Category Archives: ENT

Sudden sensorineural deafness, and vibration without a tuning fork

From this month’s BJGP: Sudden sensorineural hearing loss (SSNHL) is an otological emergency. The guidance is that sudden hearing loss that developed within the past 30 days needs to be referred for assessment within 24 hrs. If over 30 days … Continue reading

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Chronic rhinitis

This was in quite an old article: BMJ 9.2.19. Some useful points: Mometasone and fluticasone are preferred to beclometasone because they’re less bioavailable, so negligible systemic effect. No word on whether they’re more effective, though. That’s interesting. If the aetiology … Continue reading

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Audiograms

I was recently presented with an audiogram to interpret, and realised that the printout we get from our practice equipment has no labels on the axes and no accompanying notes, which is not very helpful. I remembered roughly how to … Continue reading

Posted in Credits 2019, ENT, Hearing loss | Leave a comment

Orofacial pain

This often gets inaccurately attributed to rhinosinusitis; in fact, chronic rhinosinusitis does not cause orofacial pain (although acute episodes can do so). Consider the presence or absence of nasal symptoms (blockage/congestion, +/- nasal discharge) and of tenderness or swelling of … Continue reading

Posted in Credits 2018, ENT | Leave a comment

Carcinoma of the sinuses

Notes on sinonasal carcinoma, from the BJGP May 2018: Sinonasal malignancies are rare (1/100 000). Most common, or least uncommon if you prefer, in men in 5th – 7th decade of life. Interestingly, unlike all other head/neck malignancies, it does … Continue reading

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Red flags for urgent referral of hearing loss

This article in the BMJ was about NICE guidance on hearing loss generally, but had some useful bits on warning signs that should prompt immediate referral. Referrals should be to ENT unless stated otherwise. To be seen within 24 hrs … Continue reading

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Ménière’s disease

Frequently overdiagnosed. Presents with a combination of the following symptoms, lasting for <24 hours at a time: Ear fullness Fluctuating hearing loss Low-pitch tinnitus Vertigo episodes lasting at least 20 mins at a time (typically 2 – 3 hours). Note … Continue reading

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