Raiyyan Tahsan

Raiyyan Tahsan
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ENT Case No 12.Ear Diseases

                                                  Otolaryngology Notes

                                    Common Symptoms of Otolaryngology EAR HAM

1. Ear Symptoms:-

Hearing loss – Conductive or sensorineural; gradual or sudden.

Ear pain (Otalgia) – Can be due to infection (otitis media, otitis externa) or referred pain (dental, throat, TMJ issues).

Ear discharge (Otorrhea) – Watery, purulent, or bloody discharge, often seen in infections or perforated tympanic membrane.

Tinnitus – Ringing or buzzing sensation in the ears, common in age-related hearing loss or Meniere’s disease.

Vertigo/Dizziness – Spinning sensation often caused by vestibular disorders like BPPV, Meniere’s disease, or labyrinthitis.

Fullness/Pressure in Ear – Can be due to Eustachian tube dysfunction, fluid accumulation, or barotrauma.

                           Common ENT (Otolaryngology) EAR Examinations

1. Ear Examination

a) External Ear Inspection & Palpation

Inspect for deformities, swelling, discharge, or skin lesions.

Palpate the auricle, tragus, and mastoid for tenderness (important in otitis externa and mastoiditis).

b) Otoscopic Examination (Otoscopy)

Examines the external auditory canal and tympanic membrane.

Look for earwax (cerumen), infections, perforations, fluid, or retraction of the eardrum.

c) Hearing Tests

Whisper Test – Assesses gross hearing ability by whispering numbers or words.

Tuning Fork Tests:

Rinne’s Test (512 Hz tuning fork) – Differentiates conductive and sensorineural hearing loss.

Weber’s Test – Determines unilateral hearing loss.

d) Vestibular Function Tests

Dix-Hallpike Maneuver – Used to diagnose Benign Paroxysmal Positional Vertigo (BPPV).

Romberg’s Test – Assesses balance and proprioception.

1. Laboratory Investigations:

Complete Blood Count (CBC): To check for infection (elevated WBCs in bacterial infections).

C-Reactive Protein (CRP) & Erythrocyte Sedimentation Rate (ESR): To assess inflammation.

2. Radiological Investigations:
CT Temporal Bone: For chronic otitis media, mastoiditis, or cholesteatoma.

CT Scan (Contrast/Non-contrast)

                             Commonly Used Drugs in Otolaryngology

1. Antibiotics (For Bacterial Infections)

  • Amoxicillin-Clavulanate (Augmentin)
  • Tablet 1.Moxaclav 500 mg(500mg+125mg).(AS A (Amoxicilline+Clavulanic Acid)AS A Broad spectrum penicillins).

Dose: 625 mg TID (three times daily) or 1g BID (twice daily)

  • Cefuroxime (2nd Gen Cephalosporin):-
  • Tablet 1.Cefotil Plus 500mg (500mg+125mg).(AS A Cefuroxime Axetil +Clavulanic Acid),(AS A Second generation Cephalosporins, Vaccines, Anti-sera & Immunoglobulin).

Dose: 500 mg BID

  • Azithromycin (Macrolide, for Penicillin-Allergic Patients)
  • Tablet 1.Zimax 500 AS A Azithromycin Dihydrate AS A Macrolides.

Dose: 500 mg once daily for Day 1, then 250 mg daily for 4 more days

  • Ceftriaxone (Severe Infections, IV Use)

Dose: 1–2 g IV once daily

Injection 1.Ceftron Iv 500mg/vial (AS A Ceftriaxone Sodium AS A Third generation Cephalosporins.).

  • Metronidazole (For Anaerobic Infections, e.g., Peritonsillar Abscess)
  • Tablet 1.Metro 400 (AS A Metronidazole AS A Amoebicides, Anti-diarrhoeal Antiprotozoal).

Dose: 400 mg TID

2. Antihistamines & Decongestants :-

  • Loratadine (Non-Sedating Antihistamine)
  • Tablet 1.Loratin 10 mg (AS A Loratadine AS A Non-sedating antihistamines)

Dose: 10 mg once daily

OR

  • Cetirizine
  • Tablet 1.Alatrol 10 mg (AS A Cetirizine Hydrochloride AS A Sedating Anti-histamine.)

Dose: 10 mg once daily

3. Corticosteroids (For Inflammation & Allergic Conditions)

  • Prednisolone (Systemic Steroid)

Tablet 1.Cortan 20 mg (AS A Prednisolone AS A Glucocorticoids).

Dose: 40 mg once daily for 5 days, then taper

  • Dexamethasone (IV/Oral, Potent Steroid)

Tablet 1.Dexonex 0.5mg (AS A Dexamethasone AS A synthetic glucocorticoid).

Injection 2. Dexonex IM/IV 5mg/ml 1ml Ampoule (AS A Dexamethasone AS A synthetic glucocorticoid).

Dose: 4–8 mg once daily

4. Analgesics & Antipyretics (For Pain & Fever)

  • Paracetamol (Acetaminophen)

Tablet 1.Pyrenol 500 mg AS A Paracetamol.

Dose: 500–1000 mg every 6 hours

  • Ibuprofen (NSAID, Anti-inflammatory)

Tablet 1. Clofenac SR 100MG (Sustained Released) (AS A Diclofenac Sodium AS A Drugs for Osteoarthritis, Drugs used for Rheumatoid Arthritis, Non-steroidal Anti-inflammatory Drugs (NSAIDs)).

Dose: 400–600 mg every 8 hours

  • Diclofenac (Potent NSAID)

Dose: 50 mg twice daily

5. Antifungals (For Fungal Infections of Ear, Throat, Nose)

  • Clotrimazole Ear Drops

Ear Drop 1.Clarizol 1% 10ml drop (As a Clotrimazole AS A Aural Anti-fungal preparations).

Dose: 2–3 drops TID

  • Fluconazole (Oral Antifungal for Severe Fungal Infections)

Capsule 1.Fluconazole 150 mg AS A Fluconazole AS A Drugs for subcutaneous and mycoses

Dose: 150 mg once daily

6. Antivirals (For Viral ENT Infections)

  • Acyclovir (For Herpes Simplex or Varicella-Zoster Virus in ENT)

Dose: 400 mg 5 times daily

Tablet 1.Virux 400 mg (AS A Acyclovir Herpes simplex & Varicella-zoster virus infections).

7. Other Common ENT Medications:-

  • Betahistine (For Vertigo & Meniere’s Disease)

Tablet 1.Menaril 8mg (AS A Betahistine Dihydrochloride AS A Drugs used in meniere’s diseases).

Dose: 8–16 mg TID

 Common Surgeries in Otolaryngology:-

5. Myringotomy & Tympanostomy Tube Insertion:

Indication: Chronic otitis media with effusion, recurrent ear infections.

Procedure: Creation of an incision in the eardrum to drain fluid, followed by the insertion of a tube to ventilate the middle ear.

6. Mastoidectomy:

Indication: Chronic otitis media, cholesteatoma, mastoiditis.

Procedure: Removal of mastoid air cells to treat infection or to remove a cholesteatoma.

Raiyyan Tahsan.Date:05-01-2025 Wednesday Time:-12-50-45 Pm

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