George Manjaly ENT Consultant

George Manjaly Examination Common Conditions

Common Conditions

Childhood deafness: The commonest reason for childhood deafness is secretive otitis media otherwise called glue ear. Watchful waiting after a diagnosis is made is often the best approach. Failing this, the hearing can be improved by drainage of this fluid and insertion of grommets which can be done as a day case under General Anaesthetic for children. This procedure is done for adults too.


Dizziness: There are many possible causes for dizziness. Common ENT causes include Ménière's disease, Benign Positional Vertigo (BPPV) and Acute Labrynthitis. After initial assessment and diagnosis, vestibular physiotherapy exercises will correct some of the commonest problems. Resistant cases will need further investigations such as MRI scan and Vestibular Function Tests.


Ear Discharge: A true ear discharge is a sign of infection. This may involve the skin of the outer ear (otitis externa), infection of the middle ear (otitis media) or an offensive discharge which may be a sign of a more serious condition called Cholesteatoma.


Blocked nose: The most common reason for nasal blockage is as a result of a mechanical obstruction due to a bend in the cartilage of the nose. Other causes include polyps or inflammation of the nasal lining as a result of allergic rhinitis or infective rhinitis.


Sinusitis: The usual presenting symptom for sinusitis is facial pain and nasal blockage which is very often preceded by an upper respiratory tract infection. Diagnosis is made by clinical examination of the nose and telescopic examination using an Endoscope. Chronic sinusitis will require a CT scan of the sinuses to elicit more information and planned treatment. If conservative measures fail to relieve the symptoms, then this can be corrected using Functional Endoscopic Sinus Surgery (FESS).


Bent nose: External nasal deformity is usually as a result of trauma or a congenital cause. If you are unhappy with the shape of your nose, the initial consultation will be to establish the specific areas you are unhappy about and design tailor-made treatment to address the deformity.


Snoring:Snoring is a very common problem which affects a large population. Snoring may exist on its own or it could be a sign of a more serious problem called Sleep Apnoea when the patient actually stops breathing during sleep. Assessment of snoring and sleep apnoea requires a thorough examination and endoscopy to decide on treatment. The treatment is tailor-made again to focus on general factors such as obesity and life style changes such as diet, smoking and alcohol. Local factors focus on the nasal airway and soft palate abnormalities.


Sore throat: Sore throat could be due to a viral infection, bacterial infection, gastro-oesophageal reflux or allergic pharyngitis. Recurrent acute tonsillitis affecting the quality of life and losing time off work can benefit from tonsillectomy.


Hoarse voice: This is commonly due to inflammation of the voice box as a result of viral or bacterial infection of the larynx. However, in patients who smoke excessively, possibility of malignancy should be excluded. Examination includes a full ENT examination and an Endoscopy to examine the voice box.


Neck lumps: A lump in the neck which is seen from outside should be taken seriously. The commonest reason for neck lumps are:

-enlarged lymph glands as a result of infection
-enlargement of the thyroid gland (goitre)
-inflammation or growth within the salivary glands ( sub-mandibular, parotid gland )

Assessment includes a full examination of the neck and an endoscopy to examine the relevant areas. Diagnosis will usually require a fine needle aspirate (biopsy) before definitive treatment can be decided.


Cancer of the head and neck: Although head and neck cancer is rare, any patient with a voice change or sore throat lasting more than 6 weeks, difficulty in swallowing food, or loss of weight or any neck lumps persisting more than 3 weeks, or an ulcer that does not heal, or any bleeding from the upper airway requires ENT consultation.

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