image credit: jasleen_kaur – otoscope
Editor: Joel Hardman
Reviewed: Janice Yeung
In a hurry? Make sure you know
- Important signs and symptoms for early referral; Upper airway obstruction (stridor, foreign body), active bleeding, button batteries
What history should JMOs know/collect?
- Standard history including duration and nature of symptoms. Important general points in medical background (other than previous ENT issues) include; diabetes, immunosuppression, anti platelet/anti coagulation, smoking
- Ears – pain, discharge, hearing, dizziness, previous otology issues/surgery
- Nose – (facial) pain, rhinorrhea, nasal obstruction, allergies, previous sinonasal issues/surgery
- Throat – breathing, voice changes, swallowing, smoking,
What examinations and investigations should JMOs perform/collect results of?
- Ears – otoscopy, swab discharge
- Nose – anterior rhinoscopy, CT paranasal sinuses
- Throat – Oral cavity examination, neck palpation, lateral airways xray, CT neck soft tissues
What additional information would impress you?
- Knowing specific drops/sprays used by the patient
- Tuning fork assessment in otology exam
- Details of previous ENT interventions
What are common mistakes/omissions made by JMOs?
- Incidental radiological findings of fluid in the mastoid air cells or mucosal thickening in the paranasal sinuses are rarely significant in the absence of clinical signs and symptoms
- The best treatment for otitis externa is topical drops rather than oral antibiotics
Textbook – ABC of Ear, Nose and Throat (Harold S. Ludman, Patrick J. Bradley)
Watson, Zara. (2017). Epistaxis. [podcast]. Available at: https://onthewards.org/epistaxis/ [Accessed 5 April 2017]
Hardman, Joel. (2017). Sore ear. [podcast]. Available at: https://onthewards.org/sore-ear/ [Accessed 9 August 2017]