrative elements, and physical exam findings were abstracted from standardized sexual assault reporting forms. We analyzed data with descriptive statistics and compared specific variables using chi-square testing.ResultsOf the 580 subjects 99% were female, with a median age of 27 (interquartile range 22–35 years). The most common injury location was the neck (57.2%), followed by the mouth (29.1%). We found that 19.1% of the victims had no injuries evident on physical exam and 29.8% reported a loss of consciousness. Eye/eyelid and neck findings did not significantly differ between subjects who reported blows to the head in addition to strangulation and those who did not. The time that elapsed between assault and exam did not significantly correlate with the presence of most head and torso physical exam findings, except for nose injury (P = 0.02).ConclusionSlightly more than half of the victims who reported strangulation during sexual assault had visible neck injuries. Other non-anogenital findings were present even less frequently, with a substantial portion of victims having no injuries documented on physical exam. The perpetrators’ use of blows to the head may account for many of the non-anogenital injuries observed, but not for the neck and eye/eyelid injuries, which may be more specific to non-fatal strangulation. More research is needed to definitively establish strangulation as the causal mechanism for these findings, and to determine whether any long-term neurologic or vascular sequelae resulted from the observed injuries.

Comparison of Previously Injured Body Regions in Elite Freestyle and Greco-Roman Wrestlers

AbstractThe aim of this study was to compare the injured body regions that elite Freestyle and Greco-Roman wrestlers suffered from and to determine the importance of injuries. 41 Freestyle and 51 Greco-Roman wrestlers, who were practicing in Turkish National Wrestling Team camps, participated in this study. ‘Chi Square’ and student t tests were used in statistical analyses. When examined injury status and body regions distribution between Freestyle and Greco-Roman wrestlers, significant difference was found in head and trunk injuries according to wrestling styles (p&lt;0.05). No difference was found in upper/lower extremities and lesion/scrape and friction burns status of the wrestlers according to wrestling style (p&gt;0.05). There was significant difference in trunk and upper extremity injuries with respect to weight category (p&lt;0.05 and p&lt;0.001). Significant difference was also found in nose injuries according to wrestling styles (p&lt;0.05). When examined wrestling style and upper extremity injuries according to the number of injuries, there was found significant difference between two styles in muscle injuries, finger and wrist injuries (p&lt;0.05). The difference between toe injuries in respect to the wrestling style was statistically significant (p&lt;0.05). Results: Greco-Roman wrestlers experienced more injuries in trunk, head and nose compared to Freestyle wrestlers. Trunk, lower and upper extremity injuries varied depending on weight categories. Neck, back, lumbar and chest injuries were more common in Greco-Roman wrestlers. Freestyle wrestlers were more vulnerable to muscle injuries while Greco-Roman wrestlers were more vulnerable to finger and wrist injuries. It is recommended to improve some abilities excellently such as aerobic power, strength, balance and neuro-motor coordination in wrestling. Techniques should be taught well to the wrestlers, most risky extremities for injury have to be applied extra training and these extremities should be protected from injuries by several tapes, bandages or gears during exercise. Freestyle wrestlers ought to be more careful in diving move. Using ear protector in addition to preventive measures can be recommended during training in order to prevent temporal bone fractures and swellings.

