SurgSpace / Specialties / Otolaryngology, Head & Neck
Otolaryngology, Head & Neck
Ear, nose, throat and the neck's compartments: the airway always first, the thyroid and the nerves that decide the voice, and the high-volume operations, tonsils, grommets, septum, whose small complication lists are learned precisely because the operations are so common.
See the disease
Conditions
The diseases, each with the image that defines it.
Each disease with the image that defines it: what it looks like, what the scan shows, and which operation answers it.
Upper airway obstruction
The final common pathway of the specialty's emergencies.
- The causes
- Infection (supraglottitis, deep neck abscess), tumour, haematoma after neck surgery, foreign body, angioedema and trauma: different diseases, one converging physiology.
- Reading the signs
- Stridor's pitch localises (inspiratory above the glottis, biphasic at it, expiratory below); voice change, drooling and posture grade the threat; and fatigue with quietening noise is deterioration wearing improvement's clothes.
- The team response
- Senior anaesthesia and ENT together, early: the assessment (awake fibre-optic nasendoscopy) and the plan (intubation, front-of-neck access, theatre-based management) are made before the crisis, in the room, out loud.
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- Tracheostomy's place
- An airway secured below the obstruction: electively for the anticipated problem, urgently for the failing one, and its aftercare (humidification, suction, the blocked-tube drill) is a ward competency, not a specialist mystery.
Surgical thyroid disease
A gland whose operations are defined by their neighbours.
- Who comes to surgery
- Nodules with suspicious cytology, differentiated cancers, compressive goitres, and thyrotoxicosis beyond medical control: the indications sort into cancer, compression and control.
- The nodule pathway
- Ultrasound grades the nodule, fine-needle aspiration cytology grades the cells, and the combination sets the operation's extent: the pathway's discipline prevents both missed cancers and needless thyroidectomies.
- The operation's anatomy
- The recurrent laryngeal nerve found and preserved on each side, the parathyroids and their blood supply respected on the capsule: the operation is an anatomy examination with consequences.
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- The aftermath
- Voice assessed, calcium tracked (transient hypocalcaemia is common, permanent hypoparathyroidism the feared rarity), hormone replacement after total thyroidectomy, and the haematoma drill known by every covering doctor.
Head & neck cancer
Squamous carcinoma in the aerodigestive lining, staged by the neck.
- The disease
- Squamous cell carcinoma of the mouth, pharynx and larynx: smoking and alcohol are the classic drivers, HPV the newer one in the oropharynx, and the neck's nodes the common currency of spread.
- Presentations that must not be missed
- A persistent lateral neck lump, hoarseness beyond three weeks, unilateral sore throat or otalgia, non-healing oral ulcers, and dysphagia: each has a two-week-wait door attached.
- Workup order
- Look (examination and nasendoscopy), needle (ultrasound-guided FNA of the node), image (CT or MRI, chest included), then biopsy the primary under anaesthesia: open neck biopsy first remains the classic pathway error.
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- Treatment
- Surgery and radiotherapy, alone or combined, with systemic therapy in the advanced disease: function, voice, swallowing, appearance, is the second axis of every decision, and rehabilitation is part of the treatment, not an afterthought.
Epistaxis
A vascular plexus in a dry, exposed corner, and an escalation ladder for when it fails.
- The anatomy
- Little's area on the anterior septum, where several arteries anastomose under thin mucosa, supplies most bleeds; the sphenopalatine territory supplies the posterior ones that fill throats rather than tissues.
- The ladder
- Correct first aid, topical vasoconstriction, cautery of a seen vessel, anterior packing, posterior packing, then surgical ligation or embolisation: each rung earns its place by the failure of the one below.
- The systemic half
- Anticoagulants and antiplatelets, hypertension, and the rare coagulopathy or telangiectasia syndrome: recurrent or refractory bleeding is a systemic question wearing a nasal disguise.
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- The packed patient
- Packing is a treatment with its own care plan: analgesia, sometimes antibiotics, planned removal, and in the frail, admission, since posterior packs and marginal physiology mix badly.
Hub shaped by the Surgical Specialties Lead with the ENT reviewer (open seat). Images and videos carry their source; educational use for supervised learning, not clinical guidance.