Primary care
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Bell's palsy is acute weakness of the facial muscles associated with compression of cranial nerve VII. The annual incidence is 20 to 30 per 100,000. Diagnosis is based on a thorough history and physical examination, with careful attention to exclude other causes of facial weakness, such as stroke or Lyme disease. ⋯ Physical therapy and Botox injections can help patients with persistent symptoms. The roles of surgery and acupuncture remain unclear. Close follow-up is warranted and patients without improvement should be referred to a specialist.
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Head and neck cancers are heterogenous cancers with rising incidence of treatable/curative cancers. They are treated comprehensively by multidisciplinary teams. Survivors of head and neck cancers often deal with the sequalae of therapy and with increasing survival rates, it is anticipated that the primary care physicians are going to encounter more patients in their clinics in the coming years. The clinicians should be aware of physiologic and functional changes in vital organs involving daily activities such as eating, drinking, speech and communication, and also be prepared to be a part of the cancer survivorship plans.
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Dysphagia, or difficulty swallowing, has significant impacts on patients' quality of life. A thorough history and physical examination can provide important information to determine if dysphagia is originating from oropharyngeal or esophageal causes. Identifying the underlying pathology contributing to dysphagia allows for optimal treatment and improved quality of life.
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About 85% of US adults with hearing loss have unmet hearing needs, creating significant individual and population effects on chronic conditions, socioeconomics, and quality of life. This article reviews the diagnosis and management of hearing loss, overcoming systemic barriers, resources in limited primary care settings, and a multidisciplinary approach.
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Tinnitus is considered a symptom and not a diagnosis. It varies in its presentation from unilateral to bilateral and intermittent to constant. ⋯ Management includes helping the patient cope with their tinnitus using tools such as cognitive behavioral therapy among others. Education is also crucial to help patients understand and overcome the challenges associated with this symptom.