Perhaps one of the most important parts of a history taking is the identifying of red flags or symptoms suggestive of a more serious underlying pathology. The following list comprises ENT specific red flag symptoms.

 

Head & neck cancers

 

• Smoker +/- drinker

Increased risk of oral, laryngeal, and pharyngeal cancer in smokers or drinkers. Doing both has a synergistic effect for all head and neck cancers.

 

• Dysphagia

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• Dysphonia

      Persistent > 3 weeks 

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• Haemoptysis

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• Neck lump

 

• Referred otalgia

Rare, however, can represent cancer in tonsil, tongue, larynx, or pharynx

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• Weight loss

Unexplained or unplanned 

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For more information please see our head and neck cancers page

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Ear

 

• Persistent unilateral hearing loss/tinnitus

Could represent an acoustic neuroma 

 

• Immunocompromised elderly patients with otalgia

Higher risk of malignant otitis externa

 

• Facial nerve palsy in presence of ear disease

Cholesteatoma, AOM

 

Nose 

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• Unilateral symptoms 

Nasal obstruction, pain, polyps - unilateral anything is more concerning

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• Unexplained epistaxis

Rule out a postnasal space lesion

 

• Orbital symptoms 

e.g. Visual loss in sinusitis  

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