![]() Trauma (e.g., nose foreign body, nasal fracture).Iatrogenic (e.g., due to septoplasty, tight nasal packs).Perforation through all of the layers of the nasal septum (including cartilage), resulting in a communication between the nasal cavities.Ulceration through the mucosa, submucosa, and perichondrial layers, resulting in exposure of the nasal cartilage.Overview of nasal septal ulceration and perforation References: Nasal septal ulceration and perforation Treatment: septoplasty (a surgical procedure that corrects a deviation of the bone or cartilage of the nasal septum).Evaluation of potentially damaged adjacent structures after trauma to the nose (e.g., bone fractures).Preoperative planning and identification of ancillary sinonasal pathologies (e.g., sinusitis).Anterior rhinoscopy and/or nasal endoscopy : visualization of the deviated septum.Difficulty breathing (typically only in one nostril).Iatrogenic ( septoplasty / rhinoplasty, obstetric forceps delivery ).Trauma (e.g., septal hematoma due to facial and/or nasal fractures ).Congenital (e.g., due to growth disturbances or intrauterine conditions resulting in pressure on the facial bones).Definition: significant displacement of the nasal septum from the midline that often leads to nasal airway obstruction.Cauliflower ear: a permanent deformity of the ear caused by an untreated or inadequately drained auricular hematomaĭrainage or aspiration of auricular hematomas is always indicated.Patients can return to sports after 7 days if the hematoma does not reaccumulate.Prophylactic administration of levofloxacin for 7–10 days after drainage.Daily follow-up for 3–5 days to monitor for reaccumulation.Hematomas > 7 days old: referral to otolaryngology or plastic surgery.Large auricular hematomas ( > 2 cm ), and auricular hematomas 2–7 days old: incision, drainage, and placement of a compression dressing (to prevent reaccumulation). ![]() ![]() Small ( ≤ 2 cm) auricular hematomas ≤ 2 days old: needle aspiration.Loss of normal anatomical landmarks of the anterosuperior aspect of the auricle.Sudden tense, tender, and fluctuant swelling of the auricle.Pathophysiology: trauma to the ear → bleeding from the perichondral vessels → accumulation of blood and serous fluid between the perichondrium and the cartilage → subperichondrial hematoma≤≥.Penetrating trauma: lacerations and/or perforation of the ear (e.g., due to earring misplacement, ear piercing).Blunt trauma : blows to the ear (e.g., during boxing or wrestling).Jeppesen GmbH, Frankfurt 2001.Īcknowledgement Image courtesy Freedigitalphotos. Human Performance & Limitations – JAA ATPL Theoretical Knowledge Manual. Lippincott, Williams & Wilkins, Philadelphia 2002.ģ. It is advisable that in case of doubt about your fitness to fly or related clarifications, please consult your doctor.ġ. Hence the information provided here may be of use to everyone who flies. Though this piece has been written with focus on aircrew, especially pilots, barotrauma is known to occur in non-pilot aircrew, passengers, especially at the extremes of ages, as well as, those who choose to fly despite of a cold or flu. The law states that the volume (V) of gas in inversely proportional to its pressure (P), with temperature (T) remaining constant, i.e. The applicable physical law is Boyle’s law. This can lead to problems in the ear ( Otitic Barotrauma), sinuses ( Sinus Barotrauma), in the intestine or a bad tooth ( Aero-odantalgia).īarotrauma is caused by the expansion of trapped gases in the body cavities due to changes in the pressure between ambient and semi-closed or closed cavities in the body. It usually occurs during flying or under water operations (diving) and the symptoms collectively are called as “Barotrauma”. This is caused by the change in the ambient pressure occurring during ascent or descent, especially if one is suffering from common cold, flu or sore throat. ![]() This is a true incidence of barotrauma of ears in a combat pilot. I called out on RT about my unbearable pain, …and landed with great difficulty.” As I continued descent there, I had an excruciating pain in my ears, as if it is going to burst. But when I started my descent to come back to land, I realised that I could not equalise pressure in my middle ears, despite vigorous attempts of Valsalva. As I climbed, I had some difficulty in clearing my ears. “ In my haste to complete my syllabus sortie, despite of a recovering cold, I went ahead for the sortie that morning. ![]()
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