IAN PEATE is a Visiting Professor at Northumbria University, a Senior Clinical Fellow at the University of Hertfordshire, and a Professorial Fellow at the University of Roehampton. He is also the Editor-in-Chief of the British Journal of Nursing and the Consultant Editor of the Journal of Paramedic Practice and the International Journal of Advancing Practice.

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• Preface viiiAcknowledgements x1 Anatomy and Physiology: Ear, Nose and Throat 1Anatomy and Physiology of the Ear 1Physiology of Hearing 5The Organ of Corti 6Physiology of Balance 6Integration of Hearing and Balance 7Anatomy and Physiology of the Nose 8Olfaction 10Resonance of the Voice 12Anatomy and Physiology of the Throat 13The Anatomy of the Throat 13The Physiology of the Throat 14Conclusion 15Glossary of Terms 15Multiple Choice Questions 16References 182 Assessment of the Ears, Nose and Throat 19Assessment of the Ears 19History Taking 19The Physical Examination 21Assessing the Ear Canal and the Eardrum 23Inspecting the Tympanic Membrane 24Hearing Acuity Tests 24Assessment of the Nose 26History Taking 26The Physical Examination 28Assessment of the Throat 30Documentation and Follow-up 32Conclusion 32Glossary of Terms 33Multiple Choice Questions 34References 353 Tinnitus 36Pathophysiological Changes Associated with Tinnitus 36Epidemiology 39Risk Factors 40Clinical Presentation 42Clinical Investigations and Diagnosis 42Management 46Health Teaching 47Conclusion 48Glossary of Terms 49Multiple Choice Questions 50References 524 Ménière’s Disease 53Pathophysiological Changes Associated with Ménière’s Disease 53Epidemiology 54Risk Factors 54Clinical Presentation 58Stages of Ménière’s Disease 59Clinical Investigations and Diagnosis 60Findings in Ménière’s Disease 63Management 64Driving 65Health Teaching 65Conclusion 67Glossary of Terms 68Multiple Choice Questions 69References 705 Sinusitis 72The Paranasal Sinuses 72Functions of the Paranasal Sinuses 72Pathophysiological Changes Associated with Sinusitis 73Anatomy and Drainage Pathways 74Mechanisms of Sinusitis Development 75Clinical Course of Infections 75Epidemiology 77Risk Factors 77Clinical Presentation 79Differential Diagnoses 80Complications 80Clinical Investigations and Diagnosis 81Chief Complaint 81Symptom Description 81Associated Factors and Conditions 82Environmental and Occupational Exposures 83Medications and Treatments 83Lifestyle Factors 83Family History 83Review of Systems 84Management 85Health Teaching 85Conclusion 87Glossary of Terms 88Multiple Choice Questions 89References 906 Nasal Polyps 91Nasal Obstruction 91Anatomical Blockage 91Inflammatory Conditions 91Foreign Body in the Nose 91Clinical Approach and Management 92Pathophysiological Changes Associated with Nasal Polyps 92Cytokine and Chemokine Release 93Epithelial Damage and Remodelling 94Tissue Oedema 94Structural and Functional Alterations 94Immunological Factors 94Genetic Factors 94Microbiome Alterations 94Epidemiology 95Risk Factors 96Clinical Presentation 98Clinical Investigations and Diagnosis 99Contents viiNasal Endoscopy 100Allergy Testing 100Aspirin Sensitivity Testing 100Biopsy 100Laboratory Tests 100Differential Diagnosis 100Functional Endoscopic Sinus Surgery 101Management 101Health Teaching 103Conclusion 104Glossary of Terms 105Multiple Choice Questions 105References 1067 Laryngeal Cancer 108Communicating Effectively 108Pathophysiological Changes Associated with Laryngeal Cancer 109Cellular Changes 109Structural and Functional Changes 110Systemic Changes 110Advanced Stages 110Epidemiology 110Risk Factors 111Clinical Presentation 113Clinical Investigations and Diagnosis 115Management 116Health Teaching 119Conclusion 121Glossary of Terms 121Multiple Choice Questions 122References 1238 Tonsillitis 125Lymphoid Tissue 125Quinsy 125Pathophysiological Changes Associated with Tonsillitis 127Epidemiology 129Risk Factors 129Clinical Presentation 130Differentiating Viral and Bacterial Tonsillitis 131Clinical Investigations and Diagnosis 132Management 137Health Teaching 137Conclusion 138Glossary of Terms 139Multiple Choice Questions 139References 141MCQ Answers 142Index 143

IAN PEATE is a Visiting Professor at Northumbria University, a Senior Clinical Fellow at the University of Hertfordshire, and a Professorial Fellow at the University of Roehampton. He is also the Editor-in-Chief of the British Journal of Nursing and the Consultant Editor of the Journal of Paramedic Practice and the International Journal of Advancing Practice.

