Precise ENT
A 25 year old male patient complained of sore throat fever and bilateral earache of 3 days duration. He then developed very high fever 40 C, severe left earache, inability to open the mouth, drooling of saliva and a minimal difficulty in respiration. -What…
🖇 Diagnosis.
Acute follicular tonsillitis (sore throat, fever and bilateral earache) complicated by left peritonsillar abscess (quinsy) (high fever 40 C, localized left earache, inability to open the mouth and drooling of saliva.
🖇 Treatment.
1.Drainage of the quinsy.
2.Medical treatment for acute tonsillitis.
3.Tonsillectomy is indicated after 2-3 weeks.
Acute follicular tonsillitis (sore throat, fever and bilateral earache) complicated by left peritonsillar abscess (quinsy) (high fever 40 C, localized left earache, inability to open the mouth and drooling of saliva.
🖇 Treatment.
1.Drainage of the quinsy.
2.Medical treatment for acute tonsillitis.
3.Tonsillectomy is indicated after 2-3 weeks.
Precise ENT
A 7 year old boy was referred to an ENT specialist who noticed nasal intonation of voice and bilateral nasal obstruction. The mother reported that her child snores during his sleep and has repeated attacks of chest infection. -What is the diagnosis? -What…
🖇 Diagnosis.
Adenoid enlargement (bilateral nasal obstruction, nasal intonation of voice).
📍Repeated attacks of chest infection=due to nasal obstruction the child is a mouth breather and air inspired is not cleaned or conditioned by the nose and so causes chest infection, also the enlarged adenoid is infected and causes a descending chest infection.
🖇 Investigation.
X-ray lateral view skull to show the enlarged adenoid and the narrowed or obstructed airway.
🖇 Treatment.
-Medical treatment for 6 weeks.
-If fail: adenoidectomy.
Adenoid enlargement (bilateral nasal obstruction, nasal intonation of voice).
📍Repeated attacks of chest infection=due to nasal obstruction the child is a mouth breather and air inspired is not cleaned or conditioned by the nose and so causes chest infection, also the enlarged adenoid is infected and causes a descending chest infection.
🖇 Investigation.
X-ray lateral view skull to show the enlarged adenoid and the narrowed or obstructed airway.
🖇 Treatment.
-Medical treatment for 6 weeks.
-If fail: adenoidectomy.
Precise ENT
A 5 year old child underwent an adenotonsilectomy operation.On discharge from the recovery room, the child was conscious, blood pressure 110/80, pulse rate 100/min and the respiratory rate 16/min. Four hours later, the nurse reported to the resident that the…
🖇 Diagnosis.
Reactionary post tonsillectomy hemorrhage (4 hours after an adenotonsillectomy operation, rising pulse, vomiting of 150 cc of blood).
🖇 Treatment.
-Antishock measures (fluid and blood transfusion, steroids).
-Rapid control of bleeding by readmitting to the operation room and controlling the bleeding which could be either from the adenoid site or the tonsil bed.
Reactionary post tonsillectomy hemorrhage (4 hours after an adenotonsillectomy operation, rising pulse, vomiting of 150 cc of blood).
🖇 Treatment.
-Antishock measures (fluid and blood transfusion, steroids).
-Rapid control of bleeding by readmitting to the operation room and controlling the bleeding which could be either from the adenoid site or the tonsil bed.
Precise ENT
A child 4 years old presented to an ENT specialist because of snoring of two years duration.His mother reported that her son has persistent mucoid nasal discharge that becomes sometimes purulent. For the last month, she began to notice that he does not respond…
Adenoid hypertrophy complicated by bilateral otitis media with effusion is due to eustachian tube obstruction and subsequent otitis media with effusion.
Precise ENT
-What is the diagnosis? -Name the possible differential diagnosis.
🖇Squamous cell carcinoma of right tonsil.
🖇Tonsillitis, aphthous ulcer, benign oropharyngeal lesion ...ect.
🖇Tonsillitis, aphthous ulcer, benign oropharyngeal lesion ...ect.
Common ototoxic drugs.
🖇Aminoglycoside antibiotics. -Streptomycin.
-Gentamycin.
-Tobramycin.
-Neomycin.
-Kanamycin.
-Amikacin.
🖇Diuretics.
-Loop diuretics.
🖇Antimalarials.
-Quinine.
-Chloroquine.
🖇Cytotoxic drugs.
-Cisplatin.
-Carboplatin.
🖇Analgesics.
-Salicylates.
-Indomethacin.
-Iboprofen.
🖇Chemicals.
-Alcohol.
-Tobacco.
-Marijuana.
🖇Miscellaneous.
-Erythromycin.
-Ampicillin.
-Propranolol.
🖇Aminoglycoside antibiotics. -Streptomycin.
-Gentamycin.
-Tobramycin.
-Neomycin.
-Kanamycin.
-Amikacin.
🖇Diuretics.
-Loop diuretics.
🖇Antimalarials.
-Quinine.
-Chloroquine.
🖇Cytotoxic drugs.
-Cisplatin.
-Carboplatin.
🖇Analgesics.
-Salicylates.
-Indomethacin.
-Iboprofen.
🖇Chemicals.
-Alcohol.
-Tobacco.
-Marijuana.
🖇Miscellaneous.
-Erythromycin.
-Ampicillin.
-Propranolol.
