Head + Neck Conditions and Treatments

Question 1

What is auricular haematoma?

Answer 1

Collection of blood under the skin of the outer ear - if not drained or treated then get cauliflower ear
Pain, swelling, bruising

Question 2

What is the treatment for auricular haematoma?

Answer 2

Incision and drainage
Pressure dressing and possible antibiotics

Question 3

What is acute otitis externa?

Answer 3

Inflammation of external auditory meatus - pseudomonas aeruginosa
Itch, pain and discharge

Question 4

What is the treatment for otitis externa?

Answer 4

Antibiotic or steroid ear drops.
Sofradex, Gentisone HC or Otomize spray
Cilodex if perforated
Fungal - clotrimazole or Nystatin

Question 5

What is malignant otitis externa?

Answer 5

Osteomyelitis of temporal bone - risk of spreading to skull
Diabetic or immunosuppressed patients
Granulation tissue in EAC

Question 6

What is the treatment for malignant otitis externa?

Answer 6

Antibiotics needed for weeks or months
Anti-pseudomonas antibiotics for 4-6 weeks

Question 7

What is otitis media with effusion?

Answer 7

Glue ear - sterile fluid in middle ear as impaired eustachian tube so low pressure
Loss of hearing and seen on otoscope

Question 8

What is the treatment for otitis media with effusion?

Answer 8

Observation for 3 months
May need otovent or grommets inserted

Question 9

What is acute suppurative otitis media?

Answer 9

Pus in the middle ear - otalgia and otorrhea
Fever and bulging membrane

Question 10

What is the treatment for acute suppurative otitis media?

Answer 10

Observation and pain killer
Wait and review then possible antibiotics

Question 11

What is tympanosclerosis?

Answer 11

Calcification in tympanic membrane and maybe in middle ear - thickening of the drum
Usually asymptomatic but can have hearing loss

Question 12

What is the treatment for tympanosclerosis?

Answer 12

Usually none
Only need if hearing loss - myringotomy

Question 13

What is a cholesteatoma?

Answer 13

Abnormal collection of skin cells in middle ear
Rare and if left untreated can damage ear
Offensive otorrhea + hearing loss

Question 14

What is the treatment for cholesteatoma?

Answer 14

Mastoidectomy to remove cholesteatoma

Question 15

What is otosclerosis?

Answer 15

Irregular bone remodelling - growth in middle ear causing hearing loss
Conductive hearing loss

Question 16

What is the management for otosclerosis?

Answer 16

Hearing aid and stapedectomy

Question 17

What is the treatment for facial nerve palsy?

Answer 17

Treat underlying cause
Steroids and eye car
If Bells palsy - prednisolone

Question 18

What is Benign Paroxysmal Positional Vertigo (BPPV)?

Answer 18

Repeated episodes of vertigo caused by loose otoconia moving out of utricle into semi-circular canal
Vertigo and nystagmus

Question 19

What is the treatment for BPPV?

Answer 19

Dix-Hallpike is diagnostic
Espley manoeuvre is treatment

Question 19

What is vestibular neuronitis?

Answer 19

Inflammation of vestibular nerve - acute vertigo which can last for hours
Nausea and vomiting

Question 20

What is the treatment for vestibular neuritis?

Answer 20

Anti-nausea medication
Anti-viral drugs - acyclovir
Corticosteroids

Question 21

What is Meniere’s disease?

Answer 21

Rare condition of inner ear - vertigo, hearing loss + tinnitus. Also feeling of fullness in ear.

Question 22

What is the treatment for Meniere’s disease?

Answer 22

Beta-histamine - vasodilator
Stemetil PRN - antiemetic

Question 23

What is epistaxis?

Answer 23

Nosebleeds
Commonest site is little’s area - Kiesselbach on anterior
Posterior - Woodruff

Question 24

What is the management/ treatment for epistaxis?

Answer 24

First aid compression and head tilt - 10-15 mins Cotton wool with adrenaline or nasal cautery with silver nitrate Then nasal balloon catheter

Question 25

What is the management and treatment of orbital cellulitis?

Answer 25

IV antibiotics Nasal decongestants CT scan and possible surgical drainage

Question 26

What is the treatment of acute sinusitis?

Answer 26

Symptomatic relief with pain killers If no improvement - topical steroids Then antibiotics

Question 27

What is the treatment of a periorbital abscess?

Answer 27

Emergency referral Urgent Ct and IV antibiotic Drain pus from outside or endoscopically

Question 28

What is a ethmoidal mucoceole?

Answer 28

Mucous cyst of paranasal sinus - ethmoidal air cells Commonly asymptomatic but can have visual impairment

Question 29

What is the treatment for ethmoidal mucoceole?

Answer 29

FESS - drainage by surgery

Question 30

What are nasal polyps?

Answer 30

Painless soft growths inside the nose - asthma and aspirin sensitivity Blocked nose, PN drip, nasal discharge, and hyposmia

Question 31

What is the treatment for nasal polyps?

Answer 31

Oral and nasal steroids Immunotherapy and diet Endoscopic sinus surgery and polypectomy

Question 32

What is the treatment for an angiofibroma?

Answer 32

Preoperative embolization of blood vessels and lots of blood available