ENT

Inflammation of the external auditory canal ("swimmer's ear"), usually bacterial (Pseudomonas aeruginosa, Staphylococcus aureus). Pain, itch and discharge with a tender, oedematous, debris-filled canal. The must-not-miss is necrotising (malignant) otitis externa in the diabetic/immunocompromised.

Acute infection of the middle ear, very common in young children (short, horizontal Eustachian tube), usually following a URTI. Ear pain and fever with a red, bulging tympanic membrane; most resolve spontaneously, so antibiotics are used selectively.

A collection of non-purulent fluid in the middle ear without acute infection — the commonest cause of childhood hearing loss. PAINLESS conductive hearing loss with a dull, retracted drum. Usually self-limiting; the concern is the impact of hearing loss on speech and learning.

A defect in the tympanic membrane from acute otitis media (most common), direct/penetrating trauma (cotton bud), barotrauma or a blast injury. Most heal spontaneously; the management points are keeping the ear dry and avoiding ototoxic drops.

An abnormal collection of keratinising squamous epithelium in the middle ear/mastoid that erodes bone and is locally destructive. The classic picture is a chronic, FOUL-smelling ear discharge with hearing loss and an attic/marginal retraction filled with white squamous debris. It is not a cancer but behaves aggressively — it needs surgery.

A suppurative complication of acute otitis media in which infection spreads to the mastoid air cells. Post-auricular swelling, erythema and tenderness PUSHING THE PINNA FORWARD/down in an unwell child — a clinical emergency needing admission, IV antibiotics, and often surgery.

A hereditary disorder of abnormal bony remodelling around the stapes footplate, fixing it in the oval window and causing a progressive CONDUCTIVE hearing loss in young adults. Often bilateral, worse in pregnancy, with a positive family history.

Age-related, bilateral, symmetrical SENSORINEURAL hearing loss from progressive loss of cochlear hair cells (high frequencies first). The commonest cause of hearing loss in older adults, managed with hearing aids.

Rapid-onset (≤72 hours) sensorineural hearing loss of ≥30 dB over ≥3 contiguous frequencies — an ENT EMERGENCY. Usually idiopathic, but must exclude a retrocochlear lesion. Early high-dose corticosteroids improve the chance of recovery, so it needs same-day/urgent assessment.

The commonest cause of vertigo: dislodged otoconia (calcium debris) in the posterior semicircular canal trigger brief, intense, ROTATIONAL vertigo on head movement. No hearing loss or tinnitus. Diagnosed with Dix-Hallpike and cured with the Epley repositioning manoeuvre.

Acute inflammation of the vestibular nerve (vestibular neuritis) or the whole labyrinth (labyrinthitis), usually post-viral. A SINGLE, PROLONGED episode of severe constant vertigo with nausea lasting days. Labyrinthitis additionally causes hearing loss (the cochlea is involved); vestibular neuritis spares hearing.

A disorder of the inner ear from raised endolymph volume (endolymphatic hydrops), giving recurrent attacks of the TRIAD: episodic vertigo (lasting minutes–hours), fluctuating sensorineural hearing loss, and tinnitus, often with aural fullness. Hearing loss eventually becomes permanent.

Symptomatic inflammation of the nose and paranasal sinuses, usually following a viral URTI; only a small minority become bacterial. Nasal blockage/discharge with facial pain/pressure. Mostly self-limiting — antibiotics are rarely needed, and the job is to spot the rare orbital/intracranial complication.

Benign, oedematous, pale outgrowths of inflamed nasal/sinus mucosa, part of chronic rhinosinusitis. Bilateral nasal obstruction, reduced smell and rhinorrhoea in adults. UNILATERAL polyps are a red flag; polyps IN A CHILD warrant a cystic fibrosis check.

Nosebleed. Most bleeds are ANTERIOR from Little's area (Kiesselbach plexus) and stop with first aid; posterior bleeds are heavier and higher-risk. Management runs first aid → cautery → packing → ENT, with attention to anticoagulation and haemodynamics.

An IgE-mediated hypersensitivity of the nasal mucosa to allergens (pollen, house-dust mite, animals), seasonal or perennial. Sneezing, itch, clear rhinorrhoea and congestion — distinct from infective rhinosinusitis by the itch, sneezing and lack of fever/purulence. Part of the atopic triad.

A self-limiting viral infection of the upper airway — the common cold. Coryza, sore throat, cough and malaise lasting about a week. The clinical job is reassurance and safety-netting, NOT antibiotics, and recognising the few who need more (e.g. secondary bacterial infection, the unwell infant).

