Post on 24-Jan-2017
Dr. M.T.D. LakshanMBBS MS(Oto) DOHNS(Eng) FEB ORL-HNS (Europe)
FRCSEd ORL-HNS (UK) Consultant ENT and Head and Neck Surgeon
Hearing Loss
Sensorineural deafness in patients of type 2 diabetes mellitus in Uttar Pradesh: a pilot study
Vilas Misra, C G Agarwal, N Bhatia, G K Shukla Indian Journal of Otolaryngology and Head and Neck Surgery 2013, 65:
DM & ENT Hearing Loss
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Otitis Externa: Review and Clinical Update
J David Osguthorpe, David R Nielsen American Family Physician 2006 November 1, 74 (9): 1510-6
DM & ENT Fungal Otitis Externa
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DM & ENT Deep Neck Space Infections
Predisposing Factors of Complicated Deep Neck Infection: An Analysis of 158 Cases.
Lee J-K, Kim H-D, Lim S-C. Yonsei Medical Journal. 2007;48(1):55-62. doi:10.3349/ymj.2007.48.1.55.
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DM & ENT Fungal Sinusitis
Neuro-ophthalmology of invasive fungal sinusitis: 14 consecutive patients and a review of the literature
Matthew J Thurtell, et al Clinical & Experimental Ophthalmology 2013, 41 (6): 567-76
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DM & ENTVestibular Function
Characterization of Vestibulopathy in Individuals with Type 2 Diabetes Mellitus
Bryan K Ward et al Otolaryngology—Head and Neck Surgery 2015, 153 (1): 112-8
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DM & ENT Malignant Otitis Externa
Malignant otitis externa
Matthew J Carfrae, Bradley W Kesser Otolaryngologic Clinics of North America 2008, 41 (3): 537-49, viii-ix
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Hearing Loss
Fungal Otitis Externa
Malignant Otitis Externa
Fungal Sinusitis
Deep Neck Space Infections
Vestibular Function
DM & ENTlearnent.NET
Malignant Otitis Externa
Fungal Sinusitis Deep Neck Space Infections
3learnent.NET
InvestigationsSwab
PTA CT
Bone Scans EUA + Biopsy
Treatment
Quinolone 4 - 6W Surgery - limited role Hyperbaric Oxygen
Elderly Patient Excruciating Otalgia Lower cranial Nerve Palsies Granulations in the ear DM
Clinical Features
Necrotizing Otitis Externa
learnent.NET
InvestigationsSwab
PTA CT
Bone Scans EUA + Biopsy
Treatment
Quinolone 4 - 6W Surgery - limited role Hyperbaric Oxygen
Elderly Patient Excruciating Otalgia Lower cranial Nerve Palsies Granulations in the ear DM
Clinical Features
Necrotizing Otitis Externa
learnent.NET
InvestigationsSwab
PTA CT
Bone Scans EUA + Biopsy
Treatment
Quinolone 4 - 6W Surgery - limited role Hyperbaric Oxygen
Elderly Patient Excruciating Otalgia Lower cranial Nerve Palsies Granulations in the ear DM
Clinical Features
Necrotizing Otitis Externa
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Necrotizing Otitis Externa
90% Diabetics
Mortality 10 - 50%
Malignant Otitis Externa
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Malignant Otitis Externa
Fungal Sinusitis Deep Neck Space Infections
3
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Fungal Ball / Mycetoma Allergic Fungal Sinusitis
Chronic invasive non granulomatous
Chronic invasive granulomatous
Acute invasive
5learnent.NET
Co-morbidity No Percentage
Diabetes 11 100%
Hypertension 3 27.2%
Hyperlipidemia 2 18.2%
Metabolic Acidosis 2 18.2%
IHD 1 11.1%
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Nasal Mass Orbital / Palatal
Intracranial DM
Other Immunodeficiency
Investigations
CT
EUA + Biopsy
Treatment
Systemic Anti-fungals Surgery
Clinical Features
Fungal Sinusitis
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Nasal Mass Orbital / Palatal
Intracranial DM
Other Immunodeficiency
Investigations
CT
EUA + Biopsy
Treatment
Systemic Anti-fungals Surgery
Clinical Features
Fungal Sinusitis
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Nasal Mass Orbital / Palatal
Intracranial DM
Other Immunodeficiency
Investigations
CT
EUA + Biopsy
Treatment
Systemic Anti-fungals Surgery
Clinical Features
Fungal Sinusitis
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Malignant Otitis Externa
Fungal Sinusitis Deep Neck Space Infections
3learnent.NET
Complications
Airway Obstruction
Airway Soiling
Septic Thrombosis
Carotid Artery
RuptureMediastinitis
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Neck Lump Fever
Odynophagia Stridor
DM Other
Immunodeficiency
Investigations
FBC, ESR/CRP CT
Culture ABST
Treatment
Systemic Antibiotics Surgery
Clinical Features
DNSI
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Neck Lump Fever
Odynophagia Stridor
DM Other
Immunodeficiency
Investigations
FBC, ESR/CRP CT
Culture ABST
Treatment
Systemic Antibiotics Surgery
Clinical Features
DNSI
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Neck Lump Fever
Odynophagia Stridor
DM Other
Immunodeficiency
Investigations
FBC, ESR/CRP CT
Culture ABST
Treatment
Systemic Antibiotics Surgery
Clinical Features
DNSI
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DMCommonest
Systemic Disease
Complicated ICU/
Hospital Stay Risk
DNSI
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Hearing Loss
Fungal Otitis Externa
Malignant Otitis Externa
Fungal Sinusitis
Deep Neck Space Infections
Vestibular Function
DM & ENTlearnent.NET
MTD Lakshan learnent.net
@mtdlakshan lakshent@gmail.com