•Blunt trauma to the ear causes its separation, allowing for blood to collect and form a hematoma.
•If the blood is not drained, the collection causes infection or cartilage necrosis, leading to perichondritis, and ultimately causing the cosmetic complication of what is known as cauliflower ear.
•If the blood is not drained, the collection causes infection or cartilage necrosis, leading to perichondritis, and ultimately causing the cosmetic complication of what is known as cauliflower ear.
Results happen over time, not overnight.Work hard, stay consistent and be patient🙏❤️
https://www.researchgate.net/profile/Abusufian-Elhaj-2/achievement/65b0e397669f07074dfc8ad2 via @researchgate https://www.researchgate.net/profile/Abusufian-Elhaj-2/achievement/65b0e397669f07074dfc8ad2
ResearchGate
Abusufian Hassan Ahmed Elhaj | Achievement
See this researcher's achievement on ResearchGate.
🛑Case.
A 10 year old child was having a right mucopurulent otorrhea for the last 4 years.
A week ago he became dizzy with a whirling sensation, nausea, vomiting and nystagmus to the opposite side; his deafness became complete and his temperature was normal.
Three days later he became feverish, irritable and continuously crying apparently from severe headache.
Also he had some neck retraction.
The child was not managed properly and died by the end of the week.
✔️Diagnosis and reasons.
Right chronic suppurative otitis media "mucopurulent otorhea of 4 years duration "complicated by suppurative labyrinthitis "dizziness, nausea and vomiting with nystagmus to the opposite side and complete loss of hearing" and then complicated by meningitis "fever, severe headache and neck retraction".
✔️Explanation of some manifestations.
•Whirling sensation: vertigo due to inner ear inflammation.
•Nystagmus to the opposite side: suppurative labyrinthitis leading to fast phase of eye movement to the opposite ear and slow phase to the diseased ear, nystagmus direction is called according to the fast phase.In serous labyrinthitis with no inner ear cell destruction the direction of nystagmus is toward the diseased ear.
•Severe headache: increased intracranial pressure due to meningitis.
•Neck retraction: due to meningeal inflammation.
A 10 year old child was having a right mucopurulent otorrhea for the last 4 years.
A week ago he became dizzy with a whirling sensation, nausea, vomiting and nystagmus to the opposite side; his deafness became complete and his temperature was normal.
Three days later he became feverish, irritable and continuously crying apparently from severe headache.
Also he had some neck retraction.
The child was not managed properly and died by the end of the week.
✔️Diagnosis and reasons.
Right chronic suppurative otitis media "mucopurulent otorhea of 4 years duration "complicated by suppurative labyrinthitis "dizziness, nausea and vomiting with nystagmus to the opposite side and complete loss of hearing" and then complicated by meningitis "fever, severe headache and neck retraction".
✔️Explanation of some manifestations.
•Whirling sensation: vertigo due to inner ear inflammation.
•Nystagmus to the opposite side: suppurative labyrinthitis leading to fast phase of eye movement to the opposite ear and slow phase to the diseased ear, nystagmus direction is called according to the fast phase.In serous labyrinthitis with no inner ear cell destruction the direction of nystagmus is toward the diseased ear.
•Severe headache: increased intracranial pressure due to meningitis.
•Neck retraction: due to meningeal inflammation.
🛑Case.
A 10 year old child complained of a right mucopurulent otorhea for the last 2 years.
He suddenly became feverish and this was associated with diminution of the ear discharge.
There was also tenderness on pressure behind the auricle.
The retroauricular sulcus was preserved.
There was no retroauricular fluctuation.
✔️Diagnosis and reasons.
Right chronic suppurative otitis media "mucopurulent discharge of 2 years duration" complicated by mastoiditis "fever with decreased ear discharge, tenderness behind the auricle with preservation of retroauricular sulcus; it is not an abscess because there is no retroauricular fluctuation".
✔️Explanation of some manifestations.
•Diminution of ear discharge: reservoir sign discharge decreases but is still there and whenever discharge decreases fever and other constitutional symptoms increase in intensity.
•Tenderness behind the auricle: due to inflammation of the bone of the mastoid process and its overlying periosteum.
•Retroauricular sulcus preserve: as the inflammatory process is subperioteal.
•No retroauricular fluctuation: it is mastoiditis and so is not a mastoid abscess yet.
A 10 year old child complained of a right mucopurulent otorhea for the last 2 years.
He suddenly became feverish and this was associated with diminution of the ear discharge.
There was also tenderness on pressure behind the auricle.
The retroauricular sulcus was preserved.
There was no retroauricular fluctuation.
✔️Diagnosis and reasons.
Right chronic suppurative otitis media "mucopurulent discharge of 2 years duration" complicated by mastoiditis "fever with decreased ear discharge, tenderness behind the auricle with preservation of retroauricular sulcus; it is not an abscess because there is no retroauricular fluctuation".
✔️Explanation of some manifestations.
•Diminution of ear discharge: reservoir sign discharge decreases but is still there and whenever discharge decreases fever and other constitutional symptoms increase in intensity.
•Tenderness behind the auricle: due to inflammation of the bone of the mastoid process and its overlying periosteum.
•Retroauricular sulcus preserve: as the inflammatory process is subperioteal.
•No retroauricular fluctuation: it is mastoiditis and so is not a mastoid abscess yet.