Ear, Nose and Throat - U.S.A.  (ENT USA) Hints for Doctors
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Ears:  
 
#1.  Ear Pain.  Only 50% of ear pain comes from the ears.  If treated with multiple antibiotics and the eardrum is normal, look for other causes such as TMJ pain or maxillary sinusitis.

#2.  Swimmer's ear or external otitis is often caused by pseudomonas.  In the child, open the canal with a pope ear wick and use ear drops.  Do the same in the adult but you may also want to use Cipro.

#3.  Itching ears are often caused by a fungus.  Lotrimin or Tinactin solution can be of help.  I prescribe it four drops four times a day for two weeks.

#4.  Ear pressure may be referred from the sinuses or nose much like an ice cream headache.   Ear fluid is seldom present if the patient does not complain of hearing loss.

#5.  If pus is draining out of the external canal, always treat with oral antibiotics AND ear drops.  If an ear tube is present 33% of these infections are pseudomonas, thus, ear drops are needed.

#6.  Dizziness from the inner ear is vertigo.  Vertigois the sensation of motion, sometimes spinning.  Light-headedness is usually not from inner ear disease.

#7.  Ear fluid rarely causes dizziness.

#8.  New advances in digital hearing aids are helping many patients with sensorineural hearing loss.

Nose:

#1.  If a patient has chronic nasal and facial complaints, obtain sinus films they may show a sinusitis. 

#2.  Severe and chronic headaches are usually not caused by sinusitis, a sinus CT scan can rule out sinusitis as a cause.

#3.  Maxillary mucus retention cysts are common and most do not need treatment.

#4.  Do not use decongestants in patients with high blood pressure, especially if on Beta Blockers.

#5.  Follow patients on nasal steroids to diagnosis mucosal atrophy early and prevent a septal perforation.

Throat:

#1.  The most common cause of hoarseness in the non-smoker is gastroesophageal reflux, even if no heartburn symptoms are present.

#2.  The most common cause of food sticking in the lower throat is gastroesophageal reflux, even if no  heartburn symptoms are present

#3.  Persistent hoarseness needs a laryngeal exam to rule out a throat cancer and other disorders.

 
     
 
 
     

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