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latest updates

updated the thyroid examination - 2/6
Malay in the wards - 16/4/2017
updated Blood pressure examination - 23 August



Tuesday, 7 August 2012

the "gist" of ENT

Ear

  • ASOM
    • presentation - severe ear pain, swollen red tympanic membrane without normal cone of light, typically in children
    • Rx - Antibiotics, analgesics, antihistamine, myringotomy and grommet
  • otitis media with effusion
    • Rx - Myringotomy and grommet
    • aetiology may be Nasopharyngeal Carcinoma - look at demographics
  • CSOM
    • perforation of tympanic membrane
  • Otitis Externa
  • Cholestetoma
    • presentation - foul-smelling scanty discharge from ear, with hearing loss
    • Rx - mastoidectomy
    • Aetiology - ossicles erosion
  • "Vertigo" (Inner Ear conditions)
  • Perichondritis
    • painful inflammation of the pinna
    • Rx by analgesics and antibiotics
    • complication
      • cartilage necrosis and ear deformity  (cauliflower deformity)
  • perichondrial abscess
    • complication
      • cartilage necrosis and ear deformity (cauliflower deformity)
  • preauricular sinus
  • preauricular abscess
    • Rx - analgesics, incision/Drainage and antibiotics - if recurrent, resection of sinus tract
  • furunculosis 
    • hair follicle infection by staph. aureous
    • Rx- antibiotics
    • complications 
      • malignant otitis externa (it is not a malignancy) 
  • mastoditis
    • presentation - swelling erythmatous shining skin behind the ear, typically in children
    • aetiology - mastoid abscess
    • Rx- incision and drainage
  • Bell's Palsy
    • viral aetiology - good prognosis

Nose

  • Allergic Rhinitis
  • Chronic Rhinitis
  • Vasomotor Rhinitis
  • Infective Rhinitis
  • atrophic rhinitis
  • tonsillitis
  • Sinusitis
    • interpretation of X-ray
    • Rx - Antibiotics, anti histamines if recurrent, percutaneous drainage 
    • complications 
      • Meningitis
      • orbital abscess
  • Epistaxis
  • Polyps
    • presentation - unilateral facial pain for 3 weeks

  • Angiofibroma
    • presentation - extensive epistaxis in young males
  • nasal bone fracture
    • interpretation of lateral X-ray
    • Rx - reduction, analgesics, nasal splint
  • foreign body
    • complications
      • aspiration
      • epistaxis
  • epistaxis
    • aetiology
      • ritter's area damage
    • Rx - trotter's maneuver, if extensive Epistaxis, nasal packing, angiography and embolisation - if still not resolving, ligate external carotid

Throat

  • Acute tonsillitis
    • presenttion - odynophagia, fever for 3 days
    • Rx - IV fluid, systemic antibiotics, gargles
    • complication
      • quinsy's 
      • peritonsillar abscess
      • parapharyngeal abscess
  • Chronic Tonsillitis
  • Peritonsillar abscess
  • Foreign body aspiration
  • laryngeal polyps
  • Laryngeal Carcinoma
  • retropharyngeal abscess
    • presenting with fever, sore throat and odynophagia
    • Ix - lateral X-ray show displacement of oesophagus more than 1 thickness of vertebral body, airway is sternosed and loss of lordosis of spine
  • adenoid hypertrophy
    • presentation - young patient presenting with snorting
    • Ix - air column narrowing seen in lateral X-ray of nasopharynx
    • Rx - adenoidectomy
    • nasopharyngeal carcinoma
      • presentation - chinese gentleman with conductive hearing loss 
  • maxillary carcinoma
  • salivary gland tumour
    • most commonly - pleomorphic adenoma, siladenitis
    • presentation - swelling in neck, increasing in size especially in eating sour food
  • squamous cell carcinoma
    • 90% of cancer in head and neck 
    • may have leukoplakia

            others

            facial palsy

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