ENT contitions

Furunculosis is a staphylococcal infection of a hair follicle in the outer ear canal causing severe ear pain and a localised swelling that may discharge pus. Treat with aural toilet, keeping the ear dry and analgesia, incision and drainage when needed, and amoxicillin-clavulanate only for systemic symptoms or cellulitis.

Parapharyngeal tumours are rare neoplasms arising within the parapharyngeal space, a deep potential space located lateral to the upper pharynx and extending from the skull base to the hyoid bone. Both benign and malignant tumours may develop from the numerous structures contained within this space, including the salivary glands, nerves, lymphatic tissue, and blood vessels.

Acute otitis media is middle-ear infection after a cold, with fever, ear pain, restlessness and a red bulging ear drum. Give analgesia, and amoxicillin (80–90 mg/kg/day in children) only for severe cases or children under 2 years; refer complications such as mastoiditis or persistent discharge.

Adenoid hypertrophy causes mouth breathing, snoring, noisy breathing, sleep apnoea and glue ear, mainly in children. Treat with cetirizine, saline spray and a short decongestant course, and refer for adenoidectomy when obstruction persists; consider tumours in adults who snore.

Sensorineural hearing loss comes from the cochlea or auditory nerve and may be congenital or acquired; every newborn should be screened with otoacoustic emissions. Management is rehabilitation – hearing aids, cochlear implants, speech therapy and sign language – with avoidance of noise and ototoxic medicines.