Obtain good history of smoking, radiation, change in voice or hoarseness. Refer to ENT Vertigo Sense of motion - not the same as dizziness must differentiate between the two. No permanent hearing loss. Meniere's disease - triad of low frequency hearing loss, vertigo and tinnitus. Vestibulobasilar insufficiency - seen in elderly patients, AJD of cervical spine can impinge vertebral artery.
Human bites are more dirty than animals.
Clean non-human bites can be closed primarily if seen in 5 hrs or less. Human bites closed in a delayed manner. Use wet to dry dressing changes for 2-5 days then close primarily. Treat avulsions with delayed manner. Antibiotics - oral, Augmentin 500mg TID x 14 days.