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CASES IN
ENT
AND PICTURE QUIZ
CASE 1
A 36-year-old woman presents with recurrent episodes of
right-sided tinnitus, hearing loss and vertigo. Episodes
typically last between 10-30 minutes. He also describes a
'full' sensation in his right ear. Otoscopy is unremarkable and
the cranial nerve examination is normal.
Diagnosis?
Meniere's disease
More common in middle-aged adults
Triad of Recurrent episodes of vertigo, tinnitus and hearing
loss (which type?)
Episodes last minutes to hours
Prevention of attacks?
Betahistine,? Salt restriction
Let’s say this patient had absent corneal relfex on
examination. Would your differential diagnosis change?
Acoustic neuroma
CASE 2
A 31-year-old man presents with bilateral
hearing loss and tinnitus. There is a family
history of similar problems. Examination of
the tympanic membranes:
Diagnosis?
Otosclerosis
What is otosclerosis?
•Autosomal dominant.
•Replacement of normal bone by vascular spongy bone.
Onset is usually at 20-40 years
•conductive deafness
•tinnitus
•tympanic membrane - 10% of patients may have a 'flamingo
tinge', caused by hyperaemia
•positive family history
CASE 3
2) POSTERIOR:
Known as Woodruff’s plexus
hypertension +/- anticoagulants
Main features:
foul smelling discharge
hearing loss
Management:
Refer to ENT for consideration of surgical removal
PICTURE QUIZ
RHINOPHYMA
Reinke’s
oedema
(Gross
oedema of the
vocal folds)
This patient is
presenting with
renal failure and
nose deformity.
WEGENER’S
GRANULOMATOSIS
CAULIFLOWER
EAR-
UNTREATED
AURICULAR
HEMATOMA
QUINSY
(PERITONSILLAR
ABSCESS)
THANK YOU!
ANY QUESTIONS?