Otolaryngology

A

• Acute Mastoiditis - Pediatric and Adult Management

  Postauricular pain, swelling, and outward ear displacement suggest mastoiditis. Start IV antibiotics and obtain imaging when complications are suspected. Consult ENT for drainage if abscess or poor response.
• Adult Epiglottitis — Airway First, Targeted Antibiotics, and Controlled Imaging

  Abrupt sore throat, dysphagia, muffled voice, and drooling with normal oropharyngeal exam suggests epiglottitis. Avoid agitating the airway; secure in a controlled setting if signs of obstruction. Start IV ceftriaxone + vancomycin (coverage varies) and obtain lateral neck radiograph or fiberoptic exam when safe.

B

• Benign Paroxysmal Positional Vertigo - Epley Maneuver

  Posterior canal BPPV presents with brief positional vertigo and torsional upbeating nystagmus. Treat with canalith repositioning maneuvers such as Epley and provide home instructions.
• Benign Paroxysmal Positional Vertigo — Diagnosis & Epley

  BPPV: brief positional vertigo from canalithiasis. Diagnose with Dix‑Hallpike (posterior canal) and supine roll (horizontal canal). Treat with canalith repositioning (Epley, BBQ roll); avoid prolonged vestibular suppressants.
• Button Battery in Nose - Emergency Removal

  Causes rapid tissue injury. Remove emergently in the emergency department or operating room with ENT support, irrigate copiously, and arrange follow up for delayed necrosis.

C

• Cholesteatoma — Diagnosis & Surgery

  Keratinizing squamous epithelium in the middle ear/mastoid causing bone erosion. Diagnose by otoscopy and CT; treat with tympanomastoidectomy (canal wall up/down). Lifelong follow‑up to detect recurrence.

D

• Deep Neck Space Infection - Recognition and Management

  Sore throat, neck swelling, fever, and trismus raise concern. Secure airway early when needed, start broad IV antibiotics, obtain contrast CT, and consult ENT for drainage.

E

• Epiglottitis (Adults) — Airway Strategy, Antibiotics, and ICU Monitoring

  Rapidly progressive sore throat, odynophagia, drooling, muffled voice, and stridor. Avoid agitation; secure the airway with awake fiberoptic technique when needed. Give broad IV antibiotics and steroids as adjunct; admit to ICU for monitoring.
• Epiglottitis in Adults — Recognition & Airway Plan

  Adult epiglottitis presents with severe sore throat, odynophagia, and muffled voice. Prioritize airway assessment; avoid agitation; secure airway early if stridor/respiratory distress; give IV antibiotics and steroids.
• Epiglottitis — Adult Airway and Antibiotics

  Airway emergency with odynophagia, drooling, and muffled voice; secure airway early with expert help; start IV antibiotics covering H. influenzae, streptococci, and staphylococci.
• Epistaxis - Acute Management and Packing

  Most bleeds are anterior. Apply firm compression, topical vasoconstrictor, cautery for visible source, and pack if bleeding persists. Treat posterior bleeds with urgent specialty involvement.
• Epistaxis — Anterior and Posterior Management

  Control bleeding with firm compression, topical vasoconstrictor and anesthetic, cautery for visible anterior source, and packing when needed; manage posterior bleeds with packing and specialty support.
• Epistaxis — Initial and Definitive Management

  Most anterior bleeds stop with compression and topical vasoconstrictor; cautery or packing for persistent bleeds; manage anticoagulants and consider posterior bleed with hemodynamic instability.

F

• Foreign Body Ingestion — Button Batteries & Magnets

  Button batteries and multiple magnets are GI emergencies. Immediate imaging; urgent endoscopic removal for esophageal button batteries and for ≥2 magnets. Observe single small magnets if distal and asymptomatic with close follow‑up.

H

• Hoarseness — Evaluation & Red Flags

  Persistent hoarseness >2–4 weeks warrants laryngoscopy. Identify red flags (stridor, airway compromise, hemoptysis, weight loss) and risk factors (smoking).

