Ear and Nose injuries Auricular hematoma cauliflower ear common in wrestlers use proper headgear evaluate for concomittant injuries with an otoscopic evaluation treatment aspiration wrapping Septal hematoma subperiosteal hematoma of the nasal septum that occurs secondary to facial trauma nasal congestion is the most common symptom treatment: urgent decompression under local anesthesia complications: saddle nose deformity with subsequent collapse - necrosis of septal cartilage septal abscess- may occur within 72 hours unless urgent decompression performed Eye Injuries Common in baseball, basketball, racketball, boxing, martial arts Injuries include traumatic mydriasis a transient phenomenon during which the iris fails to constrict properly, resulting in a dilated pupil caused by contusion to iris sphincter treated with bedrest corneal abrasion diagnosed with fluorescent stain and UV light treat with topical antibiotics, topical NSAIDS, eye patch, and nonurgent referral to ophthalmologist hyphema blood in the anterior chamber treat with eye patch and to ER or emergent ophthalmologist ruptured globe sunken appearance vitreous exudate requires referral to ER or emergent ophthalmologist orbital wall fracture may cause occular muscle entrapment requires referral to ER or emergent ophthalmologist retinal detachment Bright flashes, stabbing pain, visual field cut requires referral to ER or emergent ophthalmologist Presentation vision loss decreased acuity floaters or flashers double vision Physical exam hyphema blood in anterior chamber may represent vitreous or retinal injury Dental injuries An avulsed tooth is a medical emergency and should be replaced immediately the likelihood of survival of the tooth depends on the length of time that the tooth is out of the socket and the degree to which the periodontal ligament is damaged. Tooth handling includes the tooth should be handled only by the crown end and not the root end it can be rinsed of debris with water or normal saline solution then place temporarily in buccal fold or placed in a container with milk, saline, or neutral buffered solution re-insertion into the socket or transportation in the mouth in pediatric patients represents a risk for aspiration Treatment the tooth and the athlete should be transported to the dentist for reinsertion as soon as possible and preferably within an hour