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Otolaryngology Case Studies
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An 18-year-old female complains of episodic nosebleeds, especially in the winter.
Possible Diagnosis: Epistaxis. Recommended treatment plan: Nasal moisture with saline sprays or creams, cauterization for recurrent bleeds, and addressing underlying causes if present.
A 60-year-old male with a 30-pack-year smoking history presents with unilateral nasal obstruction and epistaxis.
Possible Diagnosis: Nasopharyngeal carcinoma. Recommended treatment plan: Biopsy for diagnosis, followed by radiation and chemotherapy as primary treatments.
A 55-year-old smoker presents with a persistent earache and unilateral progressive hearing loss.
Possible diagnosis: Otitis media or cholesteatoma. Recommended treatment plan: For otitis media, antibiotics and possibly myringotomy. For cholesteatoma, surgical removal.
A 5-year-old boy has a barking cough, stridor, and a low-grade fever.
Possible diagnosis: Croup (laryngotracheobronchitis). Recommended treatment plan: Humidified air, corticosteroid therapy, and nebulized epinephrine for severe cases.
A 25-year-old female presents with episodic rotational vertigo, hearing loss, and tinnitus in one ear.
Possible Diagnosis: Meniere's disease. Recommended treatment plan: Low sodium diet, diuretics, and possibly intratympanic steroids or gentamicin injections.
A 35-year-old presents with hearing loss, a sensation of ear fullness, and autophony (hearing one's own voice loudly).
Possible Diagnosis: Patulous Eustachian tube. Recommended treatment plan: Staying well-hydrated, nasal drops that may help close the eustachian tube, and surgical treatments if severe.
An elderly patient presents with unilateral watery rhinorrhea that worsens with eating or exposure to cold air.
Possible Diagnosis: Gustatory rhinitis. Recommended treatment plan: Intranasal anticholinergic agents, avoiding triggers, and counseling.
A 70-year-old female complains of a dry mouth, difficulty wearing dentures, and altered taste sensation.
Possible Diagnosis: Sjögren's syndrome. Recommended treatment plan: Artificial saliva, good oral hygiene, and consultation with rheumatology for systemic management.
A 3-year-old child presents with a high fever and drooling and is sitting upright and leaning forward.
Possible Diagnosis: Epiglottitis. Recommended treatment plan: Emergency airway management, intravenous antibiotics, and possible intubation.
A 30-year-old presents with dizziness and a spinning sensation that worsens with certain head movements.
Possible diagnosis: Benign paroxysmal positional vertigo (BPPV). Recommended treatment plan: Epley maneuver or other canalith repositioning procedures and vestibular rehab therapy.
A 40-year-old with a history of GERD presents with a chronic cough, throat clearing, and a sensation of a lump in the throat.
Possible Diagnosis: Laryngopharyngeal reflux. Recommended treatment plan: Lifestyle changes, proton pump inhibitors or H2 blockers, and dietary modifications.
A professional singer presents with voice fatigue, reduced vocal range, and breathy voice quality.
Possible Diagnosis: Vocal fold hemorrhage or nodules. Recommended treatment plan: Voice rest, steroid injections if hemorrhagic, and potential voice therapy or phonomicrosurgery for nodules.
A 50-year-old presents with a rock-solid, immobile mass in the lateral aspect of the neck.
Possible Diagnosis: Metastatic lymph nodes from squamous cell carcinoma. Recommended treatment plan: Biopsy for histologic diagnosis, imaging for primary source, and appropriate oncologic referral for surgery and/or chemotherapy and radiation.
A 23-year-old presents with unilateral facial paralysis, inability to close the eye on the affected side, and loss of taste sensation.
Possible Diagnosis: Bell's palsy. Recommended treatment plan: Corticosteroids, possibly antiviral therapy, and eye protection if unable to close the eyelid.
A 17-year-old presents with severe sore throat, fever, swollen lymph nodes, and white patches on the tonsils.
Possible Diagnosis: Streptococcal pharyngitis. Recommended treatment plan: Oral penicillin or amoxicillin, symptomatic treatment with analgesics, and fever control.
