ENT Red Flags

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

  • Dysphonia

      Persistent > 3 weeks 

  • Haemoptysis

  • Neck lump

 

  • Referred otalgia

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

  • Weight loss

Unexplained or unplanned 

For more information please see our head and neck cancers page

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 

  • Unilateral symptoms 

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

  • Unexplained epistaxis

Rule out a post nasal space lesion

 

  • Orbital symptoms 

e.g. Visual loss in sinusitis