Otolaryngology

Overview

Otolaryngology involves the diagnosis and management of disorders of the ears, nose, and

throat. The general internist should be able to evaluate and manage such common disorders, such

as pharyngitis, otitis, and sinusitis, and recognize more complicated conditions that require

subspecialty consultation. He or she should play a key role in screening for and prevention of

aerodigestive tract malignancies, which occur particularly often in patients who smoke. The

general internist should also be competent in evaluating such specific symptoms as hoarseness,

hearing loss, and facial pain.

Common Clinical Presentations

Ears

· Discharge

· Hearing loss

· Pain

· Tinnitus

· Vertigo

Nose

· Airway obstruction

· Congestion or discharge, sneezing

· Epistaxis

· Facial or sinus pain

· Nocturnal airway obstruction, sleep apnea

· Snoring

Throat

· Cervical adenopathy

· Hoarseness

· Oral lesions

· Sore throat

Procedure Skills

Ears

· Insertion of wick in auditory canal

· Removal of cerumen

Nose

· Anterior nasal packing

· Speculum rhinoscopy

· Transillumination of maxillary sinuses

Throat

· Indirect laryngoscopy (optional)

Primary Interpretation of Tests

Nose

· Waters’ view radiograph of sinuses

Ordering and Understanding Tests

Ears

· Audiometry

Nose

· Aeroallergen skin sensitivity testing

· Limited computed tomography of the sinuses

· Radiography of the sinuses

Throat

· Culture

· Polysomnography

· Rapid streptococcal antigen test