A 45-year-old female complains of hoarseness lasting for 2 months, with no recent upper respiratory infections.
Possible diagnosis: Vocal cord nodules or polyps. Recommended treatment plan: Voice rest, speech therapy, and if persistent, microsurgical removal.
A 50-year-old female presents with a slowly enlarging neck mass and a history of radiation exposure to the head and neck.
Possible Diagnosis: Thyroid cancer. Recommended treatment plan: Fine-needle aspiration biopsy for diagnosis, followed by surgery, possibly radioactive iodine, and TSH suppression therapy.
A 28-year-old swimmer complains of ear pain, itchiness, and hearing reduction after swimming sessions.
Possible Diagnosis: Otitis externa (Swimmer's ear). Recommended treatment plan: Topical antibiotic drops with or without corticosteroids, avoid water exposure, and pain management.
A 67-year-old male with diabetes presents with facial pain, nasal congestion, and blackish nasal discharge.
Possible Diagnosis: Invasive fungal sinusitis. Recommended treatment plan: Urgent surgical debridement, systemic antifungal therapy, and control of underlying diabetes.
A 65-year-old male with a history of asbestos exposure presents with dysphagia and weight loss.
Possible Diagnosis: Laryngeal cancer. Recommended treatment plan: ENT evaluation with laryngoscopy, CT/MRI for staging, and surgery, radiation, and/or chemotherapy depending on the stage.
A 27-year-old male experiences sudden severe vertigo, nausea, and hearing loss in one ear.
Possible diagnosis: Labyrinthitis. Recommended treatment plan: Symptomatic relief with antiemetics and antihistamines, corticosteroids, and possibly antiviral medication.
A 10-year-old boy presents with snoring, restless sleep, and daytime sleepiness.
Possible Diagnosis: Pediatric obstructive sleep apnea. Recommended treatment plan: Adenotonsillectomy as first-line therapy, weight loss if overweight, and CPAP for residual or severe cases.
A 2-year-old child presents with a foul-smelling, unilateral nasal discharge and nasal obstruction.
Possible Diagnosis: Foreign body in the nose. Recommended treatment plan: Prompt removal of the foreign body by an otolaryngologist, possible antibiotic treatment if secondary infection is present.
A 32-year-old male presents with a sore throat, difficulty swallowing, and a muffled voice.
Possible diagnosis: Peritonsillar abscess. Recommended treatment plan: Needle aspiration or incision and drainage, antibiotic therapy, and pain management.
A 22-year-old female presents with bilateral nasal congestion, purulent nasal discharge, and facial pressure for over 12 weeks.
Possible diagnosis: Chronic sinusitis. Recommended treatment plan: Nasal corticosteroids, saline nasal irrigation, and if bacterial, antibiotics.
A 4-year-old with a cold has pus draining from the left ear and pain relief after the discharge.
Possible Diagnosis: Acute otitis media with tympanic membrane perforation. Recommended treatment plan: Oral antibiotics, analgesics, and follow-up to ensure healing of the perforation.
An 8-month-old infant presents with irritability, frequent touching of the ears, and fever.
Possible Diagnosis: Acute otitis media. Recommended treatment plan: Observation or amoxicillin if indicated based on age and severity, analgesics for pain, and possible follow-up hearing tests.
A 21-year-old complains of recurrent, painful oral ulcers, genital ulcers, and ocular issues.
Possible Diagnosis: Behçet's disease. Recommended treatment plan: Topical steroids for oral ulcers, systemic immunosuppressive agents for severe or systemic involvement, and ophthalmologic consultation.
A 55-year-old presents with progressive nasal blockage, anosmia, and a change in nose shape.
Possible Diagnosis: Nasal polyps. Recommended treatment plan: Intranasal corticosteroids, saline nasal douches, and if severe, oral corticosteroids or surgery (endoscopic sinus surgery).
A 70-year-old reports gradual hearing loss over several years and difficulty hearing in noisy environments.
Possible Diagnosis: Presbycusis. Recommended treatment plan: Hearing aids, assistive listening devices, and possibly cochlear implants in severe cases.
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