63 Topical Use of Tranexamic Acid in the Emergency Department

The usage of topical TXA has been shown in certain cases of epistaxis to reduced time to stop bleeding, rates of rebleeding, time spent in the emergency department and increased patient satisfaction. Local administration of topical TXA has since been described in various settings in emergency medicine journals. This study seeks to evaluate the use of tranexamic acid as a medication for the management of epistaxis and other superficial hemorrhages in the emergency department (ED) of local community hospitals. Retrospective review of adult ED patients from two community hospitals presenting with epistaxis or other superficial hemorrhage, treated with topical tranexamic acid (TXA) and discharged home between 2016 and 2019. Excluded from the study are traumatic nose injuries, major trauma patients, post-operative patients, and patients with incomplete data. Abstracted data included demographics, chief complaints, discharge diagnosis, history of anticoagulant use, outcome of TXA use, and 72 hours return to the ED with recurrent hemorrhage. Data analysis was performed on the index cases only. Demographics and outcomes are reported as descriptive statistics. Significance is set at 0.05 for comparison between anti-coagulation groups. There were 341 cases meeting inclusion criteria. Ten cases were excluded with four nasal trauma, three post-operative cases, and three with missing data. Nineteen case were patients returning within 72 hours, leaving 312 index cases. There were 192 cases of epistaxis and 120 cases of cutaneous (81) or mucosal (39) wounds. Overall, 48.4% of the patients were on outpatient anti-coagulants with 7.7% on two medications. The 72-hour return rate was 5.8% with 6.8% in the epistaxis group and 4.2% in the superficial wound group. Outpatient anti- coagulation did not affect 72 hours returns in epistaxis (6.5% versus 7.1%; p=0.856) but was significant in superficial wounds (11.6% return in anti-coagulant group versus 0%; p=0.002). In this four-year study of topical tranexamic acid use in two community emergency departments, 48.4% of the patients were on outpatient anti-coagulants. The 72-hour return rate for epistaxis was 6.8% and not affected by anti-coagulant use while the return rate for superficial wounds was 4.2% and impacted by anti-coagulant use. Epistaxis and superficial wound treated in the emergency department with topical tranexamic acid have a small return rate for hemorrhage control, despite outpatient anti-coagulant use.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

Beware of the dog

In 2018, there were 8.9 million dogs in the UK, 6.6 million UK households own a dog, and between 1981 and 2015 there were 78 human deaths from dog bites in England and Wales. Surgical challenges include infection, dealing with arm and nose injuries and when to close a wound. Effective legislation derives in part from appropriately robust studies, but some lack sufficient scientific rigour. Dog breed identification in the absence of DNA analysis is unreliable and reward-based dog owner interaction is superior to punishment-based training. Legislation that is based on the targeting of specific breeds should be abandoned.

Facial Injuries in Handball: A Survey of Handball Coaches.

The aim of this study was to investigate the occurrence of facial trauma in handball players in South Korea.Forty-one handball coaches responded to an 11-item standardized questionnaire. Twenty-three coaches (56.1%) stated that their players had experienced a facial injury and reported 56 patients.The nose was the most common site of the injuries (51.7%), followed by the eye (19.6%) and cheek (12.5%). The most common causes of nose injuries were being hit by a hand (26.8%), elbow (12.5%), and ball (8.9%). Most of the nose injuries were fractures (41.1%). The most common causes of the injuries were being hit by a hand (37.5%), elbow (30.3%), and ball (16.1%). The most common type of facial injury was fracture (41.1%), followed by contusion (26.8%), and laceration (21.4%). The most common position of the player was pivot (25.0%), followed by center back (21.4%), and right back (19.6%). Among the facial injuries experienced by pivots, the nose (12.5%) was the most common site, followed by the eye (8.9%). The most common causes of the injuries in pivots were being hit by a hand (12.5%) and an elbow (12.5%). The mean convalescence period after the facial injuries was 3.2 ± 1.6 weeks. No respondents stated that their players wore a mouthguard.Team doctors should be aware of the high frequency of nasal bone fractures and prepare for them. A suture set should be prepared for lacerations. If a player is hit in the eye by a ball, the possibility of retinal injury should be considered.

CAN BODY PROPORTIONS SERVE AS A PREDICTOR OF RISK-TAKING BEHAVIOURS IN WOMEN AND MEN?

