ENT

Question 1

Classic presentation of cholesteotoma?
Finding on PE?
Mgmt?

Answer 1

Discharge from ear canal and hearing impairment
“Polyp” is a cholesteotoma until proven otherwise
Referral to ENT
Note: it is an abnormal collection of squamous epithelial cells within the middle ear and mastoid process, it is erosive to local structures.

Question 2

Once a thyroglossal duct cyst has been identified clinically what is the next step in mgmt?

Answer 2

Ultrasound neck to look for normal thyroid tissue

Need to make sure a patient has a normal thyroid gland prior to surgery and that the cyst does not represent the sole functioning thyroid tissue.

Question 3

Indications for referral of otitis external to ENT

Answer 3

Treatment failure
Cellulitis extending past the margin of the external ear canal
Extreme pain
Extensive swelling and discharge likely to require suction or insertion of ear wick
Concern for possible malignant otitis externa

Question 4

Indications for referral of otitis media with effusion to ENT?

Answer 4

1. Symptoms persist past 6-12 weeks
2. Severe hearing difficulty
3. Immediately for T21 or cleft palate pt

Question 5

Teenage male presenting with hx of nasal obstruction and recurrent ear infections and epistaxis, exam shows a red-blue mass in the nostril. What pathology

Answer 5

Juvenile angiofibroma

Note: benign but can be locally destructive. Tx is with surgical excision