Diabetes in ENT practice can take a serious turn because when people come to us with nonresolving neck infections, recurrent facial nerve palsy, sudden sensorineural hearing loss, and recurrent nasal bleeding they are all medical emergencies.

Nothing works until the underlying deranged blood glucose level is identified and corrected.

This is where it’s important to be aware.

In ENT practice Diabetes causes mainly two types of complications:

1)Neuropathy

Bells palsy, SSNHL(Sudden sensorineural hearing loss), Unilateral vocal cord palsy, dysphagia, progressive hearing loss, vertigo.

2)Immunodeficiency because of impaired white cell phagocytic activity.

Immunodeficiency causes poor wound healing areas surgery or trauma.

Nonresolving infections include life-threatening conditions like malignant otitis externa, and invasive fungal rhinosinusitis/Rhino-cerebral mucormycosis.

Deep neck space infections often become complicated because of poor blood sugar control.

Nonresolving mouth ulcers, recurrent episodes of mucositis, and glossitis can all be presenting symptoms in patients with Diabetes.

Sudden onset ear discharge,persistent ear discharge ,acute otitis media in adults or earache with otomycosis ,malignant otitis externa are all clues to  underlying poor blood sugar control.

In all these cases, urgent control of blood sugar requires hospitalization and insulin to control blood sugar . The problem is because of the stress of acute infection blood sugar control is an even bigger struggle.

Primary care physicians and ENT surgeons both will need to motivate patients for better blood sugar control. In the long run, together with medication, and lifestyle, it’s the patient’s motivation that can make healing possible.

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