Operational Otolarynogology
General Otolaryngology
Frequent Referrals:
Rhinitis
(allergic & non-allergic)
Nasal
Obstruction
Sinusitis
Peritonsillar Abscess
Tonsillitis
Snoring
Reflux (GERD/LPR)
Tympanic
Membrane perforation
Otitis
externa
Fractures
Allergic Rhinitis
Symptoms…Seasonal
Sneezing, itching, rhinorrhea, obstruction
May note specific allergen causing trouble
Perennial
Primarily obstruction, alternating
Nasal Obstruction
Positional
Seasonal
Resolves with Afrin
Responsive to Nasal Steroids
Exam
Polyps
Septal deviation/spurs
Rhinorrhea
Assess air flow
Allergic Rhinitis
Treatment…Antihistamine/topical steroid
Obstructive symptoms respond to daily nasal steroids (Flonase,
Nasonex) for at least 6 weeks
Antihistamine for other sxs (Allegra 180mg or Zyrtec 10mg daily)
Vasomotor Rhinitis
May be associated with position, temperature, or other factors.
Does not usually respond to nasal steroids Nasal Ipratropium
Bromide (Atrovent) is effective.
2 strengths: .03% for children, .06% for adults q-6-8h prn
rhinorrhea
Non-formulary
Continue to PowerPoint® Lecture... |
Sinusitis
Symptoms
Pain, pressure, nasal discharge, cough, fever, dental pain
Evaluation
Purulent rhinnorhea, pressure with forward flexion, sinus TTP
Management
Afrin, one drop per nostril for 7 days
Saline irrigations
Antibiotics
Acute rhinosinusitis…
7 - 30 days
H. flu, Strep pneumo, Moraxella
Hi dose amox, augmentin, Tequin
Chronic rhinosinusitis
>12 weeks
Refer to ENT with CT after 21 days of Abx treatment
(Augmentin 2g po BID, Tequin 400mg QD or
Clindamycin 300mg po QID)
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Lecture by
LCDR Alicia Sanderson
Surface Warfare Medicine Institute
2006 Surface Warfare Medical Officer Indoctrination Course
Naval Operational Medicine Institute
340 Huise Road
Pensacola FL 32508-1092
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