90% of nosebleeds
arise from Kiesselbach's area anterior nasal septum, susceptible to trauma, drying, and infection.
occur from terminal branches of sphenopalatine and internal maxillary arteries.
might be less apparent, with blood draining into posterior nasopharynx.
Commonly associated with disorders such as blood dyscrasias, hypertension, or diabetes
Posterior nosebleeds are more severe, more common in adults.
Epistaxis Manifestations of anterior nosebleeds
Obvious bleeding from nares, Bleeding into posterior nasal and oral pharynx, Nausea and vomiting can occur from swallowing blood.
Topical vasoconstrictors, Chemical agents for cauterization, Topical anesthetics, if packing is required, Prophylactic antibiotic therapy
Epistaxis Management of bleeding
Anterior bleeding managed by first aid measures, Posterior bleeding can require nasal packing.
Treatment of Epistaxis
Chemical or surgical cautery to sclerose involved vessels, Ligation or embolization of internal maxillary artery
Nasal Trauma or Surgery Unilateral fracture involves
one side of the nose; causes little displacement or cosmetic deformity.
Nasal Trauma or Surgery Bilateral fractures
are more common: depression or displacement of both nasal bones to one side.
Nasal Trauma or Surgery Complex fractures can involve
the septum, ascending processes of the maxilla, and frontal bones of face.
Nasal Trauma or Surgery Manifestations
Epistaxis, Hematomas, Periorbital edema and ecchymoses, Bony crepitus, Bilateral fractures: flattened appearance to the nose, an S or C configuration from deviation.
Complications of nasal fracture
Septal hematomas, Abscess formation, Septal perforation or deviation, Cerebrospinal fluid leakage, Obstruction can occur.
Fractures in nasoethmoidal or frontal region
can disrupt the dura, causing CSF leakage or rhinorrhea.
is suspected by watery nasal drainage that tests positive for glucose.
Nasal Trauma or Surgery Treatments
Reduction and external splint application, Ice used to control edema and bleeding, Nasal packing might be necessary to control epistaxis.
Nasal Trauma or Surgery Surgical repair
Complex nasal fractures, Nasal septal deviation, Persistent CSF leakage, Rhinoplasty is surgical reconstruction of the nose, Deviation of the septum repair, Endoscopic repair
Obstructive sleep apnea- absence of respirations lasting from 15 seconds to 45 seconds
Obstructive sleep apnea
is the most frequent type sleep apnea.
Central sleep apnea
is rare, and caused by a neurological disorder.