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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
learnent.NET
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
learnent.NET
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
learnent.NET
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
learnent.NET
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
learnent.NET
Malignant Otitis
Externa
learnent.NET
learnent.NET
learnent.NET
learnent.NET
learnent.NET
Malignant Otitis
Externa
Necrotizing
Otitis Externa
learnent.NET
learnent.NET
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
learnent.NET
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
learnent.NET
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
learnent.NET
Necrotizing
Otitis Externa
90% Diabetics
Mortality
10 - 50%
Malignant Otitis
Externa
learnent.NET
Malignant Otitis
Externa
Fungal Sinusitis Deep Neck
Space Infections
3
learnent.NET
Fungal Sinusitis
learnent.NET
learnent.NET
learnent.NET
learnent.NET
learnent.NET
learnent.NET
learnent.NET
learnent.NET
learnent.NET
Fungal Ball / Mycetoma Allergic Fungal Sinusitis
Chronic invasive
non granulomatous
Chronic invasive
granulomatous
Acute invasive
5
learnent.NET
learnent.NET
learnent.NET
Co-morbidity No Percentage
Diabetes 11 100%
Hypertension 3 27.2%
Hyperlipidemia 2 18.2%
Metabolic Acidosis 2 18.2%
IHD 1 11.1%
learnent.NET
Nasal Mass
Orbital / Palatal
Intracranial
DM
Other
Immunodeficiency
Investigations
CT
EUA + Biopsy
Treatment
Systemic Anti-fungals
Surgery
Clinical Features
Fungal Sinusitis
learnent.NET
Nasal Mass
Orbital / Palatal
Intracranial
DM
Other
Immunodeficiency
Investigations
CT
EUA + Biopsy
Treatment
Systemic Anti-fungals
Surgery
Clinical Features
Fungal Sinusitis
learnent.NET
Nasal Mass
Orbital / Palatal
Intracranial
DM
Other
Immunodeficiency
Investigations
CT
EUA + Biopsy
Treatment
Systemic Anti-fungals
Surgery
Clinical Features
Fungal Sinusitis
learnent.NET
~100% Diabetics
50-80% Mortality
Invasive
Fungal Sinusitis
learnent.NET
Malignant Otitis
Externa
Fungal Sinusitis Deep Neck
Space Infections
3
learnent.NET
Deep Neck
Space Infections
learnent.NET
learnent.NET
1. Straight Spine
2. Wide RPS
learnent.NET
learnent.NET
learnent.NET
learnent.NET
Complications
Airway
Obstruction
Airway
Soiling
Septic
Thrombosis
Carotid
Artery
Rupture
Mediastinitis
learnent.NET
learnent.NET
Neck Lump
Fever
Odynophagia
Stridor
DM
Other
Immunodeficiency
Investigations
FBC, ESR/CRP
CT
Culture ABST
Treatment
Systemic Antibiotics
Surgery
Clinical Features
DNSI
learnent.NET
Neck Lump
Fever
Odynophagia
Stridor
DM
Other
Immunodeficiency
Investigations
FBC, ESR/CRP
CT
Culture ABST
Treatment
Systemic Antibiotics
Surgery
Clinical Features
DNSI
learnent.NET
Neck Lump
Fever
Odynophagia
Stridor
DM
Other
Immunodeficiency
Investigations
FBC, ESR/CRP
CT
Culture ABST
Treatment
Systemic Antibiotics
Surgery
Clinical Features
DNSI
learnent.NET
DM
Commonest
Systemic
Disease
Complicated
ICU/
Hospital Stay
Risk
DNSI
learnent.NET
Hearing Loss
Fungal Otitis
Externa
Malignant Otitis
Externa
Fungal Sinusitis
Deep Neck
Space Infections
Vestibular
Function
DM & ENT
learnent.NET
Malignant Otitis
Externa
DNSIFungal Sinusitis
learnent.NET
learnent.NET
MTD Lakshan
learnent.net
@mtdlakshan
lakshent@gmail.com

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