An 18-year-old boy comes to the ENT outpatient with complaints of left sided nasal obstruction for the past 6 months. Insidious in onset, the obstruction is worsening progressively. It is associated with occasional whitish, mucoid nasal discharge that is not foul smelling or blood stained. There is no history of headache or symptoms of nasal allergy like excessive sneezing and watery rhinorrhoea.   Examination   The external appearance of the nose is normal as are the vestibules. On anterior rhinoscopy, a solitary, greyish mass is seen in the left nasal cavity. The mass is smooth and glistening and occupies the lower part of the nasal cavity. The middle turbinate appears to be normal. The mass is further examined with a cotton tipped probe – it is insensitive to touch, does not bleed and can be … Read entire article »

  A 25-year-old man presents to the ENT outpatient with complaints of right ear discharge for the past two years. The discharge is small in quantity, white to yellow in colour, purulent, often foul-smelling but not blood stained. It is continuous and not associated with upper respiratory infections. He also complains of hearing loss in the right ear for about the past one year. He is unable to hear whispers and low tones. He does not complain … Read entire article »

A 15-year-old girl presents to the ENT outpatient with history of throat pain for the past 3 days. It began as mild discomfort or sore throat and has now developed into odynophagia or pain on swallowing. She also has fever – low grade and intermittent, not associated with chills or rigors. She has no history of cough or change in voice. She also has no nasal or ear symptoms. She gives history of similar complaints occurring … Read entire article »

A 25-year-old male patient presents to the outpatient with history of bilateral nasal obstruction for the past 2 years. The obstruction has been on and off but has become continuous over the past 15 days. It is sometimes associated with headache. There is also history of excessive sneezing and nasal discharge. The discharge is thin and watery, not foul smelling or blood-stained and is occasionally associated with watering of the eyes. There is history of itching in the nose, palate and eyes. There is no history of fever. The symptoms are often triggered off by exposure to dust.   Examination   The external appearance of the nose is normal. There is no abnormality in the vestibule. Anterior rhinoscopy reveals serous discharge in both nasal cavities. The inferior turbinates are hypertrophied, bluish and boggy on both … Read entire article »

A case of acute otitis media with discussion on diagnosis and treatment of AOM.   A 4-year-old boy is brought to the ENT outpatient by his mother with complaints of severe right earache since the previous day. The pain was most severe at night. This morning the mother noticed slight watery discharge from the right ear. The patient has fever. He has been suffering from cold and nasal discharge since about three days. There is no past history of similar complaints. There is no history of repeated upper respiratory infections or nasal complaints. There is also no other significant medical history. The child’s immunization status is up to date.   Examination   The child is febrile. His right ear canal is filled with whitish, mucoid discharge. Cleaning the discharge reveals a red and congested tympanic membrane with … Read entire article »

A 30-year-old male patient presents to the ENT outpatient with history of left ear discharge for the past two years. The ear discharge is intermittent and occurs in episodes that last for a few days each. These episodes are often associated with acute upper respiratory infections. The discharge is moderate in quantity, white in colour and thick and sticky (mucoid) in consistency. It is not foul smelling or blood stained. There is no associated ear ache. … Read entire article »