ENT Presentations

Question 1

What are some causes of ear discharge?

Answer 1

Infections
Damaged ear drum
Foreign body

Question 2

What is tinnitus?

Answer 2

Hearing noises but not from an outside source

No cure. Treated with sound therapy devices like hearing aids, behavioural therapies and medication

Question 3

What are some causes of of tinnitus?

Answer 3

• Hearing loss
• Ménière’s disease
• Diabetes, thyroid disorders or multiple sclerosis.
• Anxiety or depression
• Medicines side effects: chemotherapy, antibiotics, NSAIDs

Question 4

What is Ménière’s disease?

Answer 4

A very severe disease where there are attacks of vestibular neuritis / labyrinthitis

Usually unilateral
Starts between 40-60yrs
Treatment: gentamycin injections to destroy the ear function or surgery

Question 5

What are some causes of a painful ear?

Answer 5

• Arthritis of the jaw
• Ear infection (acute/chronic)
• Ear injury from pressure changes Eg. high altitude
• Foreign object or ear wax
• Perforated eardrum.
• Sinus infection.
• Sore throat

Question 6

What is the pathophysiology of vertigo?

Answer 6

Caused by asymmetry in the vestibular system due to damage to or dysfunction of the labyrinth, vestibular nerve, or central vestibular structures in the brainstem or cerebellum

Question 7

What are some types of dizziness?

Answer 7

1. Vertigo
2. Disequilibrium: sensation of impending fall, like the floor is tilting
3. Presyncope: feeling that you’re going to faint
4. Light-headedness

Question 8

What are the differentials for hearing loss?

Answer 8

• Sensorineural
• Conductive
• Mixed (sensorineural and conductive)
• Auditory neuropathy spectrum disorder (ANSD)

Question 9

What is Auditory neuropathy spectrum disorder (ANSD)?

Answer 9

When the ear hears but there there is a problem sending it to the brain

Question 10

How can snoring be treated?

Answer 10

Environmental changes: Sleep Position, Lose Weight, Avoid Alcohol,
Open Nasal Passages, Change Pillows, Stay Well Hydrated

Or surgical correction of the obstruction

Question 11

What are some ENT causes of facial pain?

Answer 11

• Neuralgia eg. trigeminal
• Temporal mandibular joint (TMJ) pain
• Sinus related
• Burning mouth syndrome
• Periodontal disease
• Trigeminal autonomic cephalgias

Question 12

What is burning mouth syndrome?

Answer 12

Persistent idiopathic facial pain of non-dental origin

Characterised by burning sensation on the tongue

Question 13

What are Trigeminal autonomic cephalgias?

Answer 13

Unilateral episodic headache accompanied by ipsilateral cranial autonomic features

Can be mistaken for trigeminal neuralgia

Question 14

What are some causes of hoarse voice?

Answer 14

• Laryngitis
• Growths/ scarring on vocal cords
• Vocal cord paralysis
• Horner’s syndrome

Question 15

What is the presentation of an acoustic neuroma?

Answer 15

• Unilateral hearing loss
• Blurred/double vision
• Unilateral facial weakness/pain
• Tinnitus
• Vertigo
• Ataxia
• Dysphagia

Question 16

What is an acoustic neuroma?

Answer 16

A benign tumour that grows on the vestibular nerve
Associated with neurofibromatosis type 2 (NF2)

Treated with surgical removal, minimised with stereotactic radiation, or just monitored if not growing

Question 17

What is infectious mononucleosis?

Answer 17

• Often mistaken for strep throat -

Most commonly caused by Epstein-Barr virus (EBV)
Most common in teenagers

Features:
- Extreme fatigue, fever, sore throat, head and body aches, lymphadenopathy, swollen liver/ spleen, rash

Question 18

What is obstructive sleep apnoea?

Answer 18

When the walls of the throat relax and narrow during sleep, interrupting normal breathing

The worse the obstructive sleep apnoea, the greater the risk of coronary artery disease, heart attack, heart failure and stroke