ENTALGIA CASE PRESENTATION #1 THOMAS V. NUNN, D. O.
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1 ENTALGIA THOMAS V. NUNN, D. O. CASE PRESENTATION #1 47 year old female presents with left ear pain present for 4 years constant, increasing in severity pain level 10/10, affects ADL quality: deep, boring associated symptoms: tinnitus, dysphagia, jaw pain cause: unsure Has see 9 previous physicians modifying factors: oxycodone helps a little 1
2 Case Presentation #1 Past Medical History: hypertension anxiety/depression Past Surgical History: TAH/BSO appendectomy arthroscopic knee surgery Case Presentation #1 Medications: oxycodone/apap 10mg 4x/d paroxetine amlodipine 5mg Allergies: meperidine penicillin 2
3 CASE PRESENTATION #1 Exam: general: AAOx3 afebrile eyes: PERRLA, EOM-I ears: normal pinna, EACs: small amount cerumen left TMs: normal, no middle ear effusion, mobile, hearing grossly normal Oro-pharynx: normal palate and uvula, atrophic tonsils Neck: tender left jaw, left submandibular area, left TMJ; no lymphadenopathy CASE PRESENTATION #1 Next step? antibiotics?? pain management?? psych referral?? review old records?? imaging?? What kind?? additional examination/referral?? 3
4 CASE PRESENTATION #1 Additional exam: solid mass felt on bimanual exam (tonsil area) CT: possible calcified, elongated styloid process-left 3-D reconstruction: confirmed Feedback Show details More Eagle Syndrome Image Causes may of be subject to copyright.learn more Eagle Syndrome Eagles Syndrome Panoramic Eagles Syndrome Pano Who Treats Eagle Syndrome Eagle Syndrome Panoramic Radiograph Eagle -Barrett Syndrome Complications of Eagle Syndrome Eagle Syndrome Surgery Eagle Syndrome X-ray Eagle Syndrome Radiography C-spine Eagle Syndrome Eagle Syndrome Symptoms Treatment 4
5 CASE PRESENTATION #1 Diagnosis?? otalgia Left TMJ pain Left Eagles syndrome 5
6 CASE PRESENTATION #1 Treatment: local anesthesia dental evaluation surgery: intraoral extraoral CASE PRESENTATION #1 Eagles syndrome: outcomes with surgery complete symptom relief: 80% partial symptom relief: 15 % 6
7 CASE PRESENTATION #2 60 year old male with left ear pain duration: 2 months timing: constant quality: deep severity: 5/10 etiology: unknown modifying factors: ibuprofen helps some CASE PRESENTATION #2 Social history: Married with 3 children ex-smoker (40 pack years) occasional alcohol usage accountant hobbies: hunting and target shooting 7
8 CASE PRESENTATION #2 PMH: DM type 2 (trying to control with diet) hypertension dyslipidemia osteoarthritis PSH: rotator cuff repair hernia repair tonsillectomy CASE PRESENTATION #2 Meds: Naproxen 220 mg twice daily Pravastatin at bedtime Aspirin 8 mg Allergies: NKDA 8
9 CASE PRESENTATION #2 Exam: general: obese, VSS, AAOx3 ears: normal; slight hearing loss bilaterally nose: deviated nasal septum to the right; polyps seen on the right oral: dentures both oro-pharynx: absent tonsils; palate and uvula normal neck: no obvious abnormalities lungs: clear heart: RRR without murmurs CASE PRESENTATION #2 Now what?? audiometrics?? imaging?? additional examination?? referral visualize larynx 9
10 CASE PRESENTATION #2 Supraglottic cancer: usually squamous cell carcinoma often asymptomatic until late often present with otalgia or cervical adenopathy (not hoarseness or SOB necessarily) 10
11 CASE PRESENTATION #3 21 year old male chief complaint: right-sided throat pain duration: 2 days timing: constant pain: severity 10/10 associated symptoms: unable to swallow modifying factors: nothing cause: unknown CASE PRESENTATION #3 PMHx: nothing PSHx: negative Meds: acetaminophen Allergies: NKDA 11
12 CASE PRESENTATION #3 Examination: General: appears ill, febrile Ears: normal. Nose: normal Oropharynx: Patient unable to open mouth to exam Neck: tender, enlarged level II nodes Lungs: clear Heart: RRR without murmurs CASE PRESENTATION #3 Impressions?? Dental infection?? Mononucleosis?? Peritonsillar abscess?? 12
