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Otorhinolaryngology > Disease of the nose and paranasal sinuses > Flashcards

Disease of the nose and paranasal sinuses Flashcards

1
Q

Allergic rhinitis PE findings

A

• Pale, boggy, hypertrophic turbinates w/ whitish or clear discharge
• ≤ septal deviation
• Cobblestoning posteriorto pharyngeal wall
• Wheezing, if w/ asthma

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2
Q

Allergic rhinitis complications

A

• Asthma
• Otitis media
• Rhinosinusitis
• Tonsillopharyngitis
• Laryngitis
• Bronchitis
• Conjunctivitis

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3
Q

Cancer of the nasal cavity common site is

A
  1. Lateral wall—50%
  2. Septum
  3. Vestibule
  4. Turbinate
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4
Q

May present as a unilateral persistent and progressive nasal obstruction (depends on tumor size) and foul smelling nasal discharge (from necrosis) and it is usually right sided

A

Cancer of the nasal cavity

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5
Q

May present as a unilateral persistent and progressive nasal obstruction (depends on tumor size) and foul smelling nasal discharge (from necrosis) and it is usually right sided

A

Cancer of the nasal cavity

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6
Q

Level ll: upper internal jugular (deep cervical) chain parts

A

• superiorly: base of the skull at the jugular fossa
• inferiorly: inferior border of the hyoid bone
• anteriorly: posterior border of the submandibular gland
• posterolaterally: posterior border of the sternocleidomastoid muscle
• medially: medial border of the internal carotid artery

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7
Q

Cancer of the paranasal sinus incidence

A

• 0.2% of all cancers of the body
• 3% of cancers of the URT
• More common in males with ratio of 2:1
• 80% affect the maxillary sinuses, 25% or more the ethmoids, the rest are rare 95% occurs over 40 years of age ~80% are squamous cell carcinoma

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8
Q

Chronic sinusitis leading to metaplasia of the normal respiratory epithelium can cause

A

Cancer of the paranasal sinus

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9
Q

Maxillary sinus tumours clinical parameters (Dental)

A
  1. Loosening of teeth
  2. Pain in the premolar or molar teeth
  3. Swelling of palate or alveolar ridge (late sign)
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10
Q

Maxillary sinus tumours clinical parameters (Nasal)

A
  1. Unilateral nasal obstruction and discharge
  2. Nasal mass – occasionally only a bulge on the lateral wall
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11
Q

Maxillary sinus tumours clinical parameters (Nasal)

A
  1. Unilateral nasal obstruction and discharge
  2. Nasal mass – occasionally only a bulge on the lateral wall
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12
Q

Maxillary sinus tumours clinical parameters (Face)

A
  1. Bulging of the cheek (usually a late sign)
  2. Numbness and paresthesia esp. of the area supplied by the infraorbital nerve
  3. Involvement of skin
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13
Q

For late stage maxillary sinus treatment

A

Orbital exenteration

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14
Q

Juvenile Nasopharyngeal Angiofibroma (Histopathology)

A

Grossly pedunculated tumor, smooth seemingly wellencapsulated bluish or pinkish in color

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15
Q

Sign and Symptoms are due to vascularity of the tumor, mechanical obstruction and pressure necrosis

A

• Frequent and profuse epistaxis
• Nasal obstruction
• Middle ear effusion
• Conductive deafness
• Proptosis and bulging of cheek

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16
Q

An imaginary line drawn from the inner canthus to the angle of the mandible for tumor prognosis

A

Ongren’s line
-Tumor below the line 71%
-Superior to this line 25%

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17
Q

An imaginary line drawn from the inner canthus to the angle of the mandible for tumor prognosis

A

Ongren’s line
-Tumor below the line 71%
-Superior to this line 25%

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18
Q

Means there’s no cancer, only abnormal cells with the potential to become cancer

A

Stage 0

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19
Q

Means the cancer is small and only in one area

A

Stage I

20
Q

Mean the cancer is larger and has grown into nearby tissues or lymph nodes

A

Stage II and III

21
Q

Means the cancer has spread to other parts of your body

A

Stage IV

22
Q

Patterns of Tumor Spread

A

• Anteriorly -cheek and skin
• Posteriorly - pterygomaxillary fossa, pterygoid plates, nasopharynx, sphenoid sinus, base of skull
• Medially - nasal cavity
• Superiorly -orbits, ethmoid sinuses
• Inferiorly - palate, bucal sulcus
• Intracranial - ethmoid and cribriform plates
• Lymphatic - submandibular, upper jugular, retropharyngeal nodes
• Systemic - lungs occasionally

23
Q

Tumor classification and staging (T1)

A

tumour limited to maxillary sinus mucosa with no erosion.

