Zero to Finals

Paediatric, ENT and primary-care clinicians get a concise neck-lump review. A midline or near-midline soft, fluctuant lump that moves upwards with tongue protrusion suggests thyroglossal cyst, with ultrasound, infection recognition, ectopic thyroid tissue and Sistrunk procedure shaping assessment and referral.

Paediatric and ENT clinicians get an overview of congenital lymphatic malformations presenting as soft, non-tender, transilluminating neck or axillary swellings. Feeding difficulty, dysphagia, breathing problems, infection or haemorrhage require escalation, while uncomplicated lesions may be observed or considered for sclerotherapy or surgery.

Paediatric, ENT and primary-care clinicians get a focused review of ankyloglossia. Tongue appearance and movement are considered alongside latch, clicking, feed duration, weight gain and maternal nipple symptoms, with monitoring for effective feeding and frenotomy reserved for symptomatic cases.

Paediatric and ENT teams get an overview of cleft lip and palate, with early priorities around feeding, swallowing and specialist cleft-service referral. It also covers surgical timing, speech, hearing, dental development and psychosocial follow-up.

Paediatric, primary-care and urgent-care clinicians get a focused review of childhood epistaxis. It covers Little’s area, forward positioning, continuous pressure to the soft nostrils, bilateral or posterior bleeding, escalation thresholds, cautery, packing and assessment for an underlying bleeding disorder.

Good for GPs, paediatric clinicians and students revising speech delay, mishearing, school difficulty or social withdrawal. It distinguishes conductive, sensorineural and mixed hearing loss, with glue ear, newborn screen limitations, otoscopy, audiometry, tympanometry and hearing devices in view.

Post-tonsillectomy bleeding can be primary or secondary, and a patient who swallows blood may hide the scale of bleeding. This concise ENT review helps with ABCDE assessment, upright positioning, early ENT involvement and preparation for theatre when bleeding is significant.

Severe unilateral sore throat is not always uncomplicated tonsillitis. Trismus, drooling, difficulty swallowing saliva, uvular deviation and a hot potato voice point towards peritonsillar abscess and same-day hospital assessment, with analgesia, hydration, antibiotics and drainage planning.

A sore throat can look straightforward, but antibiotic choices need more than tonsillar exudate. The review links fever, swallowing pain, oral intake, ear and neck examination, Centor or FeverPAIN scoring, and safety-netting for complications such as quinsy or airway concern.

Sore throat with dysphagia, neck swelling or a grey-white pharyngeal membrane should keep respiratory diphtheria in mind. The urgent sequence is isolation, PPE, notification, antitoxin for respiratory disease, antibiotics and swabs, with close contacts managed through public health advice.