ENT Pathologies

Question 1

List the complications of thyroid surgery

Answer 1

• hypocalcaemia (usually transient, can be treated with IV replacement)
• hypothyroidism (caused by partial/total thyroidectomy, life-long thyroxine therapy)
• recurrent or superior laryngeal nerve damage (causes dyspnoea and hoarseness)
• neck haematoma (can increase pressure in neck compartment causing compression of structures esp. trachea)
• thyrotoxic storm (excessive TSH release, usually self-resolves)

Question 2

Hyperparathyroidism (definition, causes, signs and symptoms, and management)

Answer 2

Definition: increased PTD release by the parathyroid glands/in response to low Ca2+

Causes: parathyroid adenoma/carcinoma, gland hyperplasia, vit D deficiency, pancreatitis, chronic kidney disease

Signs and symptoms: painful bones, renal stones, GI disturbances, psychiatric problems (eg. fatigue, lethargy, depression etc.)

Management: cinacalcet, total/subtotal parathyroidectomy

Question 3

Otitis externa (signs and symptoms, causes, and treatment)

Answer 3

Signs and symptoms: minimal discharge, itch and pain (due to acute inflammation of external auditory meatus). Hearing can be impaired if meatus becomes blocked due to swelling/discharge.

Causes: commonly S. aureus or Pseudomonas spp.

Treatment: topical drops with antibiotic/steroid drops. ‘Pope’ wicks can be useful in swelling. Systemic antibiotics in immunosuppressed/cellulitis beyond ear canal

Question 4

Otitis media (definition, signs and symptoms, and management)

Answer 4

Definition: infection caused by inflammation of the middle ear

Signs and symptoms: pain, fever, irritability, anorexia, vomiting, (can be associated with an URTI), impaired hearing (in acute infections)

Management: paracetamol/ibuprofen (resolves pain/fever), maybe delayed antibiotics if not self-resolved. Immediate antibiotics in children/immunocompromised.