Common diseases of ear, nose and throat prevalent in community level populaton of Nepal. These are the most common conditions that the people present in primary health center level. The slide includes the short introduction and management of those conditions and primary preventive measures in case they are far away from well equipped hospitals.

1. COMMON DISEASES OF EAR,
NOSE AND THROAT
Dr. Binod Chaudhary
Motipur PHC
Suddhodhan-04, Pharsatikar
Rupandehi, Nepal

2. EAR
• External ear
• Pinna
• External acoustic (auditory) canal
• Middle ear
• Internal ear

3. Disease of auricle (pinna)

5. Disease of EAC
• Congenital disorders
• Trauma
• Inflammation
• Tumors
• Others

6. Furuncle (localized acute otitis externa)
• Outer 1/3rd part
• Pain
• Tenderness
• Fever(+/-)
Antibiotics
Analgesics
Local heat
Ear packing

7. Otomycosis
• Fungal infection
• Intense itching
• Discomfort
• Pain
• Discharge with musty odour
Ear toileting
Antifungal agents
Antibiotics

8. Impacted wax or cerumen
• Impairment of hearing or sense of blocked ear
• Tinnitus
• Giddiness
Syringing
Softening and syringing

9. Foreign bodies of ear
Method of removal
Forceps removal
Syringing
Suction
Microscopic removal with special instruments
Postaural approach

11. Disease of tympanic membrane
• Retracted tympanic membrane
• Traumatic rupture
• perforations

12. Disease of middle ear
• Acute suppurative otitis media (ASOM)
• Acute necrtizing otitis media
• Otitis media with effusion
• Chronic suppurative otitis media (CSOM)

13. Acute suppurative otitis media
• Acute inflammation of middle ear.
• Bacterial and viral infection
• Routes of infection
• Eustachian tube
• External ear
• Blood borne
Staphylococcus pneumonia
Haemophilus influenzae

14. Signs and symptoms
• Deafness
• Earache
• Tinnitus
• Fever
• Discharge
• TM perforation

15. Treatment
• Antibacterial therapy
amoxicillin/ampicillin/cotrimoxazole/azithromycin
• Decongestant nasal drops
• Analgesics and antipyretics
• Ear toileting
• Myringotomy

16. Chronic suppurative otitis media
• Long standing infection of part or whole of middle ear
• Characterized by ear discharge and a permanent perforation
Clinical features
• Ear discharge
• Hearing loss
• Perforation
• Bleeding
• Middle ear mucosa

17. Treatment
Aim- control infection and eliminate ear discharge
• Aural toilet
• Ear drops
• Systemic antibiotics
• Precautions
• Surgical treatment

18. Otalgia (Earache)
• Local cause
• Furuncle, impacted wax, otitis externa, otomycosis, neoplasm, etc
• Acute otitis media, Eustachian tube obstruction, mastoiditis,, etc
• Referred cause
• Dental
• Oral cavity
• Temporomandibular joint disorders

19. Tinnitus
Causes
• Impacted wax
• Fluid in middle ear
• Acute otitis media
• Chronic otitis media
• Presbyacusis
• Noise induced hearing loss, etc

20. Hearing loss
• Conductive hearing loss
• Sensorineural hearing loss

21. Disease of nose and
paranasal sinuses

22. Disease of external nose
• Cellulitis
• Nasal deformities
• Tumors

23. Furuncle or boil
• Acute infection of hair follicle
• Staphylococcus aureus
• Painful and tender
Warm compression
Analgesics
Topical and systematic antibiotics

24. Deviated nasal septum
• Caused by trauma or developmental
• Nasal obstruction
• Headache
• Sinusitis
• Epistaxis
• Anosmia
• External deformity
• Middle ear infection
Surgical treatment

25. Septal abscess
• Secondary infection of septal hematoma
• Several bilateral nasal obstruction
• Pain and tenderness
• Fever with chills and frontal headache
Incision and Drainage
Systemic antibiotics

26. Acute rhinitis
• Viral, bacterial or irritative
• Burning sensation at the back of nose
• Nasal stuffiness
• Rhinorrhoea
• Sneezing
• Nasal discharge
Antihistaminics and nasal decongestants
Antibiotics if bacterial

27. Foreign bodies
• History of foreign bodies
• “if a child presents with unilateral, foul smelling nasal discharge,
foreign body must be excluded.”
Removal

28. Epistaxis
Causes
• Trauma
• Infections
• Foreign bodies
• Neoplasms
• Atmospheric changes
• Deviated nasal septum

29. First aid
Cauterization
Anterior nasal packing
Posterior nasal packing

30. Acute sinusitis
• Acute inflammation of sinus
Causes
• Nasal infection
• Trauma
• Dental infection
• Obstruction to sinus ventilation and drainage
• Previous attack
• Poor general hygiene

31. Clinical features
• Fever, general malaise and body ache
• Headache
• Pain
• Tenderness
• Redness and oedema of cheek
• Nasal discharge
• Postnasal discharge

32. Treatment
• Antimicrobial drugs
• Nasal decongestant drops
• Steam inhalation
• Analgesics
• Hot fomentation
• Surgery (antral lavage)

33. Disease of throat

34. Acute pharyngitis

35. Clinical features
• Throat discomfort
• Malaise
• Fever
• Pain
• Dysphagia
• Headache

36. Treatment
General measures- bed rest, plenty of fluids, warm saline
gargles,analgesics
Specific treatment- antibiotics

37. Tonsillitis
• Acute and chronic tonsillitis
• Inflammation of tonsils
Symptoms
• Sore throat
• Difficulty in swallowing
• Fever
• Earache

38. Sign
• Often the breath is foetid
• Hyperemia of pillars, soft palate and uvula
• Tonsils- red and swollen with yellowish spots

39. Treatment
• Bed rest and plenty of fluid
• Analgesics
• Antimicrobial therapy
• Tonsillectomy

40. Acute epiglottitis
• Acute inflammatory condition of epiglottis and nearby structures
• Marked edema, may obstruct the airway
• Serious condition that affects children of 2-7 years of age but can also
affect adults.
• H. influenzae

41. Clinical features
• abrupt in onset with rapid progression
• Sore throat and dysphagia
• Dyspnea and stridor. Rapidly progressive and may prove fatal unless
relieved
• Fever upto 400C
Examination
• Visualization using tongue depressor
• Indirect laryngoscopy
• X-ray soft tissue neck, lateral view.
(examination is avoided for fear of precipitating complete obstruction.
Better done in operation threatre.

42. Treatment
• Hospitalization
• Medication
• Adequate hydration
• Humidification and oxygen
• Intubation or traceostomy