ENT

Question 1

Why is ENT important?

Answer 1

common site for cancer
affects all senses
includes the airway

Question 2

what does modern ENT include?

Answer 2

skull base surgery
major head and neck surgery
facial plastics and reconstruction
voice clinic

Question 3

Nose and sinuses?

Answer 3

rhinosinustis
nasal polyps
catarrh
facial pain

Question 4

4 sinuses name?

Answer 4

frontal, ethmoidal, maxillary and sphenoid

Question 5

define rhinosinusitis?

Answer 5

inflammation of the noses an dor sinuses characterised by 2 or mor symptoms. 
ArS<4 weeks crs >12 weeks 
nasal blockage, discharge 
facial pain 
and endoscopic polyps could pop up.

Question 6

definite rhinosinusitis diagnosis when?

Answer 6

Nasal symptoms
Blockage/ congestion
– Discharge
– Pressure, pain, loss of smell

Question 7

Treatment for rhinosinusitis?

Answer 7

nasal douching
topical steroid
in ARS oral antibiotic after 5/7 days then short course of decongestant if severe

Question 8

how to treat catarrh

Answer 8

excess biuld up of mucus in the nose. can be painful but just reassure and remove by nasal douching

Question 9

facial pain and rhinosinusitis?

Answer 9

Isolated facial pain is not sufficient for diagnosis of RS
• Consider non-sinogeniccausesif:

• Non-sinogenic causes include: – Migraine
– Cluster headaches
– Paroxysmal hemicrania
– Trigeminal neuralgia

Question 10

what can arise in the throat, head and neck?

Answer 10

Tonsillitis and complications – Snoring/ OSA
– (Upper airways malignancy) – Acid reflux
– Thyroid
– Neck Lumps

Question 11

tonsillitis and when to refer?

Answer 11

antibiotics if unwell
refer if unable to eat and digest
breathing affected
quinsy: pyrexia and trismus

Question 12

what can asymmetric tonsils be a sign?

Answer 12

lymphoma

Question 13

unilateral otalgia?

Answer 13

this can be referred pain in relation to tonsillitis

Question 14

neck lumps what to do?

Answer 14

refer and FNAC imaging

Question 15

neck lumps in children?

Answer 15

this is very common 
usually reactive 
be concerned if ? enlarging 
supraclavicular 
>2cm 
fixed/round/hard and non tender

Question 16

snoring and treatment

Answer 16

epworth score useful
weight loss is important
nasal treatment
cpap is 1st line for OSA

Question 17

otitis externa? mild/mod/severe

Answer 17

mild: follows infected water 
in ear 
starts with itching tipical treatment. 
mod: keep ear bone dry and topical abx
severe:top abx and may require systemic treatment, spreading cellulitus

Question 18

otitis externa?

Answer 18

overuse of abx

treatment is topical antifungal- canneston drops

Question 19

Acute otitis media and complications?

Answer 19

resolves itself in 3 days 
consider abx if worsening , systemic illness or high risk patient 
meningitis 
abcess 
inner ear infection- vertigo 
facial nerve palsy

Question 20

otitis media with effusion?

Answer 20

common
consider surgery
grommets in children with persistent bilateral OME
hearing aids are an alternative and are preferred in patients with down syndrome

Question 21

TMJ dysfunction

Answer 21

Pain/ tenderness of jaw – Pain in TMJ
– Aching in ear
– Difficulty chewing
– Facial pain
– Locking of jaw

Question 22

Hearing loss

Answer 22

common with dementia and can provide hearing aid