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Miscellaneous ear, nose, and throat disorders

Last updated: August 11, 2021

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This article provides an overview of ear, nose, and throat conditions not discussed elsewhere, including common ones (e.g., deviated nasal septum) as well as uncommon ones (e.g., decompression sickness, ear barotrauma, auricular hematoma).

For an overview of differential diagnoses for hearing loss, see the corresponding article.

  • Definition: significant deviation of the nasal septum from midline; which often leads to obstruction of nasal breathing.
  • Etiology
  • Clinical findings
  • Diagnostics
  • Treatment
    • Septoplasty to correct the deviation is indicated if there are significant symptoms.
  • Complication of surgery
    • Nasal septum perforation
      • Etiology: sequela of septal hematoma (e.g., due to nasal fracture, septoplasty, or rhinoplasty)
      • Clinical features: nasal whistling sound with breathing
      • Diagnostics
        • Anterior rhinoscopy: to directly visualize abnormalities of the anterior to middle part of the septum
        • Posterior rhinoscopy: to directly visualize abnormalities of the middle to posterior part of the septum (via endoscopy)
        • CT: for more detailed evaluation of the nasal septum (and adjacent structures)
      • Treatment: : surgical restoration of physiologic configuration/structure (septoplasty)

References:[1][2][3]

References:[5][6][7]

  • Definition: formation of air embolisms as a result of a rapid decline of barometric pressure within the body
  • Etiology
  • Pathophysiology (in diving)
    • The pressure increases as the diver dives deeper → more oxygen and nitrogen are dissolved in the blood.
    • During normal ascent → pressure decreases and the tension of gas in the blood exceeds the surrounding pressure → dissolved nitrogen changes back into its gaseous form → the gas is exchanged with the lungs and breathed out.
    • In rapid ascent → formation of nitrogen gas bubbles within the blood vessels → insufficient time for the gas to be released via the lungs → gas bubbles remain in circulation and obstruct proper blood flow air embolism
  • Clinical features
  • Treatment
    • Hyperbaric, 100% oxygen
    • Hydration
    • Positioning maneuvers (left lateral decubitus and lowering the head zone of the bed)
  • Prevention

References:[8][9][10]

References:[9][11]

Surgical drainage is always indicated!

References:[12][12][13][14]

  • Definition: chronically patent (open) eustachian tube
  • Etiology
  • Clinical features
    • Usually asymptomatic
    • Autophony: unusually loud hearing and booming of one's own voice (hallmark of patulous eustachian tube)
    • Hearing one's own breathing
    • No hearing loss
    • Symptoms disappear when the affected individuals lye down or when abdominal pressure increases.
  • Diagnostics: Otoscopy shows synchronous movement of the eardrum during respiration.
  • Treatment
    • Often not required as the condition does not generally cause ear complications.
    • Medical management, such as hydration, is initially considered.
    • Weight gain is not effective.
    • Surgical management is reserved for severe cases.
  1. Pulley SA. Decompression Sickness. Decompression Sickness. New York, NY: WebMD. http://emedicine.medscape.com/article/769717-overview. Updated: July 12, 2016. Accessed: February 23, 2017.
  2. Chandy D, Weinhouse GL. Complications of SCUBA diving. In: Post TW, ed. UpToDate. Waltham, MA: UpToDate. https://www.uptodate.com/contents/complications-of-scuba-diving?source=search_result&search=decompression%20sickness&selectedTitle=1%E2%88%BC64#H10.Last updated: May 19, 2016. Accessed: February 23, 2017.
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  7. Garefis P, Grigoriadou E, Zarifi A, Koidis PT. Effectiveness of conservative treatment for craniomandibular disorders: a 2-year longitudinal study.. J Orofac Pain. 1994; 8 (3): p.309-14.
  8. Bhattacharyya N, Deschler DG, Sullivan DJ. Clinical Presentation, Diagnosis, and Treatment of Nasal Obstruction. In: Post TW, ed. UpToDate. Waltham, MA: UpToDate. https://www.ncbi.nlm.nih.gov/pubmed/25822556.Last updated: May 10, 2017. Accessed: October 2, 2017.
  9. Watson D. Septoplasty. In: Meyers AD, Septoplasty. New York, NY: WebMD. https://emedicine.medscape.com/article/877677. Updated: May 15, 2017. Accessed: March 6, 2018.
  10. Romo T III. Septal Perforation. In: Meyers AD, Septal Perforation. New York, NY: WebMD. https://emedicine.medscape.com/article/878817. Updated: March 16, 2016. Accessed: March 6, 2018.
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  15. Deviated Septum. http://www.entnet.org/content/deviated-septum. Updated: January 1, 2017. Accessed: February 23, 2017.
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