ENT Telephone Clinics During the Coronavirus Pandemic: An Analysis of 400 Telephone Consultations at a District General Hospital

Background: The COVID-19 pandemic led to the introduction of telephone consultations in order to provide specialist health care remotely. This study analyses the outcomes of ear, nose, and throat (ENT) telephone consultations. Methods: Retrospective analysis was undertaken of 400 ENT telephone consultations. Results: All 2-week-wait neck or face lump patients underwent imaging and 78% were successfully discharged. 80% of vertigo patients and 100% of 2-week-wait throat symptom patients were offered face-to-face consultations. All primary hyperparathyroidism patients were managed remotely, being discharged, or with telephone follow-up. The majority of routine referrals were managed without the need for face-to-face consultation. Conclusion: Vertigo patients and 2-week-wait throat symptom patients should be offered a face-to-face consultation in the first instance. For patients with neck or face lumps, initial referral for imaging may improve patient flow and facilitate safe discharge. It is appropriate to continue with telephone consultations for all other patient groups.

Otorrhoea

The discharging ear, also known as otorrhoea, is a common ear, nose and throat symptom and defined as drainage or flow exiting the ear. The discharge can be wax, blood, pus, mucus, or cerebrospinal fluid. The underlying cause can usually be determined from the history and physical examination. Most patients with otorrhoea can be managed within primary care and do not require referral or hospital admission. This article considers the common causes of a discharging ear, appropriate management, guidance for referral of patients to secondary care and some key take home points.

Web based fuzzy diagnosis system and evaluation for five diseases with sort throat symptom

Automatic disease diagnosis has been human concern for a long time. Since people are so busy and the doctors visit expenses areso expensive, a lot of different attempts have been done in the field of design of expert system for disease diagnosis. This paper describes aproject work aiming to develop a web based fuzzy expert system for human disease diagnosis. This program models the thinking pattern andhuman activity and leads to close the expert system and human action method. In this paper we have consulted with different physicians andanalyzed the diagnosis procedure and modeled them with a fuzzy expert system. This project is based on development of a web-based clinicaltool designed to improve the quality of the exchange of health information between health care professionals and patients . This system hasbeen tested on five diseases with sort throat symptom such as mononucleosis, scarlet fever, pharyngitis or tonsillitis, common cold and virusinfection and exhibited satisfactory results.

Catarrh - the patient experience

Background: No study to date has looked at the symptoms of chronic catarrh as defined by the patients themselves. We looked to explore the catarrh experience through the eyes of patients using a qualitative approach. Methodology/principal: Forty-eight patients referred to Secondary Care with chronic catarrh, postnasal drip or persistent throat clearing completed an open-ended questionnaire from which a comprehensive symptom list was generated. Nineteen of these patients undertook semi-structured interviews to explore symptomatic themes relating to their catarrh using grounded theory analysis. Results: A standardised list of 38 catarrh-related symptoms was generated covering a wide topography. A common theme amongst interviewees was the frustration of being unable to expectorate mucus rather than expelling too much. Conclusions: Difficulties exist in establishing whether the extensive list of symptoms associated with catarrh is a result of differing experiences for patients or simply differing lexicon describing the same experience. Many of these symptoms are not included in the most commonly used nose/throat symptom instruments. Furthermore a distinction should be made between patients with true rhinitis who expel mucus and those who present with apparent postnasal drip or throat clearing but who cannot expectorate, whose management ought be focused more on symptom-coping strategies rather than medication or investigation.

Non-voice-related throat symptoms: comparative analysis of laryngopharyngeal reflux and globus pharyngeus scales

Background:This study calculated the comparability of two throat symptom assessment scales devised to evaluate either laryngopharyngeal reflux or globus.Setting:United Kingdom hospital out-patient departments.Method:A total of 334 subjects, with and without throat symptoms, completed the Reflux Symptom Index and/or the Glasgow and Edinburgh Throat Scale. The following were calculated for the resultant data: Cronbach's α coefficient, principal component analysis, Kaiser normalisation, varimax and oblimin rotation, and eigenvalues.Results:Analysis of data from the Reflux Symptom Index and the Glasgow and Edinburgh Throat Scale revealed clearly similar symptom domains regarding (1) coughing and blockage, and (2) globus or postnasal drip or throat-clearing, as did combined analysis of their amalgamated items. Both instruments had good overall internal consistency (α = 0.75 and 0.81, respectively). The ‘heartburn or reflux’ item in the Reflux Symptom Index mapped poorly to each underlying factor.Discussion:The most commonly used laryngopharyngeal reflux and globus assessment questionnaires appear to detect very similar symptom clusters. The management of throat disorders may previously have been over-reliant on the presenting pattern of throat symptoms. Our findings indicate a need to revisit the traditional clinical classification of throat symptoms.