EAR
1. Discharge: it could be
Serous- Otitis Externa , Chronic Otitis Media
Mucoid- Chronic Otitis Media (safe)
Mucopurulent & foul smelling- Chronic Otitis Media (dangerous)
Watery- CSF otorrh treatment – medical followed by surgical eradication of disease in middle ear and reconstruction of ear drum. CSF Otorrhoea- reconstructing the defect in skull base responsible for CSF leak
2. Hearing loss: 2 types;
  Conductive: this is due to loss of integrity of sound conducting apparatus (or) fixation of ossicles.Treatment is reconstructing the ossicular chain (or) mobilizing the fixed ossicle.
  Nerve deafness: this is due to degeneration of auditory nerve. Cause can be  old age, trauma, ototoxic drugs, metabolic disorderscan be treated by giving  steroids, hearing aids.
3. Ear pain: can arise from ear itself (or) from its surrounding structures. Local- Infections of external ear- Furuncle, Otitis externa, Otomycosis Infections of middle ear, Eustachian tube dysfunction, Mastoiditis, Malignancies.Referred otalgia- 5 Ts
  Tongue
  Tooth
  Throat
  TM joint
  Tube Eustachian
4. Ringing sensation/ Tinnitus-
    a. Subjective- wax
Fluid in middle ear
Middle ear ventilation
Abnormally patent Eustachian tube
Meniere’s disease
Otosclerosis
Tumours of auditory nerve
Anaemia
Hypertension
Migraine
CNS disorders
   b. Objective- vascular tumours like
Palatal myoclonus
Psychogenic
5. Giddiness/ Vertigo-
6. Bleeding from ear-
Trauma- laceration of EAC with FB fracture base of skull in RTA
ASOM
Glomus tumours
Haemangiomas
7. Itching sensation-
General disorders- Dermatitis, Allergies, Diabetes
Local- Otomycosis
8. Swellings around the ear;
Preauricular tags, sinuses, cysts
Perichondritis
Mastoiditis
Tumours
NOSE
1. Nasal obstruction- it can be Unilateral / Bilateral
Continuous / Intermittent aggravated with cold.
MC causes- Deviated Nasal Septum
Inferior Turbinate Hypertrophy
Foreign bodies- (unilateral)
Polyps
Growths like Angiofibroma, Inverted Papilloma.
Rx- corrected by Septoplasty / FESS depending upon the cause
2. Nasal discharge- it can be mucoid- infection(cold)
  Watery- allergy, polyps it can be unilateral /bilateral can be whitish / yellowish
  MC causes- foreign body, upper respiratory tract infections (rhinitis, sinusitis) tumours causing stasis of secretions by blocking their openings
3. Head ache: due to inflammation in rhinitis the osti of the sinuses get bocked causing stasis of secretions.this causes unilateral / bilateral moderate to severe headache.
  Site- frontal & maxillary sinuses- forehead
  Ethmoid – bridge of nose
  Sphenoid- occiput, vertex, mastoid region
  Rx. Medical Surgical- FESS (functional endoscopic sinus surgery)
4. Recurrent attacks of cold – in dicates the severity of the problem. The predisposing condition should be identified and treated accordingly with medicines (or) surgery,
    a. Subjective- wax
5. Bleeding from nose (EPISTAXIS)- very alarming & frightening situation to the patient. Causes could be –
6. Sneezings : more commonly it is caused due to allergy association with nasal polyps , bronchial asthma should be considered
Trauma- laceration of EAC with FB fracture base of skull in RTA
ASOM
Glomus tumours
Haemangiomas
7. Loss of smell:  due to trauma upper respiratory tract infections diabetes
General disorders- Dermatitis, Allergies, Diabetes
Local- Otomycosis
8. External deformity of nose: now a days  cosmetic sense is receiving great importance. Various deformities like-
Preauricular tags, sinuses, cysts
Perichondritis
Mastoiditis
Tumours

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