Hahn Janina, Deitmer Thomas, Löhler Jan, Datzmann Thomas, Lehner René, Hoffmann Thomas K
Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Hospital, Germany; The German Society of Oto-Rhino-Laryngology, Head and Neck Surgery, Bonn, Germany; German Professional Association of Ear, Nose, and Throat Specialists, Neumünster, Germany; Clinic for Anesthesiology and Intensive Care, Ulm University Medical Center, Ulm, Germany.
Dtsch Arztebl Int. 2025 Sep 19;122(19):533-540. doi: 10.3238/arztebl.m2025.0122.
Emergencies in otorhinolaryngology are common: According to a Spanish study, approximately 12% of patients in a general emergency room have symptoms relating to the ear, nose, or throat (ENT). Such situations range in severity from minimal to lifethreatening and affect persons of all ages. These patients may pre - sent first to a general practitioner or to an emergency room without specialized ENT coverage. In this article, we discuss the assessment of clinical urgency based on symptoms, and the ensuing treatments.
This narrative review is based on pertinent publications retrieved by a literature search. Common and typical ENT emergencies are discussed, including the necessary diagnostic evaluation, time management, and treatment. For each clinical entity, "red flags" are defined, i.e., warning signs indicating the need for urgent, specialized care.
Treatment by a specialist in otorhinolaryngology (usually surgical and in-hospital, and often as part of an interdisciplinary collaboration) is needed, in particular, for clinical entities that may be life-threatening, such as otogenic or sinugenic complications, neck abscesses, angioedema, posterior epistaxis, tumor hemorrhages, and foreign bodies in the respiratory tract, as well as inner ear diseases that cause severe vertigo and vomiting.
The rising number of patients presenting to emergency rooms presents a challenge to all affected areas of the health care system. The physician in the emergency room has the task of recognizing the risk of serious complications in certain clinical situations with nonspecific symptoms that may seem harmless, and of obtaining specialized care for these patients in a timely manner. The "red flags" presented in this article can serve as an initial guide to ENT emergencies.
耳鼻咽喉科急症很常见：根据一项西班牙的研究，普通急诊室中约12%的患者有耳、鼻或喉（耳鼻喉科）相关症状。这些情况严重程度不一，从轻微到危及生命，影响各年龄段的人。这些患者可能首先就诊于全科医生或没有专门耳鼻喉科服务的急诊室。在本文中，我们讨论基于症状的临床急症评估及后续治疗。
本叙述性综述基于通过文献检索获取的相关出版物。讨论了常见和典型的耳鼻喉科急症，包括必要的诊断评估、时间管理和治疗。对于每个临床实体，定义了“红旗征”，即表明需要紧急、专科护理的警示信号。
对于可能危及生命的临床实体，尤其需要耳鼻喉科专科医生进行治疗（通常是手术治疗且需住院，并且常常是跨学科协作的一部分），这些临床实体如耳源性或鼻源性并发症、颈部脓肿、血管性水肿、后鼻孔出血、肿瘤出血、呼吸道异物，以及引起严重眩晕和呕吐的内耳疾病。
前往急诊室就诊的患者数量不断增加，这给医疗保健系统的所有相关领域都带来了挑战。急诊室医生的任务是识别某些看似无害但具有非特异性症状的临床情况中严重并发症的风险，并及时为这些患者获得专科护理。本文中呈现的“红旗征”可作为耳鼻喉科急症的初步指南。
