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Vincent’s S.C.A.N.S 
Ear, Nose and Throat (ENT), Head and Neck Surgery
Specialist Clinic
Copyright Vincent Specialist Solutions Sdn Bhd 2016. All rights reserved
Last update:  10/1/13 
EDUCATION SERIOUS    ENT, Head & Neck Infections
This patient education is provided in good faith to help patients and their families learn more about their medical conditions, the options available to them and the possible consequences of their decisions. This information is not intended to be used for diagnosis, or treatment of any specific individual. Please consult with your ENT doctor regarding your particular circumstances.
DANGER AREA of the FACE Infection in this area can be potentially life-threatening as the valveless communication between the T-zone and the central nervous system venous drainage. 
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AIRWAY COMPROMISE When you cannot breathe, NOTHING else matters !
INTRACRANIAL EXTENSION Spread of ENT infection into the brain or other components of the central nervous system can bring about disastrous consequences .
ORBITAL EXTENSION The orbital compartment is just adjacent to the ethmoid sinus  
EARLY WARNING SIGNS OF WORSE COMPLICATIONS TO COME Infection of the hearing nerve (cochlear nerve) or trauma of the temporal bone can result in permanent nerve damage.
IRREVERSIBLE HEARING LOSS, SCARRING COMPLICATIONS. Eg permanent hearing loss IN Infection of the hearing nerve (cochlear nerve) or trauma of the temporal bone can result in permanent nerve damage., Cauliflower ear in perichondrial hematoma .
RISK OF SEPSIS OR DISSEMINATED INFECTION Especially in those immunocompromised group.
EXTREMES OF AGE -TOO YOUNG OR TOO OLD ? Hearing usually returns completely after the blockage is removed. However, it may happen again in the future if the old habits of using cotton
UNDERLYING CANCER ? Some things are not as straight-forward.
Infection refers to the entrance of microorganisms eg. bacteria, virus or fungal entering through our body barriers. Though   in   most   cases,   ENT,   head   and   neck   infections   are   not   serious,   condtions   associated   with   the   complications   ot   danger   signs   below   warrant   early   referral to an ENT, Head and Neck Surgeon before it is too late.
ASPIRATION  Passage of fluid or food into your windpipe commonly due to incoordination of swallowing. Contributing factors include vocal cord palsy, degenerative nerve disease.
Incomplete closure of the vocal cords (black arrow) and stagnation of saliva (yellow arrow) due NPC nerve damage potentially causing aspiration
Ludwig’s angina (submandibular cellulitis) causing shortness of breath
Abscess over the nasal bridge - The Danger Zone of the face
Abscess arising from the left salivary (parotid) gland potentially putting the facial nerve at risk
X-ray showing a foreign body (a coin) in the esophagus, or is it in the windpipe ?
An infant with extensive periorbital abscess due to acute sinusitis
COMPLICATIONS OF SINUSITIS Orbital cellultis: redness over the left upper and lower eyelids of a child after a prolonged ‘common cold’. His condition improved with prolonged course of antibiotics.  Orbital abcess: notice the gross swelling over the left eye in an adult. He did not have obvious sinusitis symptoms prior to this. He regained normal vision after surgical treatment with a prolonged course of antibiotics. Brain abscess: notice the swelling in the brain on the CT scan.  © Vincent Tan ENT
The primary cancer discovered ‘sitting’ in the nasopharynx, the area at the back of the nose. Sure looks benign/non-cancerous !
The patient presenting  with a right neck lymph node swelling -Is this due to a cancer - a primary cancer of the lymph node (lymphoma) or a sceondary metastasis from a primary somewhere else? Or just a lymph node enlargement due to infection ?
The primary cancer discovered ‘sitting’ in the nasopharynx, the area at the back of the nose
(Please click on picture for larger view)
(Please click on picture for larger view)
© Vincent Tan ENT
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D R. V INCENT T AN Consultant Ear, Nose and Throat, Head and Neck Surgeon, MD (UKM), MS ORL-HNS (UKM), DOHNS RCS Edinburgh (UK), MRCS Edinburgh (UK), Postgrad. Allergy (UK), A.M. (Mal), Fellowship in Rhinology (Singapore) Fellowship in Head and Neck Oncology & Surgery (Amsterdam)
+603-3377 7864  +6012-3760 728