Intro to ENT

Question 1

Emergent ENT problems?

Answer 1

• upper airway obstruction:
  acute laryngeal edema
  epiglottitis
  FBs

-trauma:
facial fractures -
orbital, nasal and facial

Question 2

What calls for immediate referral?

Answer 2

• severe or persistent epistaxis
• tonsilar hemorrhage
• hoarseness assoc with neck trauma or surgery
• laryngeal obstruction and or fracture
• acute nasal fracture with septal hematoma
• complicated mastoiditis/cholesteatoma or sinusitis (periorbital cellulitis, frontal sinusitis with persistent frontal HA)
• pharyngeal/laryngeal FB
• abscess or hematoma, eg peritonsillar abscess, septal or auricular hematoma, paranasal sinus pyocele
• nasal foreign body - battery
• barotrauma with sudden onset vertigo

Question 3

Urgent referral?

Answer 3

• malignant neoplasm of head and neck: larynx, nasopharynx, oral cavity, unexplained cervical lymphadenopathy
• subacute dysphonia/airways problems, eg laryngeal papilloma, laryngeal stridor
• acute facial nerve trauma
• documented sinusitis not responding to conservative management
• paranasal sinus mucocele
• fracture of paranasal sinus
• nasal fracture with external nasal deformity
• hoarseness with sig dysphagia or present for more than 4 weeks
• progressive or persistent dyphagia
• neck masses

Question 4

Non urgent referrals?

Answer 4

• elective tonsillitis after peritonsilar abscess
• chronic tonsillitis
• adenoiditis