This Belgian paper reports the epidemiology of 1296 patients attending the emergency department with ENT problems over a five-year period. As expected the most common presentation was epistaxis, but interestingly vertigo seemed to be the second most common presentation to the emergency department during most years. This is in contrast to many British hospitals where vertigo would more commonly present to the outpatient clinic. Indeed the authors don’t seem to give a clear reason for this high proportion of vertigo patients. They hypothesise the reason for a high rate of epistaxis is due to the perception that epistaxis is a severe ENT problem requiring urgent attention by an ENT specialist. The authors compare their results to a similar German paper, which has a higher rate of less urgent problems such as earplugs, etc. They hypothesise this may be because in the Belgian institute they have daily clinic slots available for (semi-) urgent cases compared to the German paper where there are longer waiting lists for outpatients, so patients are more likely to attend the emergency department rather than wait for an outpatient appointment. The authors also report a low rate of re-attendance and of admission (8%) compared to the literature. The low admission rate may be due to patients with nasal packs not being routinely admitted, which is at odds with UK practice. This paper gives an interesting insight into the epidemiology of ENT emergencies in Belgium across a large patient group, and highlights some important differences in service arrangements compared to the UK. 

Epidemiology of ENT emergencies.
Lammens F, Lemkens N, Laureyns G, et al.
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Sunil Sharma

Alder Hey Children's Hospital, UK.

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