Master Specialist Otolaryngology (ENT5721)
for DHA Speciality

A 34-year-old woman at 28 weeks' gestation presents with a 3-day history of right-sided facial weakness, reduced taste, and inability to close the right eye. She has no limb weakness and no rash. Blood pressure is 118/74 mmHg, random glucose 4.6 mmol/L, and she is afebrile. Otoscopy is normal. She is diagnosed with Bell's palsy. Which is the most appropriate next step in management?

A 62-year-old man with type 2 diabetes (HbA1c 8.9%) undergoes uncomplicated septoplasty and bilateral inferior turbinate reduction under general anaesthesia. On the second postoperative day he develops fever of 38.7?C, severe left periorbital swelling, proptosis, and reduced visual acuity (6/18 from baseline 6/6). White cell count is 17.2 x 109/L and CRP is 210 mg/L. Which is the most appropriate next step?

A 45-year-old woman with no prior ear surgery presents with a 6-month history of left-sided foul-smelling otorrhoea, conductive hearing loss, and a retraction pocket in the attic. CT temporal bone shows soft tissue in the epitympanum with erosion of the scutum but no intracranial extension. She undergoes tympanomastoidectomy. On the first postoperative day she develops vertigo, nystagmus, and profound sensorineural hearing loss on the operated side. Which is the most appropriate next step?

A 58-year-old man with hypertension and atrial fibrillation on warfarin (INR 2.4) presents with a 4-hour history of severe epistaxis. He is haemodynamically stable with BP 148/88 mmHg and haemoglobin 132 g/L. Anterior rhinoscopy shows bleeding from Little's area. Nasal packing with a Merocel sponge is inserted and the bleeding stops. Two hours later he develops brisk bleeding around the pack. Which is the most appropriate next step?

A 7-year-old boy undergoes adenotonsillectomy for obstructive sleep apnoea. On the fifth postoperative day he presents with fever of 38.9?C, poor oral intake, and a 2 cm area of bleeding from the right tonsillar fossa. Haemoglobin is 118 g/L and he is haemodynamically stable. Which is the most appropriate next step?