Red Flags ENT

Question 1

Ear?

Answer 1

Persistent unilateral hearing loss/tinnitus
Discharging ears [espec in immunocompromised =malignant otitis externa]
Pain
Facial nerve palsy
Unilateral tinnitus and/or hearing loss w vertigo
If spontaneous nystagmus persists after 48 hrs
Significant vertigo/ imbalance persist after a month

Question 2

Nose?

Answer 2

Blood stained mucous
Facial pain [esp unilateral,persistent, getting worse]
Orbital symptoms
Sinusitus in immunocompromised, query fungal
CSF leak

Question 3

Throat?

Answer 3

Dysphonia – one mnth
Dysphagia
Odynophagia
Pain [can radiate to ear]
Any persistent growing lump

Question 4

What are some ENT emergencies to exclude?

Answer 4

Facial palsy
Bell’s palsy
Sudden hearing loss: Normal TM, unknown cause or may be due to acoustic neuroma - refer immediately
AOM+ headache - query abscess
Periorbital cellulitis - pts will lose colour vision first
Unilateral rhinorrhoea - foreign body until proven otherwise