Diabetes and ENT Ruhunu Clinical Society Lecture 2015 learnent.net

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MTD Lakshan

Here we are discussing the relationship between diabetes and Otorhinolaryngology and Head and Neck Surgery (ENT)

Health & Medicine

Dr. M.T.D. Lakshan
MBBS MS(Oto) DOHNS(Eng) FEB ORL-HNS (Europe)
FRCSEd ORL-HNS (UK)
Consultant ENT and Head and Neck Surgeon

Hearing Loss
Sensorineural deafness in patients of type 2 diabetes
mellitus in Uttar Pradesh: a pilot study
Vilas Misra, C G Agarwal, N Bhatia, G K Shukla
Indian Journal of Otolaryngology and Head and Neck Surgery 2013, 65:
DM & ENT Hearing Loss
learnent.netlearnent.NET

Otitis Externa: Review and Clinical Update
J David Osguthorpe, David R Nielsen
American Family Physician 2006 November 1, 74 (9): 1510-6
DM & ENT
Fungal Otitis
Externa
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DM & ENT Deep Neck
Space Infections
Predisposing Factors of Complicated Deep Neck
Infection: An Analysis of 158 Cases.
Lee J-K, Kim H-D, Lim S-C. Yonsei Medical Journal.
2007;48(1):55-62. doi:10.3349/ymj.2007.48.1.55.
learnent.NET

DM & ENT Fungal Sinusitis
Neuro-ophthalmology of invasive fungal sinusitis: 14
consecutive patients and a review of the literature
Matthew J Thurtell, et al
Clinical & Experimental Ophthalmology 2013, 41 (6): 567-76
learnent.NET

DM & ENT
Vestibular
Function
Characterization of Vestibulopathy in Individuals with
Type 2 Diabetes Mellitus
Bryan K Ward et al
Otolaryngology—Head and Neck Surgery 2015, 153 (1): 112-8
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DM & ENT
Malignant Otitis
Externa
Malignant otitis externa
Matthew J Carfrae, Bradley W Kesser
Otolaryngologic Clinics of North America 2008, 41 (3): 537-49, viii-ix
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Hearing Loss
Fungal Otitis
Externa
Malignant Otitis
Externa
Fungal Sinusitis
Deep Neck
Space Infections
Vestibular
Function
DM & ENT
learnent.NET

Malignant Otitis
Externa
Fungal Sinusitis Deep Neck
Space Infections
3
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Malignant Otitis
Externa
Necrotizing
Otitis Externa
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Investigations
Swab
PTA
CT
Bone Scans
EUA + Biopsy
Treatment
Quinolone 4 - 6W
Surgery - limited role
Hyperbaric Oxygen
Elderly Patient
Excruciating
Otalgia
Lower cranial
Nerve Palsies
Granulations in
the ear
DM
Clinical Features
Necrotizing Otitis
Externa
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Necrotizing
Otitis Externa
90% Diabetics
Mortality
10 - 50%
Malignant Otitis
Externa
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Fungal Ball / Mycetoma Allergic Fungal Sinusitis
Chronic invasive
non granulomatous
Chronic invasive
granulomatous
Acute invasive
5
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Co-morbidity No Percentage
Diabetes 11 100%
Hypertension 3 27.2%
Hyperlipidemia 2 18.2%
Metabolic Acidosis 2 18.2%
IHD 1 11.1%
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Nasal Mass
Orbital / Palatal
Intracranial
DM
Other
Immunodeﬁciency
Investigations
CT
EUA + Biopsy
Treatment
Systemic Anti-fungals
Surgery
Clinical Features
Fungal Sinusitis
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~100% Diabetics
50-80% Mortality
Invasive
Fungal Sinusitis
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1. Straight Spine
2. Wide RPS
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Complications
Airway
Obstruction
Airway
Soiling
Septic
Thrombosis
Carotid
Artery
Rupture
Mediastinitis
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Neck Lump
Fever
Odynophagia
Stridor
DM
Other
Immunodeﬁciency
Investigations
FBC, ESR/CRP
CT
Culture ABST
Treatment
Systemic Antibiotics
Surgery
Clinical Features
DNSI
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DM
Commonest
Systemic
Disease
Complicated
ICU/
Hospital Stay
Risk
DNSI
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Malignant Otitis
Externa
DNSIFungal Sinusitis
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MTD Lakshan
learnent.net
@mtdlakshan
lakshent@gmail.com

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