5 Conclusion:
Post-lockdown, the characteristics of patients presenting with PNIs has changed at our London trauma centre. We have experienced an increase in number of PNIs and a transformation from a cohort containing multiple aetiologies to most patients presenting with DSH. This alongside an increase in the proportion of patients with prior mental health conditions perhaps reflects the psychological impact the COVID-19 pandemic has had on mental health placing an increase in demand on both trauma, surgical and mental health services. We hope this single-centre audit of PNIs pre and post lockdown provides valuable insight for ENT surgeons working in trauma centres, highlighting the importance of multidisciplinary and sensitive management of these complex patients