The second to fourth digit ratio (2D:4D) is claimed to be a biomarker of prenatal sex steroids. This study compared 2D:4D and waist-hip ratio (WHR) in men and women with nose deformity caused by injuries suggesting risky behaviour with those of unaffected controls. This kind of facial trauma was accepted as an indicator of risk-taking behaviour. The study involved 100 patients (50 women aged 30.74±8.09 years and 50 men aged 30.98±10.86 years) who underwent rhinoplasty due to nose trauma in a hospital in Łódź, Poland, in 2015. For comparison purposes, a control sample of 70 women (aged 23.03±3.36 years) and 70 men (aged 22.87±3.46 years) was recruited. In both groups the following measurements were taken: body height, waist and hip circumferences, II and IV digit lengths and body weight. The results showed that women and men who had suffered nose injury had significantly higher values of WHR than controls. The 2D:4D in women with post-traumatic nose deformity was significantly different than the ratio in control women (p<0.0001) and presented the male pattern. It is concluded that in women risky behaviours seem to be associated with prenatal sex hormone influence, while differences in WHR suggest that this tendency is also related to postnatal hormonal factors. Risky behaviours in men should be linked to postnatal hormonal changes rather than to increased prenatal androgen exposure.

Head, Face, and Eye Injuries in Collegiate Women’s Field Hockey

Background: While there is concern regarding head, face, and eye injuries in field hockey, prompting some to recommend the use of protective equipment such as goggles and helmets, little has been written about their incidence and mechanism of injury in the modern game of field hockey. The elucidation of this information will better inform the development of maximally effective injury prevention schemes to protect the athlete while maintaining the integrity of the game. Purpose: To determine the incidence and epidemiology of head, face, and eye injuries in United States collegiate women’s field hockey players from 2004-2005 to 2008-2009. Study Design: Descriptive epidemiological study. Methods: All head, face, and eye injuries reported to the National Collegiate Athletic Association Injury Surveillance System for collegiate women’s field hockey athletes from the 2004-2005 through 2008-2009 seasons were analyzed. Data regarding the event type, injury mechanism, body part injured, type of injury, outcome, and time lost were reviewed. The weighted injury incidence per 1000 athlete-exposures (AEs) was calculated using the exposure data set for the same years; 95% CIs were calculated based on a normal approximation to the Poisson distribution. Results: There were 150 reported traumatic injuries during this time period, with a weighted occurrence of 1587.3 injuries. The overall incidence of head, face, and eye injuries in collegiate women’s field hockey was 0.94 per 1000 AEs (95% CI, 0.86-1.19). Injuries to the head or face, other than the mouth, nose, and eye, accounted for 75.3% of these injuries. The incidence of eye injuries was 0.07 per 1000 AEs (95% CI, 0.03-0.12); nose injuries occurred at a rate of 0.10 per 1000 AEs (95% CI, 0.05-0.15). The rate of traumatic dental injuries was 0.06 per 1000 AEs (95% CI, 0.04-0.14). Contact with an apparatus caused 72.9% of all injuries; specifically, contact with an elevated ball accounted for 47.9% of all injuries, and contact with an elevated stick caused 21.7% of all injuries. While the majority of players suffering a head, face, or eye injury were able to return to sport that season (90.0%), the remaining athletes suffered season-ending injuries (10%). Concussions accounted for 42.8% of all head, face, and eye injuries reported (0.40 per 1000 AEs; 95% CI, 0.32-0.53). Conclusion: Head, face, and eye injuries occur regularly in women’s field hockey. This description of the injury profile and mechanisms of injury may be used to design appropriate injury prevention schemes for the sport.