Inflammation of the pharynx and tonsils, mostly viral; the key bacterial cause is Group A Streptococcus (Strep pyogenes). The clinical task is to use the Centor/FeverPAIN scores to target antibiotics, and to spot quinsy and the glandular-fever mimic.

A collection of pus beside the tonsil (between the tonsillar capsule and the superior constrictor), usually a complication of tonsillitis. Severe UNILATERAL throat pain with TRISMUS, a "hot-potato" voice and the uvula deviated away from the swelling. It needs drainage plus antibiotics.

Life-threatening inflammation of the epiglottis and supraglottis, classically Haemophilus influenzae type b (Hib) — now rare in children due to vaccination, so increasingly seen in adults. Rapid airway obstruction: do NOT examine the throat or distress the patient; secure the airway first.

Obstruction of the upper airway — an emergency along the ABCDE pathway. STRIDOR (a harsh inspiratory noise) signals significant upper-airway narrowing. Causes span epiglottitis, anaphylaxis, foreign body, croup, deep-neck infection, trauma and tumour. The priority is recognising it and securing the airway, not diagnosing the cause first.

Hoarseness (dysphonia) from laryngeal inflammation — usually acute viral laryngitis (self-limiting) or from voice overuse, reflux, or smoking. The crucial rule: PERSISTENT hoarseness (>3 weeks), especially in a smoker/drinker, is laryngeal cancer until proven otherwise and needs urgent ENT.

Malignancy of the upper aerodigestive tract — oral cavity, oropharynx, larynx, and salivary glands. Most are squamous cell carcinomas driven by smoking and alcohol (and increasingly HPV in the oropharynx). Recognising the red-flag presentations and referring on the 2-week-wait pathway is the core skill.

A discrete swelling within the thyroid gland — very common and usually benign (colloid nodule, cyst, adenoma), but a minority are malignant. Assessment combines thyroid function, ultrasound (with a risk-stratification grade), and FNA cytology, triaging which nodules need surgery.

Malignancy of the thyroid. Differentiated cancers (PAPILLARY — commonest, and follicular) have a good prognosis; medullary (C-cell, calcitonin, MEN2 association) and anaplastic (elderly, aggressive) are less common. Often presents as a thyroid nodule or neck lump found on nodule work-up.

Obstruction of a salivary duct by a stone (sialolithiasis — most often the submandibular/Wharton duct) causing painful glandular swelling on eating; if it becomes infected, acute sialadenitis. A persistent salivary lump (especially with facial nerve weakness) needs malignancy excluded instead.

A practical framework for the neck lump, anchored on the two classic congenital cysts: a THYROGLOSSAL cyst (midline, moves up with tongue protrusion/swallowing) and a BRANCHIAL cyst (lateral, anterior to sternocleidomastoid). The overriding rule: a persistent neck lump in an adult is malignancy/metastasis until proven otherwise.

Recurrent collapse of the upper airway during sleep causing apnoeas/hypopnoeas, fragmented sleep and intermittent hypoxia. Snoring with witnessed apnoeas and daytime sleepiness in an overweight, often middle-aged patient. In children the usual cause is adenotonsillar hypertrophy. Important because of its cardiovascular consequences and the driving risk.

A squamous-cell malignancy of the nasopharynx, strongly associated with Epstein-Barr virus and markedly more common in people of Southern Chinese/Southeast Asian descent. The classic — and most-missed — presentation is a UNILATERAL middle-ear effusion in an adult (the tumour blocks the Eustachian tube) and/or a neck node.

A systemic EBV infection of adolescents/young adults presenting with a severe sore throat, gross tonsillar enlargement, marked malaise and lymphadenopathy — the key tonsillitis mimic. Two exam essentials: it causes a florid rash if given amoxicillin/ampicillin, and splenomegaly means avoiding contact sport (splenic rupture).

An aggressive, invasive infection (almost always Pseudomonas aeruginosa) spreading from the ear canal to the temporal bone/skull base — effectively a skull-base osteomyelitis. It occurs in DIABETICS and the immunocompromised, and is the must-not-miss behind "otitis externa" with severe pain, granulation tissue, and cranial nerve (especially FACIAL) palsy.

A common viral (usually parainfluenza) infection of the larynx and subglottis in young children (6 months–3 years), causing a barking cough, hoarse voice and stridor that is worse at night. It is the gradual, less-toxic mimic of epiglottitis — and is treated with a single dose of oral dexamethasone.