ENT contitions

Infection of thyroglossal duct cysts, dermoid cysts, and branchial cleft cysts is a common cause of congenital neck swelling presenting during childhood or early adulthood. These congenital lesions arise from abnormal embryological development and may remain asymptomatic until they become infected, usually following an upper respiratory tract infection or local bacterial invasion.

Ramsay Hunt syndrome is reactivation of varicella zoster virus in the geniculate ganglion, causing a vesicular ear rash, ear pain and facial nerve paralysis. Start prednisolone and acyclovir early, add topical acyclovir and analgesia, keep the ear dry, and refer to an ophthalmologist if the eye cannot close.

Mastoiditis with a subperiosteal abscess is a complication of chronic otitis media producing a painful fluctuant swelling behind the ear. Aspirate and drain it, give ciprofloxacin ear drops with IV ceftriaxone for 7–14 days, and refer for mastoidectomy at a zonal or national hospital.

Rhinoscleroma is a chronic granulomatous Klebsiella infection of the nose with foul discharge, crusting, rubbery nodules and nasal deformity. Treat with prolonged ciprofloxacin or cefixime for 4–12 weeks plus prednisolone, saline douching and surgery for deformity.

Juvenile nasopharyngeal angiofibroma (JNA) is a rare, benign but highly vascular tumour that occurs almost exclusively in adolescent males. The tumour originates near the sphenopalatine foramen in the posterior nasal cavity and nasopharynx and is characterized by locally aggressive growth despite its benign histological nature.