24
Q

Tumor classification and staging (T1)

A

tumour limited to maxillary sinus mucosa with no erosion.

25
Q

Tumor classification and staging (T2)

A

bony erosion, extension into hard palate, nasal meatus, except the posterior wall

26
Q

Tumor classification and staging (T2)

A

bony erosion, extension into hard palate, nasal meatus, except the posterior wall

27
Q

Tumor classification and staging (T3)

A

invading posterior wall, subcutaneous tissue, floor/ medial wall of orbit, pterygoid fossa, ethmoid sinus

28
Q

ant.orbit, skin of cheek, pterygoid plates, cribriform plates, sphenoid, frontal sinus

A

T4

29
Q

ant.orbit, skin of cheek, pterygoid plates, cribriform plates, sphenoid, frontal sinus

A

T4

30
Q

orbital apex, dura, brain, middle cranial fossa, nasopharynx, cranial nerves other than maxillary division of Trigeminal (V2)

A

T4b

31
Q

metastasis in single ipsilateral lymph nodes

A

N1

32
Q

metastasis in single ipsilateral lymph nodes

A

N1

33
Q

multiple ipsilateral nodes <6cms

A

N2b

34
Q

Epistaxis (Acute nasal trauma)

A
  1. With or without Nasal Bone Fractures
  2. after Nasal / Sinus Surgeries
  3. after nasal intubations
35
Q

Epistaxis (Chronic Nasal Trauma)

A
  1. Habitual nose rubbing & picking
  2. Foreign bodies
  3. Topical steroid nasal sprays
  4. Substance abuse
36
Q

Epistaxis (Chronic Nasal Trauma)

A
  1. Habitual nose rubbing & picking
  2. Foreign bodies
  3. Topical steroid nasal sprays
  4. Substance abuse
37
Q

Trotter’s method

A

make patient sit up, pinch the nose for 5-10 mins.

38
Q

Anterior Nasal Packing

A
  1. using vaselinized or antibiotic ointment soaked
  2. using formed expandable sponges
39
Q

Posterior Nasal Packing

A
  1. using foley catheter for the posterior nasal pack and antibiotic soaked gauze for the anterior pack
  2. using preformed double balloon catheter
40
Q

Hemangioma

A
  1. Capillary haemangioma
  2. Bleeding polypus of the septum
  3. Soft, dark red , pedunculated or sessile mass arising from anterior aspect of septum.
  4. Epistaxis
  5. Excision
  6. Cavernous hemangioma-tubinates /lat nasal wall
41
Q

Hemangioma

A
  1. Capillary haemangioma
  2. Bleeding polypus of the septum
  3. Soft, dark red , pedunculated or sessile mass arising from anterior aspect of septum.
  4. Epistaxis
  5. Excision
  6. Cavernous hemangioma-tubinates /lat nasal wall
42
Q

Osteoma

A
  1. Most common in frontal sinus
  2. Usually asymptomatic
  3. Can obstruct ostium of frontal sinus and cause mucocele
  4. If symptomatic - excision
43
Q

Fibrous Dysplasia

A

• Bone replaced by fibrous tissue
• Maxillary sinus -MC site
• Proptosis, nasal obstruction, facial disfigurement
• Surgical excision

44
Q

Fibrous Dysplasia

A

• Bone replaced by fibrous tissue
• Maxillary sinus -MC site
• Proptosis, nasal obstruction, facial disfigurement
• Surgical excision

45
Q

Sign and symptoms of Deviated Nasal Septum

A
  1. Difficulty of breathing thru the nosetrils
  2. Headache
  3. Facial pain
  4. Nasal congestion
  5. Snoring → sleep apnea

Otorhinolaryngology (6 decks)

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