ENT guidelines

Question 1

Viral labyrinthitis Mx

Answer 1

Self-limiting

Question 2

Vestibular neuronitis Mx

Answer 2

Acute = prochlorperazine (D2)
Ongoing = vestibular rehab

Question 3

BPPV Ix, Mx

Answer 3

Ix = dix hallpike
Mx = epley
Home exercises = Brandt-Daroff exercises

Question 4

Meniere’s
acute
ongoing
DVLA

Answer 4

Acute Mx = prochlorperazine
Ongoing Mx = vestibular rehab or betahistine
Need to tell DVLA and cant drive until settled

Question 5

Acoustic neuroma MRI location

Answer 5

cerebello pontine angle

Question 6

Laryngeal cancer referral

Answer 6

> 45 with hoarseness

unexplained neck lump

Question 7

Oral cancer referral

Answer 7

ulcer persisting for 3w
leukoplakia
neck lump

Question 8

nasal polyps cancer referral

Answer 8

If unilateral, bleeding or obstructive

Question 9

Rhinosinusitis Tx
vs
Allergic sinusitis Tx

Answer 9

Rhinosinusitis
<10d = intranasal decongestant
>10d = intranasal steroid
Pen V if unwell

Allergic sinusitis
Mild/mod = intranasal antihistamines
Severe = intranasal steroids

Question 10

thyroglossal cyst Mx

Answer 10

Excision of whole tract including portion of hyoid bone = Sistrunk procedure

Question 11

Epistaxis Mx

• minor bleeding accessible site
• major bleeding difficult to lacalise

Answer 11

silver nitrate cautery or electrocautery

packing

Question 12

otitis externa

what about OE maligna

Answer 12

steroids + Abx (gentamicin?)
2nd line = refer to ENT

OE maligna = CT scan, refer, need IV ABx against pseudomonas