Senior-clinician companion to introductory ENT notes. Educational use only; airway emergencies require immediate skilled help and local protocols.
A Word From Your Senior
The ear, nose, and throat are connected, but the safest ENT habit is knowing when a local complaint threatens airway, intracranial structures, vision, hearing, or cancer delay.
Ear and Balance
Separate conductive from sensorineural hearing loss using history, examination, bedside tests performed correctly, and formal audiology when indicated. Sudden sensorineural hearing loss is time-sensitive and should not be mistaken for simple wax or congestion.
Vertigo is a symptom, not a diagnosis. Characterise timing, triggers, hearing symptoms, neurological features, gait, headache, vascular risk, and examination findings. Positional symptoms can be peripheral, but new focal neurology, severe truncal instability, or concerning headache demands urgent central evaluation.
Nose and Throat
The nose filters, warms, humidifies, and senses, while connected sinuses and the Eustachian tube explain some symptom patterns. Persistent unilateral obstruction, bleeding, discharge, or facial symptoms deserves careful assessment rather than repeated empirical treatment.
The pharynx and larynx share breathing, swallowing, and phonation functions. Stridor, drooling, tripod posture, rapidly progressive swelling, muffled voice, inability to swallow secretions, or respiratory fatigue can signal an airway emergency. Avoid upsetting a child with suspected critical upper-airway obstruction; summon expert help.
Bedside Case
An adult has progressive hoarseness and weight loss. Document duration, smoking and alcohol exposure, reflux and voice use, swallowing, pain, neck nodes, and respiratory symptoms. Persistent unexplained hoarseness requires appropriate visualisation and referral; do not let empiric reflux treatment create diagnostic delay.
Accuracy Guardrails
- A cold can affect connected structures, but not every combined symptom is one benign infection.
- Do not irrigate an ear when perforation, surgery, foreign body, or contraindication is possible.
- Posterior epistaxis and haemodynamic compromise require early escalation.
- Antibiotics are not routine for most uncomplicated viral upper-respiratory illness.
- Referred otalgia with a normal ear examination can arise from dental, pharyngeal, laryngeal, cervical, or malignant disease.
Trusted Starting References
- NICE ENT conditions (opens in a new tab)
- WHO hearing care (opens in a new tab)
- Current local airway, epistaxis, sudden-hearing-loss, and suspected-cancer pathways.