ENT

Inflammation of the nasal mucosa and paranasal sinuses that follows blockage of their narrow drainage pathways, almost always viral and self-limiting, with antibiotics reserved for the minority who develop true bacterial superinfection or complications.

Brief, position-triggered vertigo caused by displaced otoconia in a semicircular canal; diagnose with positional testing and treat posterior-canal disease with a canalith-repositioning manoeuvre.

Cholesteatoma is a self-renewing collection of keratinising squamous epithelium in the middle-ear cleft or mastoid that can erode bone, damage hearing and spread infection; it is not a tumour and needs specialist ENT assessment.

Epiglottitis or supraglottitis is acute swelling around the laryngeal inlet that can obstruct the airway rapidly; keep the person calm and upright, avoid throat manipulation, call senior anaesthetic and ENT help and secure the airway before tests or routine treatment.

Nasal bleeding is usually anterior and responds to correct pressure, but heavy, posterior or recurrent bleeding needs structured assessment, packing and ENT escalation.

Head and neck cancer is usually a squamous cell carcinoma of the upper aerodigestive tract; persistent hoarseness, oral ulceration, dysphagia, unilateral otalgia or an unexplained neck lump needs prompt specialist assessment, with urgent escalation for airway compromise or major bleeding.

Acute mastoiditis is serious infection extending from the middle ear into the mastoid air cells; a painful red post-auricular swelling with pinna displacement is an ENT emergency because infection can form an abscess or spread to the facial nerve, venous sinuses or intracranial space.

Ménière's disease is a disorder of the inner ear causing recurrent spontaneous vertigo attacks lasting minutes to hours, with fluctuating hearing loss, tinnitus and aural pressure; diagnosis is specialist and other vestibular, neurological and retrocochlear causes must be considered.

Nasal polyps are soft oedematous inflammatory growths that usually occur bilaterally and cause nasal obstruction and reduced smell; a unilateral or bloody/atypical mass is a different problem until ENT assessment excludes tumour or another local lesion.

Inflammation or infection of the external auditory canal, usually managed with ear care, analgesia and topical treatment; severe persistent pain in a person with diabetes or immunosuppression is a necrotising otitis externa emergency.

A tympanic-membrane perforation is a hole caused most often by acute otitis media, direct trauma or pressure change; most heal spontaneously, so keep the ear dry, avoid instrumentation and unprescribed drops, and refer persistent, infected or complicated perforations.

A collection of pus between the tonsil capsule and the pharyngeal muscles (quinsy), forming when tonsillitis spreads beyond the tonsil into an adjacent tissue plane, producing trismus and a muffled voice that mark it out as a surgical emergency rather than severe tonsillitis.

Thyroid nodules are common and usually benign; assess a clinically concerning lump with thyroid function tests, greyscale ultrasound and ultrasound-guided FNAC when the established ultrasound threshold is met, then manage cytology and cancer by risk and subtype.

Vestibular neuritis causes an acute vestibular syndrome of prolonged vertigo, nausea and imbalance without hearing loss; labyrinthitis adds hearing loss and/or tinnitus, but both diagnoses are made only after urgent assessment for posterior-circulation stroke and other dangerous causes.