13 CASE PRESENTATION #3 Testing: Lab?? Imaging?? ultrasound vs CT CASE PRESENTATION #3 Treatment: Needle aspiration (often with ultrasound guidance) Incision and drainage Observation (IV antibiotics) 13
14 CASE PRESENTATION #4 47 year old male Dysphagia, odynophagia Temp up to 38 degree C Non-smoker, non-drinker CASE PRESENTATION #4 Exam: acutely ill appearing Febrile Ears: normal Oropharynx: negative for tonsillitis Neck: Tender small lymph nodes palpable zones II and III Drooling No airway distress 14
15 CASE PRESENTATION #4 Lab: WBC % neutrophils C reactive protein: 80mg/L Remainder of lab: WNL CASE PRESENTATION #4 Next step? Visualization? Imaging? Hospital admission? Reassure, return to ER if symptoms worsen? 15
16 radiopaedia.org More Image may be subject to copyright.learn 3 pages use more this image Related images ADULT SUPRAGLOTTITIS CASE PRESENTATION #4 Supraglottitis affects more than just the epiglottis less likely to cause airway compromise (in adults) a number of different organisms implicated antibiotic therapy that also covers H. flu recommended consider steroids, humidified O2, early intubation if respiratory distress 16
17 CASE PRESENTATION #5 79 year old female Tearing right eye for 4 months Pain right cheek and right medial canthus area (7/10), constant dull History chronic sinusitis requiring antibiotics 3 times yearly No significant eye history CASE PRESENTATION #5 Past medical history hypertension hyperlipidemia Past surgical history tonsillectomy TAH with BSO hemorrhoidectomy 17
18 CASE PRESENTATION #5 Exam: Elderly female, no acute distress Afebrile Vision 20/30 bilaterally Nose: mucosal edema Oropharynx: normal, absent tonsils Neck: no lymphadenopathy CASE PRESENTATION #5 Next step? Imaging? Lab? Referral? Antibiotics or steroids? dental evaluation? 18
19 CASE PRESENTATION #5 Treatment: endoscopic sinus surgery Pathology: Aspergillis Discussion: allergy work-up topical nasal steroids immunocompromised? 19
20 TMJ Laryngeal cancer Mastoiditis Eagles syndrome Foreign body Trigeminal migraine Parotid gland tumors/infections Cerebellopontine angle tumors Eustachian tube dysfunction Middle ear infection Ruptured tympanic membrane Otitis externa Ear wax blockage ] OTALGIA-CAUSES Supraglottitis (adult epiglottitis) THROAT Peri-pharyngeal PAIN-CAUSES abscess Laryngeal cancer Oropharyngeal cancer Foreign body GERD Strep throat (or bacterial or viral infections) Chemotherapy/radiation therapy Sjogrens 20
21 Trauma Foreign body Abscess (nasal furunculosis) Wegener s granulomatosis Nasal polyps Nasal carcinoma Acute sinusitis (tooth pain) Deviated nasal septum (impacted spur) NOSE/FACE PAIN-CAUSES Nerve: C2, C3, C4 spinal nerves (greater auricular and lesser occipital nerves) Discomfort usually felt over the mastoid bone Diagnoses: Cervical spine disc disease, whiplash, cervical meningiomas, tendonitis of the sternocleidomastoid muscle. EAR PAIN-REFERRED 21
22 EAR PAIN-REFERRED Nerve: Cranial nerve VII (posterior auricular nerve) Discomfort mainly behind the ear Diagnoses: Cerebellar-pontine angle tumors, geniculate neuralgia Nerve: Cranial nerve V (auriculotemporal nerve) Discomfort mainly in the front portion of the ear Diagnoses: TMJ, dental pain, parotid gland tumors or infection EAR PAIN-REFERRED 22
23 Nerve: cranial nerve IX (Jacobson s nerve) Discomfort directly deep in the ear Diagnoses: Tonsillitis, sinusitis, pharyngeal tumor, adenoiditis, eustachian tube dysfunction EAR PAIN-REFERRED Nerve: Cranial nerve X (Arnold s nerve) Discomfort directly in the ear, but more ear canal type pain Diagnoses: GERD, throat tumors, lingual tonsillitis EAR PAIN-REFERRED 23
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