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• Preface viiiAcknowledgements x1 Anatomy and Physiology: Ear, Nose and Throat 1Anatomy and Physiology of the Ear 1Physiology of Hearing 5The Organ of Corti 6Physiology of Balance 6Integration of Hearing and Balance 7Anatomy and Physiology of the Nose 8Olfaction 10Resonance of the Voice 12Anatomy and Physiology of the Throat 13The Anatomy of the Throat 13The Physiology of the Throat 14Conclusion 15Glossary of Terms 15Multiple Choice Questions 16References 182 Assessment of the Ears, Nose and Throat 19Assessment of the Ears 19History Taking 19The Physical Examination 21Assessing the Ear Canal and the Eardrum 23Inspecting the Tympanic Membrane 24Hearing Acuity Tests 24Assessment of the Nose 26History Taking 26The Physical Examination 28Assessment of the Throat 30Documentation and Follow-up 32Conclusion 32Glossary of Terms 33Multiple Choice Questions 34References 353 Tinnitus 36Pathophysiological Changes Associated with Tinnitus 36Epidemiology 39Risk Factors 40Clinical Presentation 42Clinical Investigations and Diagnosis 42Management 46Health Teaching 47Conclusion 48Glossary of Terms 49Multiple Choice Questions 50References 524 Ménière’s Disease 53Pathophysiological Changes Associated with Ménière’s Disease 53Epidemiology 54Risk Factors 54Clinical Presentation 58Stages of Ménière’s Disease 59Clinical Investigations and Diagnosis 60Findings in Ménière’s Disease 63Management 64Driving 65Health Teaching 65Conclusion 67Glossary of Terms 68Multiple Choice Questions 69References 705 Sinusitis 72The Paranasal Sinuses 72Functions of the Paranasal Sinuses 72Pathophysiological Changes Associated with Sinusitis 73Anatomy and Drainage Pathways 74Mechanisms of Sinusitis Development 75Clinical Course of Infections 75Epidemiology 77Risk Factors 77Clinical Presentation 79Differential Diagnoses 80Complications 80Clinical Investigations and Diagnosis 81Chief Complaint 81Symptom Description 81Associated Factors and Conditions 82Environmental and Occupational Exposures 83Medications and Treatments 83Lifestyle Factors 83Family History 83Review of Systems 84Management 85Health Teaching 85Conclusion 87Glossary of Terms 88Multiple Choice Questions 89References 906 Nasal Polyps 91Nasal Obstruction 91Anatomical Blockage 91Inflammatory Conditions 91Foreign Body in the Nose 91Clinical Approach and Management 92Pathophysiological Changes Associated with Nasal Polyps 92Cytokine and Chemokine Release 93Epithelial Damage and Remodelling 94Tissue Oedema 94Structural and Functional Alterations 94Immunological Factors 94Genetic Factors 94Microbiome Alterations 94Epidemiology 95Risk Factors 96Clinical Presentation 98Clinical Investigations and Diagnosis 99Contents viiNasal Endoscopy 100Allergy Testing 100Aspirin Sensitivity Testing 100Biopsy 100Laboratory Tests 100Differential Diagnosis 100Functional Endoscopic Sinus Surgery 101Management 101Health Teaching 103Conclusion 104Glossary of Terms 105Multiple Choice Questions 105References 1067 Laryngeal Cancer 108Communicating Effectively 108Pathophysiological Changes Associated with Laryngeal Cancer 109Cellular Changes 109Structural and Functional Changes 110Systemic Changes 110Advanced Stages 110Epidemiology 110Risk Factors 111Clinical Presentation 113Clinical Investigations and Diagnosis 115Management 116Health Teaching 119Conclusion 121Glossary of Terms 121Multiple Choice Questions 122References 1238 Tonsillitis 125Lymphoid Tissue 125Quinsy 125Pathophysiological Changes Associated with Tonsillitis 127Epidemiology 129Risk Factors 129Clinical Presentation 130Differentiating Viral and Bacterial Tonsillitis 131Clinical Investigations and Diagnosis 132Management 137Health Teaching 137Conclusion 138Glossary of Terms 139Multiple Choice Questions 139References 141MCQ Answers 142Index 143

IAN PEATE is a Visiting Professor at Northumbria University, a Senior Clinical Fellow at the University of Hertfordshire, and a Professorial Fellow at the University of Roehampton. He is also the Editor-in-Chief of the British Journal of Nursing and the Consultant Editor of the Journal of Paramedic Practice and the International Journal of Advancing Practice.

