ENT

Otitis externa (OE) is an inflammation, infectious or non-infectious, of the external auditory canal. In some cases, inflammation can extend to the outer ear, such as the pinna or tragus.

OE can be classified as acute lasting less than 6 weeks or chronic which lasts more than 3 months. It is also known as swimmer's ear as it often occurs during the summer and in tropical climates.

The most common cause of acute otitis externa is a bacterial infection. It may be associated with allergies, eczema, and psoriasis.

Vertigo

It is a symptom of vestibular dysfunction in the vestibular system from a peripheral or central lesion and has been described as a sensation of motion, most commonly rotational motion.

Vertigo affects all ages. In younger patients, middle ear pathology is most often the cause.

In the elderly, specific assessment is needed due to the risk of falls and their complications. Peripheral etiologies include the more common causes of vertigo, such as benign paroxysmal positional vertigo (BPPV) and Ménière disease.

Dizziness

"Dizzy" can describe so many different sensations that the clinician's first priority must be to pin down what each patient means by it. More often, each subjective sensation of dizziness can be identified more precisely as one of four types of dizziness: vertigo, disequilibrium, presyncope, or lightheadedness. The clinical approach to the dizzy patient depends crucially on distinguishing among these various kinds of dizziness, since the differential diagnosis is peculiar to each type.

Acute otitis media (AOM) is defined as an infection of the middle ear and is the second most common pediatric diagnosis in the emergency department following upper respiratory infections.

It is a spectrum of diseases that include acute otitis media (AOM), chronic suppurative otitis media (CSOM), and otitis media with effusion (OME). Infection of the middle ear can be viral, bacterial, or coinfection. The most common bacterial organisms causing otitis media are Streptococcus pneumoniae, followed by non-typeable Haemophilus influenzae (NTHi), and Moraxella catarrhalis.

Vomiting, or emesis, is the forceful retrograde expulsion of gastric contents from the body. Nausea is the unpleasant sensation that precedes vomiting. Nausea frequently is relieved by vomiting and may be accompanied by increased parasympathetic nervous system activity including diaphoresis, salivation, bradycardia, pallor, and decreased respiratory rate. Retching ("dry heaves") is the simultaneous contraction of the abdominal muscles and muscles of inspiration that may occur with vomiting.

Dizziness is often accompanied by nausea or vomiting, paleness and slowing of the pulse. Vomiting is a reflex phenomenon and sometimes accompanying symptom of dizziness and vertigo.

Motion sickness is a common and complex syndrome that occurs in response to the real or perceived motion. Its presentation can be diverse, including the gastrointestinal, central nervous system, and autonomic symptoms.

There is considerable individual variability in motion sickness susceptibility, as some individuals may suffer from minimal provocation and in others, it may be very difficult to elicit symptoms.

Motion sickness symptoms were first described by Hippocrates, who wrote, “sailing on the sea proves that motion disorders the body.” The main symptom of motion sickness, nausea, is derived from naus, the Greek word for ship (e.g., nautical). Motion sickness occurs when there is a mismatch between actual versus expected sensory inputs.

Ορισμένα χαρακτηριστικά που συνδέονται με την ναυτία των ταξιδιωτών είναι:

• Φύλο – οι γυναίκες είναι πιο ευαίσθητες από τους άνδρες

• Ηλικία – ξεκινά γύρω στην ηλικία των 6 ετών και κορυφώνεται στην ηλικία των 9 ετών – υπάρχει επακόλουθη μείωση κατά τη διάρκεια των εφηβικών ετών. Οι ηλικιωμένοι είναι οι λιγότερο ευάλωτοι στην ασθένεια κίνησης

• Επίπεδο φυσικής κατάστασης – μελέτες δείχνουν αυξημένη ευαισθησία σε άτομα με υψηλά επίπεδα αερόβιας φυσικής κατάστασης και ότι αυτό οφείλεται σε ένα πιο αντιδραστικό αυτόνομο σύστημα.

• Ιατρικές παθήσεις – ασθενείς με ιλίγγους, αιθουσαία παθολογία, νόσος του Meniere και ημικρανίες διατρέχουν αυξημένο κίνδυνο

• Ορμόνες – οι διακυμάνσεις κατά τη διάρκεια της εγκυμοσύνης και του εμμηνορροϊκού κύκλου αυξάνουν την ευαισθησία

Αν και ο ακριβής νευροβιολογικός μηχανισμός είναι ασαφής, υπάρχει θεραπευτική αντιμετώπιση για την πρόληψη και την ανακούφιση αυτής της κατάστασης.

Rhinosinusitis

Sinusitis, also known as rhinosinusitis, is inflammation of the mucous membranes that line the sinuses resulting in symptoms that may include thick nasal mucus, a plugged nose, and facial pain. Other signs and symptoms may include fever, headaches, a poor sense of smell, sore throat, and a cough. It is defined as acute sinusitis if it lasts less than 4 weeks, and as chronic sinusitis if it lasts for more than 12 weeks. Sinusitis can be caused by infection, allergies, air pollution, or structural problems in the nose. Most cases are caused by a viral infection.

Οι παράγοντες που αυξάνουν την πιθανότητα εμφάνισης ιγμορίτιδας είναιτο σκολιωτικό (στραβό) ρινικό διάφραγμα, οι υπερτροφικές ρινικές κόγχες, οι ρινικοί πολύποδες, οι λοιμώξεις του ανώτερου αναπνευστικού συστήματος, η ηλικία, το κάπνισμα, οι οδοντικές λοιμώξεις και οι οδοντιατρικές εργασίες σε περιοχές που γειτνιάζουν με τα ιγμόρεια, η αλλεργική ρινίτιδα, οι ανοσοανεπάρκειες, η κυστική ίνωση, τα θαλάσσια σπορ-καταδύσεις, τα αεροπορικά ταξίδια.

Nasal polyps

Nasal polyps are benign inflammatory and hyperplastic outgrowths of the sinonasal mucosa. Their most common manifestation is in patients with chronic rhinosinusitis (CRS).

Rhinopharyngitis or the common cold, also known simply as a cold, is a viral infectious disease of the upper respiratory tract that primarily affects the respiratory mucosa of the nose, throat, sinuses, and larynx.     

Signs and symptoms may appear less than two days after exposure to the virus. These may include coughing, sore throat, runny nose, sneezing, headache, and fever. People usually recover in seven to ten days, but some symptoms may last up to three weeks.