Misc ENT

Question 1

Aetiology of a pinna haematoma

Answer 1

blunt trauma → subperichondrial haematoma → ischaemic necrosis of cartilage and fibrosis

Question 2

Management for pinna haematoma

Answer 2

incision + drainage (better than needle aspiration)
Firm packing to auricle contour

Question 3

What is exostoses

Answer 3

smooth, symmetrical bony narrowing of external canal

Question 4

Aetiology of exostoses

Answer 4

bony hypertrophy due to cold exposure (i.e. swimmers, surfers)

Question 5

Symptoms and signs of exostoses

Answer 5

asymptomatic (unless narrowing leads to occlusion and a conductive deafness)

Question 6

Management for exostoses

Answer 6

Surgery

Question 7

What is the purpose of wax

Answer 7

Secreted in outer 1/3rd of canal to prevent maceration

Cerumen Auris

Question 8

Management for wax impaction in the ear

Answer 8

microscope-guided suction; syringing after 1 week softening with olive oil

Question 9

Aetiology of tympanic membrane perforation

Answer 9

Otitis media
Foreign body
Barotrauma
Trauma

Question 10

Management of tympanic membrane perforaiton

Answer 10

watch & wait for 6-8 weeks
If not healed, refer to ENT

Question 11

Define sialolithiasis/silaladenitis

Answer 11

stone impacting → inflammation of the salivary gland

Question 12

Aetiology of sialolithiasis/silaladenitis

Answer 12

Secondary to a stone impacting the ducts
Sialolithiasis (stone impaction; submandibular duct (Wharton’s) > parotid duct (Stenson’s))

Sialadenitis (S. aureus infection most commonly)

Question 13

Symptoms and signs of Sialolithiasis / Sialadenitis

Answer 13

foul taste in mouth
tender lymphadenopathy
submandibular mass

Question 14

Aetiology of Ludwig’s angina

Answer 14

a rare infection of the floor of the mouth and soft tissue of the neck

RF: recent dental surgery

Question 15

Symptoms and signs of Ludwig’s angina

Answer 15

Neck swelling
Dysphagia
Fever

Question 16

Management for Ludwig’s angina

Answer 16

urgent admission + airway management + IV ABx

Question 17

Symptoms and signs of gingivitis

Answer 17

Simple: painless, red swollen gums, bleeds on contact)
Necrotising ulcerative: painful, bleeding, halitosis, punched-out ulcers)

Question 18

Management for gingivitis

Answer 18

Simple: routine review by dentist
Necrotising ulcerative: urgent review, chlorhexidine mouthwash, 3/7 PO metronidazole, simple analgesia

Question 19

Symptoms and signs of pharyngeal pouch and aetiology

Answer 19

halitosis
Food getting stuck

outpouching into Zenker’s diverticulum

Question 20

Management for pharyngeal pouch

Answer 20

Dohlman’s procedure (minimally invasive stapling)

Question 21

Causes of Salivary gland swelling

Answer 21

Infective (TB, mumps)
Autoimmune (Sjogren’s, IgG4-related)
Neoplastic (lymphoma/leukaemia, adenoma)
Sarcoidosis
Calculi blockage