Common ENT Problems

Dr .Amir Siddig
Faculty of Medicine
 1- Epistaxis
1. Definition : Nasal bleeding from the fragile
nasal vessels near the surface .It can be anterior
or posterior.Common in adults and children
between 3 and 10 years.
2. Causes :
1-Dryness (dry air,decongestants,
antihistamines)
2-Foreign bodies
3-Chemical irritants
4- Allergic reaction
5-Injury to the nose
6-Repeated sneezing
7-Upper airway infection
8-Large doses of Aspirin
9-High blood pressure
10-Cancer
11-Bleeding and clotting disorders
3- Treatment
1-Anterior nasal bleeding :
.Usually self limiting
.Local compression (squeezing the nose)
.Cold compression
.Further investigation and treatment of the
underlying cause
2- Posterior Nasal bleeding :
-Needs hospital treatment
-Less common
-Can be dangerous
-Packing, decongestants, cauterization
Investigation :
1. CBC
2. PTT
3. INR
4. Nasal X-ray
5. CT scan of the nose
6. Endoscopy
 2-Airway Obstruction
1- Causes :
• Tongue in CNS depression
• Maxillofacial injuries
• Infections of pharynx, larynx and trachea
(viral,bacterial)
• Laryngeal oedema (trauma ,inhalational burn)
• Tracheomalacia
• Recurrent laryngeal nerve injury
• Foreign body
• Compression from without (tumor, goitre)
 Clinical features
• Agitation
• Cyanosis
• Gasping for air
• Dyspnoea. Laboured breathing ,use of
accessory muscles
• Stridor
• Decreased breathing sounds
• Unconscousness
• Cardiorespiratory arrest
 Treatment
• Top emergency. Brain can tolerate anoxia
for 5 minutes otherwise permanent damage
may result
• Heimlich manoeuvre for impacted foreign body
• Suction
• Chin lift and jaw thrust (comatose pt)
• Endotracheal tube
• Surgical airway ( Cricothyroidotomy, traceostomy)
• CPR (cardiopulmonary resuscitation)