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Primary Care ENT, An Issue of Primary Care: Clinics in Office Practice, E-Book

Primary Care ENT, An Issue of Primary Care: Clinics in Office Practice, E-Book

Gretchen Dickson

(2014)

Additional Information

Abstract

This issue of Primary Care: Clinics in Office Practice, edited by Gretchen Dickson, MD and Rick Kellerman, MD, is devoted to Primary Care ENT. Articles in this issue include Otitis Externa; Disease of the Internal Ear; Hearing Loss; Dizziness and Vertigo; Rhinitis; Sinusitis; Epistaxis; Laryngitis; Pharyngitis; Mouth Disease; and Neurological Syndromes pertaining to the Head and Neck.

Table of Contents

Section Title Page Action Price
Front Cover Cover
Primary Care ENT\r i
Copyright\r ii
Contributors iii
Contents v
Primary Care: Clinics In Office Practice\r viii
Foreword\r ix
Preface xi
Otitis Externa 1
Key points 1
Acute otitis externa 1
Epidemiology 1
Risk Factors 1
Pathophysiology 2
Clinical Presentation 2
Diagnosis 2
Treatment 4
Monitoring 6
Prevention 6
Complications 6
Chronic otitis externa 6
Clinical Presentation 7
Physical Examination 7
Diagnosis 7
Treatment 7
Complications 8
Summary 8
References 8
Acute Otitis Media 11
Key points 11
Epidemiology 11
Prevention 12
Diagnosis 13
Treatment 13
Analgesia 13
Antibiotic therapy 14
Observation 15
Surgical options 15
Summary 16
References 16
Hearing Loss 19
Key points 19
Introduction 19
Epidemiology 20
Clinical presentation 20
Diagnosis 20
Physical Examination 20
Imaging 22
Audiometric Evaluation 23
Etiology 24
Embryonic Developmental Anomalies 24
Genetic Causes of Hearing Loss 24
Infectious 25
Noise Exposure 25
Otosclerosis 25
Trauma 25
Ototoxicity 26
Acoustic Neuroma 26
Autoimmune 26
Central Auditory Processing Disorder 26
Presbycusis 26
Meniere Disease 27
Treatment 27
Assistive listening devices and amplification 28
Summary 29
References 29
Rhinitis 33
Key points 33
Introduction 34
Epidemiology 34
Allergic rhinitis 34
Classification 34
Pathophysiology 34
Early and late phase reactions 35
Prevention 35
Diagnosis 36
History 36
Treatment 36
Nonallergic rhinitis 37
Classification 37
Pathophysiology 38
Diagnosis/History 38
Treatment 38
Local allergic rhinitis 38
Diagnostic testing 39
Differential diagnosis 39
Medications 39
Intranasal Corticosteroids 39
Oral Antihistamines 41
Intranasal Antihistamines 41
Intranasal Ipratropium 43
Leukotriene Receptor Antagonists 43
Nasal Cromolyn 43
Decongestants 43
Combination Therapies 44
Nasal Saline 44
Anti-IgE 44
Systemic Steroids 44
Immunotherapy 44
Subcutaneous immunotherapy 44
Monitoring 45
Infectious rhinitis/rhinosinusitis 45
References 45
Rhinosinusitis 47
Key points 47
Introduction 47
Acute Versus Chronic Sinusitis 48
Pathophysiology of sinusitis 49
Normal Sinus Anatomy and Function 49
Sinus Disease 49
Clinical Signs and Symptoms of Sinusitis 49
Sinusitis or Common Cold? 50
Chronic Versus Acute Sinusitis 51
Microbiology in Sinusitis 51
Epidemiology of sinusitis 51
Frequency 51
Risk Factors for Sinusitis 52
Diagnosis 52
Classification on Sinusitis 52
Physical Examination Findings 52
Differentiating Bacterial from Viral Sinusitis 53
Use of Imaging in Acute Sinusitis 53
Treatment 54
General Management Recommendations 54
Management of Presumed Bacterial Sinusitis 54
Choice of Antibiotic for Acute Bacterial Sinusitis 55
Duration of Antibiotic Therapy in Acute Bacterial Sinusitis 56
Poor Response to Treatment or Recurrence 56
Treatment Considerations in Children with Sinusitis 56
Chronic Sinusitis 57
Complications 57
Prevention 58
Guidelines 58
Summary 59
References 59
Epistaxis 63
Key points 63
Epidemiology 63
Anatomy 63
Cause 64
Prevention 65
Evaluation 66
