ENT contitions

Vestibular migraine causes episodes of vertigo or dizziness with migraine headache and sensitivity to sound. After MRI and vestibular tests exclude other causes, treat with propranolol 40 mg twice daily or amlodipine 10 mg daily for 14 days and lifestyle trigger control.

Laryngomalacia is the most common congenital anomaly of the larynx and the leading cause of inspiratory stridor (noisy breathing) in infancy. It is characterized by partial or complete collapse of the supraglottic structures during inspiration, resulting in intermittent upper airway obstruction. Symptoms usually become apparent within the first few weeks of life, peak between 4 and 8 months of age, and gradually resolve as the laryngeal structures mature.

Vestibular schwannomas (acoustic neuromas) are benign tumours of the vestibular nerve causing one-sided hearing loss and tinnitus. Confirm with gadolinium MRI and audiology; options are observation, radiotherapy or surgical excision.

Vestibular neuritis and labyrinthitis cause sudden severe vertigo with nausea, vomiting, nystagmus and unsteadiness (labyrinthitis also with hearing loss). Treatment is symptomatic with promethazine, metoclopramide and short-term diazepam or betahistine, then balance exercises.

Acute epiglottitis is a rapidly progressive bacterial infection of the epiglottis causing severe sore throat, drooling, muffled voice, high fever and a sitting, neck-extended posture, which can obstruct the airway. Keep the patient upright and calm, give oxygen, secure the airway and admit to ICU with IV antibiotics.