1. Introduction to ENT Medicine
Aydin Mohammadi
Introduction to ENT Medicine

2. Contents What is ENT Subspecialties Anatomy recap
Common cases in daily medical practice
Q&A

3. What is ENT Otorhinolaryngology Fairly recent specialty
Came out of joint specialty with ophthalmology
Has three main subspecialties:
Otology
Rhinology
Laryngology (AKA head and neck surgeons)

5. Otology External, middle and inner ear disease
Vestibular n. disorders (Schwannomas etc)
Hearing impairment
Work closely with audiologists, and often NeuroSx

6. Rhinology Nasal, paranasal sinus, and skull base pathologies
Work closely with allergy and immunology specialists
Endoscopic surgery (FESS)
Work with NeuroSx for transphenoidal resections + skull base disease

7. Laryngology Work with the organ of voice
More than just head and neck surgery
Perform complex, often long operations on head and neck cancer patients
Oral, oropharyngeal, upper oesophageal, laryngeal pathologies

8. Anatomy 1.

9. Anatomy 2.

10. Anatomy 3.

11. Common cases in ENT

13. Otitis Externa Caused by skin bugs Treatment: Staph + Strep
Also pseudomonas  major cause
Treatment:
Swab ear
Dry wicking to remove debris
Otowick insertion
Ototopical anti-pseudomonal Tx
DRY EAR PRECAUTIONS
Occasionally oral Abx

15. Otitis Media Caused by respiratory bugs
S. pneumoniae, H. influenzae, M. catarrhalis
Also by many viruses
Little evidence for antibiotics except in severe disease – most are self limiting
Need to identify at risk populations
Recurrent OME  grommets

18. Sinusitis Most commonly allergic/polyposis
Poor drainage of the sinuses via the OMC
Initial treatment always medical:
Oral antibiotics to cover URI bacteria
Nasal steroids ++, saline washes
1-2 week course of oral steroids sometimes necessary
Surgery - FESS

20. Tonsillitis Tonsils are “external” lymph organs
Have ducts that allow antigen presentation – also allow bacterial infiltration
Viral vs Bacterial
Middle and long term issues (kidneys, heart)
∴ treat with 10 day course of Abx
Recurrent or chronic infections need tonsillectomy referral

22. Peritonsillar abscess
Trismus, high temperatures, odynophagia, and occasionally airway obstruction
Require antibiotics and drainage
Prompt treatment is important
Complications:
Spread to parapharyngeal and retropharyngeal space

24. Laryngeal cancer
Hoarse voice or no voice, dysphagia, “lump” in neck, weight loss etc
Often smoker +/- ETOH
Smoker = RR 19
ETOH = RR 4
Smoker + ETOH = RR 37 (sometimes quoted as 100)
Treatment depends on site, histolopathology, and patient factors

25. Treatments include: Radiotherapy +/- chemotherapy alone Surgery alone
Surgery + chemorads
LASERRRRR!!!!!!!!!!!!!!!!!!!!!!!

27. The End
Any questions?