OTOLOGY Name: Age: Sex: Occupation: Residence: Chief complaints: Ear discharge , Vertigo , Hard of hearing , Fullness of ear

ear , Giddiness, Itching , Tinnitus , Ear pain History of presenting complaints: Ear discharge: Side Duration: short / long Onset: sudden / insidious Severity: profuse / scanty Progression : continuous / intermitten Colour Odour: foul smelling or not Character: watery/serous/mucopurulent/purulent/blood stained Hard of hearing: Side Duration Onset Progression Giddiness/vertigo: Duration Onset Type Associated with discharge Nystagmus

Tinnitus Side Duration Onset Progression Aggravating factors Severity- high/low pitched Character- hissing/roaring/bussing sound Ear ache: Side Duration Onset Type: pricking,stabbing,burning,throbbing Severity: mild/severe Aggravating eating ,sneezing ,cough, chewing, Relieving History of headache: (intra cranial tension) Vomiting, Drowsiness, Facial weakness, Fever, Visual impairment History of nose throat symptoms: Nasal obstruction Nasal discharge Postnasal drip Throat irritation Dysphagia/odynophagia Change of voice PAST HISTORY: Previous surgery, h/o ototoxic drugs, asthma, bleeding diathesis ,h/o ht, DM ,TB, jaundice, h/o exanthematous fever, meningitis, drug allergy PERSONAL HISTORY: Mixed diet / veg h/o tobacco,alcohol

TREATMENT HISTORY: Not under any medications at present FAMILY HISTORY: No relevant family history EXAMINATION General : Conscious ,well oriented , well nourished [PICCLE] Examination of Ear: 1. Pre auricular region(sinus,tags) 2. Pinna-size ,shape,displacement 3. Post auricular region : scar.swelling 4. External auditory canal : size : narrow/wide,discharge,wax ,mass 5. Tympanic membrane: perforation,middle ear mucosa , handle of malleus, pars flaccida 6. Facial nerve examination 7.Clinical examination i. ii. iii. iv. v. Tuning fork test : Rinnes Webers Absolute bone conduction Fistula test

8.Examination of nose & PNS : External framework Philtrum , Cerumen, Anterior rhinoscopy and post . Rhinoscopy 9.Examination of oral cavity& throa,lips: Oral cavity: gums,teeth , tongue, soft and hard palate,uvula Oropharynx anterior pillar, posterior pillar, tonsil ,posterior pharyngeal wall . 10.Diagnosis (clinical ) Provisional diagnosis and treatment

EAR Ear discharge Duration Short: ASOM,frunculosis Long: AAT,Granulomatous condition,malignancy Onset : Sudden : after attack of URI seen in ASOM, Insidious: TTT,granulomatous condition,malignancy Severity: Profuse:TTT Scanty: AAT Progression : Intermittent TTT Contiuous- AAT ,granulomatous,malignancy Colour: Brownish-wax Greenish- pseudomonas,ecoli Foul smelling AAT Blood stained ASOM , stage of supppration, AAT, myringitis bullosa , malignant otitis externae, granulation tissue trauma, instrumentation, external trauma, malignancy of ear & middle ear Character: Watery: CSF, otomycosis, diffuse otitis externae Serous: allergic otitis externae,Tb Mucopurulent : benign csom Purulent otitis externae , cholesteatoma Blood stained: malignancy, glomous jugulare,granulations. Hard of hearing / impaired hearing: Fluctuant deafness- Meniers disease, secretory otitis media Noise surroundings h/o ear discharge unilateral headache: acoustic neuroma wax , impacted FB, tumours,myringitis bullosa, perforation, traumatic, Eustachian tube dysfunction Fullness of ear : ET dysfunction

Itching :with allergy , fungal infection , otitis externae, FB , impacted wax Hyperacusis: stapedial nerve palsy(facial nerve paralysis)