GEM - Curriculum Statement 15.4 ENT and Facial Problems
Knowledge Base for the nMRCGP
Curriculum Statement 15.3 ENT and Facial Problems
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Symptoms:
- hearing loss
- ear wax
- otalgia
- discharging ear
- dizziness
- tinnitus
- epistaxis
- sore throat
- hoarseness
- dysphagia
- croup
- goitre
- lymph nodes and other neck swellings
- speech delay
- foreign bodies
- facial weakness
Common and/or important conditions:
- otitis media (suppurative/secretory)
- otitis externa
- perforated tympanic membrane
- cholesteatoma
- vertigo
- Ménière?s disease
- Bell?s palsy
- tempero-mandibular pain
- trigeminal neuralgia
- pharyngitis
- tonsillitis
- laryngitis
- glandular fever
- oral candida, herpes
- salivary stones
- gastro-oesophageal reflux disease (GORD)
- Infective and allergic rhinitis
- sinusitis
- nasal polyps
- Nasal fracture
- haematoma auris
- snoring and sleep apnoea
- suspected head and neck cancer
- unilateral hearing loss in the absence of external ear pathology or obvious cause
Investigation:
- otoscopy
- tuning fork tests
- Awareness of:
- pure tone threshold audiogram
- speech audiometry, impedance tympanometry, auditory brainstem responses and otoacoustic emissions
- investigations may delay referral in suspected head and neck cancer
Treatment:
- watchful waiting and use of delayed prescriptions
- nasal cautery
- fractured nose (need manipulation under anaesthetic within two weeks for optimum result)
- Emergency care:
- septal haematoma
- epistaxis
- tonsillitis with quinsy
- oitis externa if extremely blocked or painful
- foreign body
- auricular haematoma or perichondritis
Prevention:
- screening for hearing impairment in adults and children
- awareness of iatrogenic causes of ototoxicity.
GPnotebook educational modules (GEMs):
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