Episode 38: ENT Emergencies Pearls, Pitfalls, Tips and Tricks
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Nov 19, 2013 Dr. Maria Ivankovic, an emergency physician and lecturer at the University of Toronto, teams up with Dr. Leeor Sommer, an expert in ENT skills and hands-on workshops. They dive into the intricacies of managing epistaxis, offering a four-step approach and tips for foreign body removal. Key discussions include the urgent treatment of sudden sensorineural hearing loss and the critical signs of epiglottitis. They also explain the nuances of diagnosing and managing angioedema, stressing the importance of airway assessment and effective treatment strategies.
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Best Imaging For Malignant Otitis Externa
- Prefer gallium or technetium bone scans over CT to detect early osteitis; gallium tracks infection activity for follow-up.
- Use CT to define anatomic extension, abscess, or cavernous sinus thrombosis when needed.
Treatment And Disposition For MOE
- Most non-toxic malignant otitis externa patients can be treated outpatient with oral ciprofloxacin 750 mg BID and ENT follow-up.
- Treat for 6–8 weeks and consult ENT early; admit if sick, unstable, or lacking close follow-up.
Early Management Of Sudden Hearing Loss
- In sudden sensorineural hearing loss (SSNHL) exclude trauma, neurologic signs, or conductive causes; do a focused neuro and ear exam.
- If isolated SSNHL within 72 hours, start high‑dose steroids (1 mg/kg up to 60 mg daily) and arrange urgent ENT/audiology.