L

• Laryngopharyngeal Reflux — Diagnosis & Treatment

  LPR presents with throat clearing, cough, and dysphonia. Diagnosis is clinical with laryngoscopy support; initial management is lifestyle + empiric therapy; consider reflux testing if refractory.
• Ludwig Angina — Airway First & Antibiotics

  Rapidly progressive submandibular space infection threatening airway; secure airway early, start broad-spectrum IV antibiotics with anaerobic coverage, urgent dental/surgical drainage.
• Ludwig’s Angina — Airway Strategy, Broad Antibiotics, and Early Drainage

  Rapidly progressive cellulitis of the submandibular space with tongue elevation and trismus. Prioritize a secure airway (often awake fiberoptic), start broad‑spectrum IV antibiotics covering oral anaerobes and streptococci, and obtain early surgical drainage when abscess/collection suspected.

N

• Necrotizing Otitis Externa - High Risk Ear Infection

  Severe ear pain and granulation tissue in diabetic or immunocompromised patient suggest necrotizing otitis externa. Start anti pseudomonal therapy and involve ENT for debridement and imaging.

O

• Obstructive Sleep Apnea — Surgical Options & Selection

  Surgery is for patients intolerant of CPAP or with anatomic obstruction amenable to correction. Selection based on BMI, DISE findings, and site of collapse; outcomes vary by procedure.
• Orbital Cellulitis — Imaging and IV Antibiotics

  Post-septal infection with pain on eye movement, ophthalmoplegia, or proptosis; obtain contrast CT orbits/sinuses; start IV antibiotics covering staphylococci (incl. MRSA), streptococci, and anaerobes.
• Otitis Media with Effusion in Adults — Evaluation & Treatment

  Adult OME requires search for eustachian tube dysfunction and nasopharyngeal pathology. Avoid routine antibiotics; use watchful waiting, nasal steroids if allergic, autoinflation; refer for nasopharyngoscopy with unilateral/recurrent effusions.

P

• Peritonsillar Abscess — Drainage and Antibiotics

  Muffled voice, trismus, and uvular deviation; secure airway if at risk, then needle aspiration or I&D plus antibiotics covering streptococci and anaerobes.
• Peritonsillar Abscess — Drainage, Antibiotics, and Airway Precautions

  Severe unilateral sore throat with trismus, muffled ‘hot potato’ voice, and uvular deviation. Secure airway if threatened, drain (needle aspiration/incision and drainage), and start antibiotics covering streptococci and oral anaerobes; steroids can reduce pain/edema.
• Post Tonsillectomy Hemorrhage - ED Management

  Bleeding can be brisk. Sit patient upright, suction and provide cold water rinses, apply topical vasoconstrictor, and arrange urgent ENT for operative control if active bleeding persists.

S

• Severe Epistaxis — Resuscitation, TXA, and Posterior Packing

  Manage airway and hemodynamics first. Apply topical vasoconstrictor/anesthetic, direct pressure, and cautery for anterior bleeds; use tranexamic acid–soaked pledgets as adjunct. Posterior packing and ENT consultation for uncontrolled or posterior sources.
• Sudden Olfactory Loss — Differential & Workup

  Acute anosmia/hyposmia differential includes post‑viral olfactory dysfunction, sinonasal disease, head trauma, toxins, neurodegenerative disease. Early olfactory training improves recovery; consider short steroid course for inflammatory rhinitis/sinusitis.
• Sudden Sensorineural Hearing Loss - Steroid Therapy

  Acute unilateral sensorineural hearing loss over less than 72 hours needs prompt audiometry, exclusion of conductive loss, and early steroid therapy after shared decision making.

T

• Tonsillectomy — Indications & Perioperative Care

  Indications include recurrent tonsillitis (Paradise criteria), obstructive sleep‑disordered breathing, peritonsillar abscess history, and suspicion for malignancy. Manage perioperative pain and hemorrhage risk.