Effect of humidified high flow nasal cannula on severe apnea in preterm infants

Objective To investigate the effect of humidified high flow nasal cannula (HHFNC) on severe apnea in preterm infants. Methods Eighty-two preterm infants who developed apnea more than twice in short time, recurred within 6 hours or needed mask respirator were divided into HHFNC group (n=40) and nasal continuous positive airway pressure (NCPAP) group (n=42). Both groups were given aminophylline intravenously. The total therapeutic effect rate, the number of cases who needed mechanical ventilation during the observation period, the duration of non-invasive ventilation, the duration of oxygen therapy, the oxygen exchange indexes and the complications of two groups were observed. Results There were no significant differences between two groups in the therapeutic effect rate, the number of cases who need invasive ventilation, the duration of non-invasive ventilation time, oxygen exchange indexes and the duration of oxygen usage (P>0.05). The numbers of nose injury of HHFNC group were less than those of the NCPAP group[10.0% (4/40) vs.30.9% (13/42)] (P<0.05). No significant differences were found between two groups in the complication of necrotizing enterocolitis or feeding intolerance, respiratory infection, retinopathy of prematurity, bronchopulmonary dysplasia (P<0.05). Conclusion HHFNC has the same effect as NCPAP in the treatment of severe apnea in preterm infants except for lower prevalence of nose injury. Key words: Humidified high flow nasal cannula; Severe apnea; Continuous positive airway pressure; Preterm infants

Management of Muzzle tear in an Ongole bullock

Nose injuries are more common in drought animals especially where as nylon rope was used compared with cotton rope. Prognosis is favorable in cases with early surgical correction and controlled muzzle movement

Our Treatment Approaches in Head-Neck Injuries Caused by Animal Bites

Several approaches exist for the treatment of animal attacks targeting the head and neck region. The treatment options and timing vary depending on the animal species, the nature of the defect, and the experience of the surgeon. In this study, early surgical treatment options used in head-neck injuries caused by domesticated or wild animal attacks are presented.We consider 12 patients who were admitted to our clinic between June 2006 and May 2010 with head-neck injuries caused by animal attacks. Tissue defect had developed in 10 patients due to half-wild dog bite and in 2 patients due to wolf bite. The ages of the patients ranged from 3 to 45 years (mean, 21.3 years). Among the patients included in the study, 4 had facial injury, 3 had ear, 3 had scalp, 1 had eye, and 2 had nose injuries. In all patients, early surgical reconstruction was performed after irrigation, antisepsis, and debridement. Concurrent rabies and tetanus prophylactic antibiotherapy program was started.Infection or surgical complications were not observed in any of the patients. Rabies symptoms were determined in one of the quarantined dogs under surveillance. There were no positive findings in the patient bitten by the dog. The surgical treatment results from all patients were at satisfactory levels.As a result, it is observed that, in the treatment of head and neck injuries resulting from animal bites, early acute approach has replaced the traditional long-term treatment. We believe that debridement and early surgical reconstruction used in combination with medical support and prophylactic treatment are the best treatment method.

Frequency of nose and tail injuries in cattle and water buffalo at livestock markets in Bangladesh

AbstractA total of 560 cattle and water buffalo were examined at livestock markets in Bangladesh. The aim was to assess the frequency of nose and tail injuries that could have occurred during handling and transport. The frequency of nose piercing was 64%, and 69% of the cattle and 54% of the water buffalo had rubbing or tearing injuries at the nostrils from nose ropes fitted through the pierced hole. Almost half of the nose-pierced animals (47%) had lacerations and ulcerations where the nose rope had rubbed against the nose. Pus at the nostril was observed in 56% of the animals, and 57 and 58% had severe and extended nose injuries, respectively. Nose injuries were more severe in imported Hariana cattle compared with exotic and local breeds. In cattle plus water buffalo, 39% had tail injuries of which the two major abnormalities were absent tail end (2%) and kinked tail (98%). Tail injuries were more common in cattle (51%) than water buffalo (15%). Among the cattle breeds, the frequency of tail injuries in Hariana was 65%. In conclusion, the cattle and water buffalo experienced a number of serious injuries and this calls for greater attention to be paid to handling methods in draught animals in south Asia.

