ENT EMERGENCIES EXAMPLES: A) FOREIGN BODY IN ENT SYMPTOMS: 1. Ingestion of foreign body into the airway (nose, throat, bronchus, esophagus) SERVICES/TREATMENT AVAILABLE:   • Video examination (rigid and flexible nasoendoscopy) • Removal of  foreign body in the clinic or under general anaesthesia B) ABSCESSES IN EAR, NOSE, NECK AND UPPER AIRWAY An   abscess   indicates   a   collection   of   pus   and   the   impendiing   risk   of   rupture.   Other   than   the   possibility   of spread   of   infection,   bacteremia   (bacteria   in   the   blood   stream),   septicaemia   (generalised   body   systems responding   to   infection),   abscess   in   the   airway   can   compromise   breathing.   A   rupture   of   the   abscess would   allow   the   pus   to   enter   the   airway,   potentially   causing   aspiration   into   the   lungs.   People   with diabetes mellitus are also at higher risk of developing these abscesses. SYMPTOMS: 1. Swelliing with or without pus discharge 2. General constitutional symptoms: fever, lethargic, feeling unwell 3. Uncontrolled blood sugar level in people with diabetes mellitus 4. Can also be a complication of sinusitis (purulent discharge from the nose, fever, facial pain), especially in children 5. A form of severe and aggressive infection in the ear canal (necrotising otitis externa) can result in facial nerve paralysis/weakness SERVICES/TREATMENT AVAILABLE:   • Drainage of the pus in the clinic under local anaesthesia or in the operating theatre under general anaesthesia (depending on the location and the pus and other factors) • Intravenous antibiotics • Supportive treatment C) DIFFICULTY BREATHING Some of the causes include: • Infection/inflammation o Acute epiglottitis (infection of the epiglottis) o Ludwig’s angina (submandibular cellulitis) • Abscess in the airway • Foreign body in the airway/windpipe • Cancer of the voicebox/larynx/hypopharynx (lower throat) • Paralysis of both vocal cords. • Laryngeal (voice box) injury following accidental injury, burns In   some   cases,   a   characteristic   noisy   breathing   sound   is   produced   (medical   term:   ‘stridor’)   In   all   cases where   the   patient   experiences   shortness   of   breath,   it   is   very   important   to   seek   early   treatment.   DO   NOT DELAY. D) TRAUMA  Includes    obvious    bleeding    or    swelling    following    accidental    injuries,    direct    burns,    inhalation    injury (inhalalation   of   hot   smoke   or   poisonous   fumes   in   burn   cases),   fractures,   facial   injuries,   nose   bleeding, perichondritis (collection of fluid in the pinna/the outer part of the ear). E) SUDDEN HEARING LOSS A   specific   form   of   hearing   loss   of   sudden   onset.   May   be   associated   with   ringing   sound   in   the   ear   (tinnnitus). Serial   audiometric   hearing   test      is   necessary   to   confirm   the   nature   of   this   type   of   hearing   loss.   May   indicate viral infection or reasons can be unknown. Early treatment is of paramount importance. F) SEVERE GIDDINESS/VERTIGO Whether   giddiness,   dizziness   or   vertigo,   this   condition   can   be   very   distressing   !      Furthermore,   a   severe episode   of   vertigo   (spinning   sensation   experienced   by   the   patient)   can   be   associated   with   nausea   and vomitting.   The   patient   may   require   admission   into   the   hospital.   A   concurrent   hearing   loss   can   indicate possible inner ear infection (labyrinthitis). Rarely, vertigo can be a warning sign of stroke.  

> Back to top

Ludwig’s angina (submandibular cellulitis) causing shortness of breath

Abscess over the nasal bridge

Abscess arising from the left salivary (parotid) gland

Severe injury ot the outer ear following a motor vehicle accident

X-ray showing a foreign body (a coin) in the esophagus.

An infant suffering burns injury to the outer ear

An infant with extensive periorbital abscess due to acute sinusitis

Last update:  10/1/13