Differentiating between anterior nasal bleeds and posterior nasal bleeds 67
Treatment for anterior nosebleeds 67
Treatment for posterior nosebleeds 70
References 72
Diseases of the Mouth 75
Key points 75
Introduction 75
Infections of the mouth 76
Caries 76
Description 76
Risk factors 76
Prevalence 76
Clinical implications 76
Diagnostic options and dilemmas 76
Management 77
Candidiasis 77
Description 77
Risk factors 77
Prevalence 77
Clinical implications 78
Diagnostic options and dilemmas 78
Management 78
Inflammatory conditions of the mouth 78
Gingivitis 78
Description 78
Risk factors 78
Prevalence 78
Clinical implications 79
Pharyngitis 91
Key points 91
Introduction 91
Causes/epidemiology of pharyngitis 91
History and physical examination 92
Viral Pharyngitis 93
Infectious Mononucleosis 93
Acute Retroviral Syndrome 93
GAS Pharyngitis 93
Streptococcosis 93
Scarlet Fever 93
Diagnosis 94
Acute Mononucleosis 94
Acute Retroviral Syndrome 94
Group C and G Streptococci 95
Fn 95
Treatment 95
Topical treatment 95
Systemic analgesics 95
Antibiotics 95
GAS 95
Group C or G beta-hemolytic Streptococcus 96
Fn 96
Follow-up 96
Recurrent GAS pharyngitis 96
GAS Carrier 97
Complications 97
Pediatric Autoimmune Neuropsychiatric Disorder Associated with Group A Streptococci 97
References 97
Laryngeal Problems 99
Key points 99
Introduction 99
Patient history 100
Physical examination 100
Anatomy 100
Specific conditions 101
Reinke Edema 101
Nasolaryngoscopy 109
Key points 109
Introduction: nature of the problem 109
Indications/contraindications 110
Equipment 110
Patient preparation 110
Technique 111
Complications and management 112
Postoperative care 112
Reporting, follow-up, and clinical implications 112
Outcomes 113
Current controversies/future considerations 113
Summary 113
References 113
Dizziness and Vertigo 115
Key points 115
Introduction 115
Benign paroxysmal peripheral vertigo 115
Epidemiology 116
Risk Factors 116
Pathophysiology 116
Clinical Presentation 117
Diagnosis 117
Diagnostic maneuvers 117
Radiographic imaging 119
Vestibular function testing 120
Treatment 120
Epley maneuver 120
Lempert maneuver 120
Vestibular rehabilitation 120
Pharmacologic 120
Observation 120
Surgical treatment 121
Vestibular neuritis 121
Epidemiology 121
Pathophysiology 121
Clinical Presentation 121
Diagnosis 122
Head-thrust test 122
HINTS: three steps to rule out stroke 122
Radiographic imaging 123
Vestibular function testing 123
Treatment 123
Medications 123
Vestibular rehabilitation 123
Vestibular migraine 123
Epidemiology 123
Pathophysiology 124
Clinical Presentation 124
Diagnosis 124
Treatment 124
Lifestyle 124
Medications 125
Vestibular rehabilitation 125
Meniere's disease 125
Epidemiology 125
Pathophysiology 125
Clinical Presentation 126
Diagnosis 127
Radiographic imaging 127
Vestibular function testing 127
Treatment 128
Lifestyle changes 128
Medications 128
Vestibular rehabilitation 128
Hearing aids 128
Intratympanic glucocorticoids 128
Meniett device 128
Endolymphatic sac procedures 129
Intratympanic gentamycin 129
Vestibular neurectomy 129
Labyrinthectomy 129
Bilateral disease 129
Summary 129
References 129
Neurologic Syndromes of the Head and Neck 133
Key points 133
Ear pain 134
Sinus pain 134
Herpes zoster 134
Herpes zoster ophthalmicus 137
Herpes zoster oticus: Ramsay Hunt syndrome 137
Bell's palsy and other causes of facial paralysis 138
Facial paralysis in children 140
Cranial nerve neuralgias 142
Superior laryngeal neuralgia (branch of cranial nerve X) 142
Trigeminal neuralgia 145
Glossopharyngeal neuralgia 145
Nervus intermedius (geniculate) neuralgia 146
Raeder paratrigeminal syndrome 147
Summary 147
References 147
Index 151