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Gerard Kelly MD MEd FRCS (ORL-HNS) FRCS (Ed) ENT surgeon, Leeds

ENT. a lump in my throat an update on voice, swallowing, globus & cancer. and general practice. Gerard Kelly MD MEd FRCS (ORL-HNS) FRCS (Ed) ENT surgeon, Leeds 6 th March 2014, Leeds Masonic Hall. The Leeds Teaching Hospitals NHS Trust. aims.

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Gerard Kelly MD MEd FRCS (ORL-HNS) FRCS (Ed) ENT surgeon, Leeds

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  1. ENT a lump in my throat an update on voice, swallowing, globus & cancer and general practice Gerard Kelly MD MEd FRCS (ORL-HNS) FRCS (Ed) ENT surgeon, Leeds 6th March 2014, Leeds Masonic Hall The Leeds Teaching Hospitals NHS Trust

  2. aims • give an overview of common (EN)T conditions • shows some example cases • refine our thinking of ENT problems

  3. objectives • list the main symptoms in throat conditions • relate each symptom to one condition • list the ways to examine the head and neck • identify an abnormal tonsil • list 4 differential diagnosis for dysphonia • name 3 treatments for head and neck cancer • sequence steps in assessment of a throat patient

  4. first though... • history and examination in ENT

  5. history • ears • otorrhoea • otalgia • itch • hearing • tinnitus • balance noses nasal obstruction rhinorrhoea facial pain smell epistaxis post nasal drip throats dysphagia dysphonia odynophagia pain neck lumps weight loss

  6. Throat- red flag symptoms • dysphagia • dysphonia • odynophagia • pain • neck lumps • weight loss

  7. Throat- red flag symptoms • dysphagia food sticking, level • dysphonia to be heard • odynophagia not acute • pain otalgia • neck lumps palpable • weight loss noticed

  8. head and neck cancer • almost all squamous cell carcinomas

  9. malignant head and neck disease • treatment consists of treating the primary disease and treating metastatic disease • metastatic disease is to the neck • bone, Liver, Lung, Brain metastases are rare

  10. malignant head and neck disease • treatment is by radiotherapy, surgery or a combination of both

  11. malignant head and neck disease • head and neck cancer is squamous cell carcinoma

  12. malignant head and neck disease • squamous cell carcinomas are radiosensitive • adenocarcinomas are NOT radiosensitive

  13. malignant head and neck disease • small tumours tend to be treated by radiotherapy • large tumours by radical surgery and post operative radiotherapy

  14. malignant head and neck disease • small tumours tend to be treated by radiotherapy • large tumours by radical surgery and post operative radiotherapy and most recently by chemoradiotherapy

  15. malignant head and neck disease • typical patient • old, male, smoker and drinker

  16. malignant head and neck disease • typical patient • old, male, smoker and drinker • increasing in younger patients due to HPV infection

  17. malignant head and neck disease • typical patient • old, male, smoker and drinker • increasing in younger patients due to HPV infection - • these patients can often be identified in GP

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