Some examples of my expertise with ENT conditions and how they would be investigated and consequently treated
CONDITIONS | INVESTIGATIONS | TREATMENT |
NASAL: |
|
|
Allergic Rhinitis | Full nasal work-up | Inhaled nasal steroid sprays, anti-histamines, Ipratropium Bromide, Neil Med Sinus Rinse, Allergy avoidance |
Deviated Nasal Septum | Nasal Endoscopy +/- CT scan | Septoplasty |
Nasal Polyps | Full nasal work-up | Inhaled nasal steroid sprays/drops, Neil Med Sinus Rinse, FESS (Functional Endoscopic Sinus Surgery)/ Nasal Polypectomy |
Sinusitis | Nasal Endoscopy, CT Scan of Sinuses | Inhaled nasal steroid sprays, Neil Med Sinus Rinse, FESS (Functional Endoscopic Sinus Surgery)/ Balloon Sinuplasty Dilatation |
Anosmia (Loss of Smell) | Nasal Endoscopy and CT Scan of Sinuses and Frontal lobe, UPSIT Smell test | Inhaled nasal steroid sprays, Neil Med Sinus Rinse, Bio-feedback training |
Nasal Deformity | Nasal Endoscopy and preoperative nasal photographs | Rhinoplasty/Septorhinoplasty |
Nose bleeds | Nasal Endoscopy, blood tests | Antibiotic/antiseptic nasal creams, nasal cautery, FESS- Cautery to nose/Sphenopalatine Artery Ligation |
Snoring |
Nasal Endoscopy +/- CT scan Fibre-optic Nasopharyngoscopy under controlled sedation (Adults) |
Advice- weight loss, alcohol reduction, cessation of smoking, dietary advice. Treatment of cause of nasal obstruction. CPAP (Continuous Positive Airway Pressure), MAD (Mandibular Advancement Device), UPPP (UvuloPharyngopalatoplasty) +/- Tonsillectomy |
Sleep Apnoea | Fibre-optic Nasopharyngoscopy +/- under controlled sedation (Adults), Sleep Studies, X-ray of Nasopharynx (Children) | Advice- weight loss, alcohol reduction, cessation of smoking, dietary advice. Treatment of cause of nasal obstruction. CPAP (Continuous Positive Airway Pressure), MAD (Mandibular Advancement Device), UPPP (UvuloPharyngopalatoplasty) +/- Tonsillectomy |
Foreign body in nose | Nasal Endoscopy | Removal in clinic or under GA |
EARS: | ||
Hearing Loss (Adults and Children) | PTA (Pure Tone Audiogram, Tympanogram, MRI Scan | Depends on cause |
Glue Ear (Secretory Otitis Media) (Children) | PTA, Tympanogram, X-ray of Nasopharynx | Medical treatment, Insufflation balloon, Grommets insertion |
Glue Ear (Adults) | PTA, Tympanogram, Nasopharyngoscopy, CT scan | Medical treatment, Insufflation balloon, Grommets insertion +/- biopsy of Nasopharynx |
Wax Impaction | Ear drops, Micro-suction of ears. | |
Chronic Otitis Media, with or without Cholesteatoma | PTA, Tympanogram, Microscope examination+/- suction debridement, CT Scan | Micro-suction, Antibiotic Ear drops, Tympanoplasty, Mastoidectomy |
Acute Otitis Media | Antibiotics (Aural and oral), decongestants. | |
Foreign Body | Micro-examination | Microscope-assisted removal |
(PTA if necessary) | ||
Vertigo (Meniere’s disease, Benign Positional Paroxysmal vertigo, Migraine-associated vertigo, Vestibular Neuronitis, Acute Labyrinthitis) | PTA, Tympanogram, Hallpike manoeuvre, Vestibular tests, MRI scan | Treatment of diagnosed condition (Epley manoeuvre, Vestibular Rehabilitation Physiotherapy, Vestibular sedatives, Betahistine) |
THROAT & NECK: | ||
Laryngo-pharyngeal Reflux | FOL (Fibre-optic Laryngoscopy), CT scan | Advice (dietary/weight loss), Antacids, Proton pumps inhibitors, H2 antagonists, Throat hygiene |
Vocal Cord Polyps/nodules, including Change in Voice | FOL | SALT (Speech and Language Therapy), Advice (dietary, vocal use), Micro-surgery |
Lesions on Tongue/in Oral Cavity | FOL | Excision biopsy, microbiological analysis |
Swellings in neck, including Thyroid | Blood tests, FOL, Ultra-sound scan with +/- FNA (fine Needle Aspiration for Cytology), CT scan | Aspiration of Cysts, Excision of swelling, refer to Thyroid surgeon |
Swallowing Difficulty | FOL, Blood Test, Barium Swallow Study, CT scan, FEES (Fibre-optic Endoscopic Evaluation of Swallowing) | Treatment dependent on cause. |
Tonsillitis | Tonsillectomy (if indicated) | |
Tonsil Stones (Chronic Tonsillitis) | Tonsillectomy (if indicated) | |
Submandibular Sialadenitis/stones | FOL, Ultra-sound scan | Dietary advice, antibiotics, removal of stones, excision of gland. |