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Diagnosis of ENT Disorders

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Updated October 01, 2009

Diagnosis of ENT Disorders

Outer & Inner Ear

Photo © A.D.A.M.

Many tests are used to diagnose ENT disorders. Regardless of your particular ailment, there is specific information you should always have ready for your physician to help him diagnose your problem. Here are some of the questions your doctor may ask:

  • What are your symptoms and when did they start?
  • Have you been taking any medications (over the counter, including vitamin and herbal supplements or prescription)? If so, your doctor will want to know the dosage.
  • Are you allergic to any medications? If so, what are they and what kind of reaction did you have?
  • Do you have a previous history of ENT disorders?
  • Do you have a family history of ENT disorders?
  • Do you have any other medical conditions?
  • Have you been running a fever?

Here are additional questions if the patient is a small child:

  • Has the child had nausea and vomiting? If so, has the child continued to have wet diapers?
  • Has the child been abnormally fussy or lethargic?
  • Has the child had balance problems?
  • Has the child's eating and drinking habits changed?
  • Has the child shown signs of decreased hearing, such as not responding to their name immediately or not startling at loud noises?

Diagnosis of Ear Infections

If you have signs and symptoms of an ear infection, your doctor will use an otoscope to visualize the outer ear and eardrum. If an infection is present, the ear may appear red and swollen. There may also be a fluid discharge. Unlike other infections, the exact bacteria that is responsible cannot always be determined. As such, doctors choose antibiotics that will cover the most likely organisms when they suspect a bacterial source. This is because it can be difficult to obtain a sample from the ear for a culture. Antibiotics will not cure a viral infection, and it can take as long as three weeks for your body to fight off the virus.

Diagnosis of Swimmer's Ear

With swimmer's ear, the outer ear and ear canal may be red. Upon examination, the doctor may notice pus in the ear canal, and the skin may be scaly or shedding. The doctor may be able to obtain a fluid sample for culture.

Diagnosis of Sinus Infections

If a sinus infection is suspected, an endoscope may be used to go up the nose and visualize the opening in to the sinus cavity and take a direct sinus culture. Nasal swabs are not useful due to false positive results that do not reflect the sinus pathogen. By endoscope, the doctor will be looking for inflammation and/or discharge. Four view x-rays or a CT scan may be indicated if other tests are inconclusive.

Diagnosis of Strep Throat

Strep throat causes enlarged reddened tonsils that sometimes have white patches on them; however, many viral infections can cause this as well. If strep throat is suspected, a throat culture will be taken and sent to the lab. This test is quick and easy to perform with only mild discomfort as it may cause a gagging sensation. A cotton swab is brushed against the back of the throat then sent to the lab to test for streptococcal bacteria, the cause of strep throat. The standard test can take 1 to 2 days; however, a rapid strep test can also be performed, which only takes a few minutes. If the rapid strep test is positive, antibiotics will be started. If the rapid strep test is negative, you will be sent home and the standard culture will still be performed. About 20% of negative rapid strep tests will become positive after a day or two in the laboratory. Sometimes your doctor may make the diagnosis based on classic symptoms and signs to treat you presumptively even without a swab.

Diagnosis of Sleep Apnea

Sleep apnea is a disorder causing one to stop breathing for brief periods of time while sleeping. In your first visit, the doctor will begin by obtaining a comprehensive medical history. Before ordering a sleep study, he or she will likely ask some of these questions:

  • Have you ever been told that you snore?
  • Have you ever been told that you have stopped breathing while asleep?
  • Do you awake refreshed in the morning or do you suffer from daytime drowsiness?
  • Do you suffer from mood swings or depression?
  • Do you wake up frequently in the middle of the night?

The doctor will look inside your mouth for evidence of enlarged tonsils, uvula(a bell-like piece of tissue that hangs down from the roof of the mouth toward the back of the throat) or other structures that may be blocking the airway. The uvula contains some glands and affects vocal resonance. If the doctor suspects sleep apnea, they may order a sleep study. Sleep studies are usually conducted at a sleep center. After you fall asleep, a monitor, which measures the oxygen concentration in your blood, will be placed on your finger. Normal oxygen saturation during sleep in otherwise healthy men and women is 95% to 100%. If you stop breathing while asleep, this number will drop. Another sleep study used to diagnose sleep apnea is called a "polysomnogram." It measures not only the amount of oxygen in your blood, but brain activity, eye movement and muscle activity, as well as your breathing and heart rate.

Based on your present symptoms, your doctor may choose to use a combination of these tests to diagnose your specific disorder. He will then use this information to create an effective treatment plan.

Sources:

American College of Allergy, Asthma and Immunology. Sinusitis. Accessed: November 24, 2008 from http://www.acaai.org/public/advice/sinus.htm

Medline Plus. Swimmer's Ear. Accessed: November 24, 2008 from http://www.nlm.nih.gov/medlineplus/ency/article/000622.htm

National Heart Lung and Blood Institute Diseases and Conditions Index. Sleep Apnea. Accessed: November 24, 2008 from http://www.nhlbi.nih.gov/health/dci/Diseases/SleepApnea/SleepApnea_Diagnosis.html

National Institute of Allergy and Infectious Disease. Strep Throat. Accessed: November 24, 2008 from http://www3.niaid.nih.gov/topics/strepThroat/

National Institute on Deafness and Other Communication Disorders. Ear Infections—Facts for Parents about Otitis Media. Accessed: November 24, 2008 from http://www.nidcd.nih.gov/health/hearing/otitismedia.htm#doctor.

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  3. Ear, Nose, & Throat Disorders
  4. Diagnosing ENT Disorders
  5. Diagnosis of ENT Disorders - How ENT Disorders are Diagnosed

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