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Ear, nose
and throat (ENT) deals with disorders affecting the ear, nose
and laryngopharynx, as well as with those pathologies
compromising the neck and salivary glands. Disorders affecting
any of these structures are particularly relevant, as they
usually impair the patients' quality of life due to the severity
of presenting symptoms. Furthermore, ENT disorders have a high
incidence in the population. For all of these reasons, anatomic
and physiologic knowledge of the organs studied by ENT, as well
as comprehension of the pathologies affecting them, are of
paramount importance for both laymen and healthcare
professionals.
ENT focuses on the study of the nasal passages and their related
structures, the laryngopharynx and the ear.
These structures, except the ear, form the upper airway, which
leads inhaled air to the pulmonary alveoli. During its passage
through the upper airway, air is warmed, humidified and the
largest particles are filtered out. At this level inhaled
particles are faced with the first immune barrier-Waldeyer's
tonsillar ring, as well as the action of both lysozymes and
surface immunoglobulin. On the other hand, the ear is closely
related to the upper airways; because of the direct
communication between the middle ear and the nasopharynx-through
the Eustachian tube-the ear is considered to belong to the
respiratory system. The middle ear is ventilated through this
duct; therefore it is exposed to all microorganisms colonizing
the upper airway.
ENT Common diseases -
1 Infectious rhinitis - It may have a viral for bacterial
origin, or may be associated with specific infections. Viral
infections are the most frequent ones. Clinical symptoms of
nasal mucosa inflammation include congestion, rhinorrhea,
sneezing, and nasal itching. In children, symptoms may include
impaired concentration, irritability, and sleep disorders.
2 Non-infectious rhinitis- Allergic rhinitis is the most
common cause of non-infectious rhinitis, characterized by
congestion, nasal and ocular pruritus, watery rhinorrhea and
sneezing in the presence of an allergen, due to IgE-mediated
mast cell and basophil activation. Non-infectious rhinitis may
be triggered not only by airborne allergens but also by food and
drug allergens.
3 Rhino sinusitis – Rhino sinusitis refers to
inflammation of the nasal mucosal membranes and the Para nasal
sinuses, which causes collection of fluid within these cavities
or the underlying bone. This condition is generally regarded as
a common cold or viral sinusitis.
4 Sinusitis complications - The primary complication of
sinusitis is potential chronicity, which may be caused by
inadequate treatment of an acute condition or by persistence of
another disease or abnormality determining its development. If
inadequately treated, infection may spread to neighboring
structures, such as bone or tissues surrounding the eye globe.
5 Influenza - It also known as grippe was described as a
highly contagious acute respiratory disease. It is a worldwide
epidemic disease affecting a large proportion of the population;
its causal agent, influenza virus, is isolated from the
respiratory secretions of infected patient.
6 Nasal polyposis - Nasal polyps are the most common
tumors of the nasal passages; they results from an edematous
degeneration of the nasal mucosa of inflammatory origin. They
are a frequent finding in patients with untreated allergic
rhinitis. Nasal polyp growths are round, soft, semi-translucent,
pinkish-gray structures. Symptoms usually include sensation of
nasal fullness without obstruction or impaired mucociliary
clearance.
7 Adenoid hyperplasia and adenoiditis - Clinical symptoms
of adenoid hypertrophy include nasal obstruction, oral
breathing, snoring nasal voice and sometimes, watery rhinorrhea
secondary to choanal obstruction by adenoid tissue, which
impairs mucus clearance. A cavum X-ray is useful to determine
airway obstruction by adenoid tissue.
8 Acute tonsillitis - Tonsillitis is defined as
inflammation of the palatine tonsils, in most cases, of viral
etiology. Clinical symptoms include congestion of the pharyngeal
mucosa with or without purulent tonsillar exudates sometimes,
ulcers and blisters also develop. Group A beta-hemolytic
streptococcus is the causal agent of nearly 30% of cases of
pharyngotonsillitis. It usually present with fever, abdominal
pain, vomiting, absence of nasal catarrh, adenopathies,
glossitis or palatine petechiae.
9 Nosebleed - It also known epistaxis is most frequently
observed during childhood; bleeding usually begins in the
anterior septum, a hypervascularized area, known as
Kiesselbach's plexus. Posterior nosebleed is more frequent in
older adults.
10 Allergic rhinitis - Environmental allergens such as
environmental dust, animals & domestic molds are potential
triggering factors of allergic rhinitis, depending upon
patient’s sensitivity. Some patients have symptom exacerbations
not only upon exposure to particular allergens, but also upon
changes in ambient temperature or relative humidity, or
ingestion of specific foods.

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