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• Preface viiiAcknowledgements x1 Anatomy and Physiology: Ear, Nose and Throat 1Anatomy and Physiology of the Ear 1Physiology of Hearing 5The Organ of Corti 6Physiology of Balance 6Integration of Hearing and Balance 7Anatomy and Physiology of the Nose 8Olfaction 10Resonance of the Voice 12Anatomy and Physiology of the Throat 13The Anatomy of the Throat 13The Physiology of the Throat 14Conclusion 15Glossary of Terms 15Multiple Choice Questions 16References 182 Assessment of the Ears, Nose and Throat 19Assessment of the Ears 19History Taking 19The Physical Examination 21Assessing the Ear Canal and the Eardrum 23Inspecting the Tympanic Membrane 24Hearing Acuity Tests 24Assessment of the Nose 26History Taking 26The Physical Examination 28Assessment of the Throat 30Documentation and Follow-up 32Conclusion 32Glossary of Terms 33Multiple Choice Questions 34References 353 Tinnitus 36Pathophysiological Changes Associated with Tinnitus 36Epidemiology 39Risk Factors 40Clinical Presentation 42Clinical Investigations and Diagnosis 42Management 46Health Teaching 47Conclusion 48Glossary of Terms 49Multiple Choice Questions 50References 524 Ménière’s Disease 53Pathophysiological Changes Associated with Ménière’s Disease 53Epidemiology 54Risk Factors 54Clinical Presentation 58Stages of Ménière’s Disease 59Clinical Investigations and Diagnosis 60Findings in Ménière’s Disease 63Management 64Driving 65Health Teaching 65Conclusion 67Glossary of Terms 68Multiple Choice Questions 69References 705 Sinusitis 72The Paranasal Sinuses 72Functions of the Paranasal Sinuses 72Pathophysiological Changes Associated with Sinusitis 73Anatomy and Drainage Pathways 74Mechanisms of Sinusitis Development 75Clinical Course of Infections 75Epidemiology 77Risk Factors 77Clinical Presentation 79Differential Diagnoses 80Complications 80Clinical Investigations and Diagnosis 81Chief Complaint 81Symptom Description 81Associated Factors and Conditions 82Environmental and Occupational Exposures 83Medications and Treatments 83Lifestyle Factors 83Family History 83Review of Systems 84Management 85Health Teaching 85Conclusion 87Glossary of Terms 88Multiple Choice Questions 89References 906 Nasal Polyps 91Nasal Obstruction 91Anatomical Blockage 91Inflammatory Conditions 91Foreign Body in the Nose 91Clinical Approach and Management 92Pathophysiological Changes Associated with Nasal Polyps 92Cytokine and Chemokine Release 93Epithelial Damage and Remodelling 94Tissue Oedema 94Structural and Functional Alterations 94Immunological Factors 94Genetic Factors 94Microbiome Alterations 94Epidemiology 95Risk Factors 96Clinical Presentation 98Clinical Investigations and Diagnosis 99Contents viiNasal Endoscopy 100Allergy Testing 100Aspirin Sensitivity Testing 100Biopsy 100Laboratory Tests 100Differential Diagnosis 100Functional Endoscopic Sinus Surgery 101Management 101Health Teaching 103Conclusion 104Glossary of Terms 105Multiple Choice Questions 105References 1067 Laryngeal Cancer 108Communicating Effectively 108Pathophysiological Changes Associated with Laryngeal Cancer 109Cellular Changes 109Structural and Functional Changes 110Systemic Changes 110Advanced Stages 110Epidemiology 110Risk Factors 111Clinical Presentation 113Clinical Investigations and Diagnosis 115Management 116Health Teaching 119Conclusion 121Glossary of Terms 121Multiple Choice Questions 122References 1238 Tonsillitis 125Lymphoid Tissue 125Quinsy 125Pathophysiological Changes Associated with Tonsillitis 127Epidemiology 129Risk Factors 129Clinical Presentation 130Differentiating Viral and Bacterial Tonsillitis 131Clinical Investigations and Diagnosis 132Management 137Health Teaching 137Conclusion 138Glossary of Terms 139Multiple Choice Questions 139References 141MCQ Answers 142Index 143