Tissue Adhesives for Simple Traumatic Lacerations

Abstract Reference/Citation: Farion K, Osmond MH, Hartling L, et al. Tissue adhesives for traumatic lacerations in children and adults. Cochrane Database Syst Rev. 2001(4);CD003326. Clinical Question: What is the clinical evidence base for tissue adhesives in the management of simple traumatic lacerations? Data Sources: Studies were identified by searches of the following databases: Cochrane Wounds Group Specialized Trials Register (September 2003), Cochrane Central Register of Controlled Trials (CENTRAL) (CDROM 2003, issue 3), MEDLINE (1966 to September 2003, week 1), EMBASE (1988 to 2003, week 36), Web of Science Science Citation Index (1975 to September 13, 2003) and various clinical trials registers (September 2003). Investigators and product manufacturers were contacted to identify additional eligible studies. The search terms included wounds and injuries, laceration, face injury, nose injury, tissue adhesives, and acrylates. Study Selection: Each study fulfilled the following criteria: (1) The study...

Be Prepared

Be Prepared

Przypadek gruczolaka wielopostaciowego małżowiny nosowej dolnej

The authors present the case of inferior nasal concha tumor at early growth stage. The tumor which turned out to be pleomorphic adenoma was detected accidentally at 28 years old patient with a nose injury. This localisation of pleomorphic adenoma is extremely rare. The diagnostics, description of surgery and result of a histopathological examination were presented. Reports of a literature of pleomorphic tumors located in atypical places were quoted. Authors emphasize unanimous surgical treatment and necessity of observation after surgery because of tumor recurrence possibility.

Injury Risk in Professional Boxing

Although a popular endeavor, boxing has fallen under increased scrutiny because of its association with traumatic brain injury. However, few studies have investigated the overall epidemiology of boxing injuries from representative samples, and no study has ever documented the incidence of injuries in female boxers. This study is a review of professional boxing data from the state of Nevada from September 2001 through March 2003. Medical and outcome data for all professional boxing matches occurring in Nevada between September 2001 and March 2003 (n = 524 matches) were analyzed on the basis of a pair-matched, case-control design. Cases were boxers who received an injury during the boxing matches. Boxers who were not injured served as control subjects. Both conditional and unconditional logistic regression models were used to assess risk factors for injury. The overall incidence rate of injury was 17.1 per 100 boxer-matches, or 3.4 per 100 boxer-rounds. Facial laceration accounted for 51% of all injuries, followed by hand injury (17%), eye injury (14%), and nose injury (5%). Male boxers were significantly more likely than female boxers to receive injuries (3.6 versus 1.2 per 100 boxer-rounds, P = 0.01). Male boxing matches also ended in knockouts and technical knockouts more often than did female matches (P < 0.001). The risk of injury for those who lost the matches was nearly twice the risk for the winners. Those who lost by knockout had double the risk of injury compared with those who lost by other means. Neither age nor weight was significantly associated with the risk of injury. The injury rate in professional boxing matches is high, particularly among male boxers. Superficial facial lacerations are the most common injury reported. Male boxers have a higher rate of knockout and technical knockouts than female boxers. Further research is necessary to determine the outcomes of injury, particularly the long-term neurologic outcome differences between sexes.

Classification and qualification of nose injuries: Clinical and forensic aspects

Nose injuries are of great importance in ENT and medico-legal practice. The importance lies in the frequency of injuries, diverse approaches to diagnosis, treatment and qualification of injuries used in legal proceedings in court. Objective assessment of health impairements due to an injury, requires knowledge about morphofunctional nasal characterics, therapeutic procedures and medico-legal expertise. NOSE INJURES: Nasal fractures are the most common types of facial fractures which occur in different situations. They are often combined with soft tissue injuries. The diagnosis of nasal injuries involves clinical examination, radiography and nasal endoscopy. There are several classifications of nasal injuries depending on pathological findings. The most acceptable one is the modified categorization after Harrison. The treatment of nasal injuries depends on the type of injury and possible complications. Nasal soft tissue injuries, nasal fractures, dislocations and partial dislocations should be assessed at the time of diagnosis. Medical assessment of injuries is of utmost importance for legal purposes and regarding medico-legal aspects.