Ear, Nose, Throat Flashcards
otolaryngology
head and neck surgeries
subspecialties of otolaryngology
ear, nose, throat
otolaryngology is related to
subspecialties neurootology pediatric plastic + reconstructive head + neck oncology
anatomy related to otolaryngology
ears nose oral cavity/ pharynx salivary glands larynx neck
ears
hearing + balance
outer ears
pinna
external ear
tympanic membrane
tympanic membrane
eardrum
middle ear
ossicles + eustacian tube
inner ear
facial nerve
auditory nerve
vestibular nerve
what borders the outer ear and the middle ear?
eardrum
otitis externa
red swollen, pink ear; water going into the external auditory canal; bacteria flourish; very painful; antibiotic drops needed
cerumen
can cause hearing loss; elderly
cauliflower ear
hematoma on ear
otitis media
air bubbles indicating there is fluid behind tympanic membrane; usually occurs in children 8-9 years old and sometimes in older people; very painful
cholesteatoma
invagination of the membrane; result of chonic otitis media
TM Perforation
tympanic membrane perforation
conductive hearing loss
sensorineural hearing loss; air sounds don’t get through the fluid or tympanic membrane punctured (does not relay sound well)
sensory neural hearing loss
sounds get to the organs of hearing, but because of a neural issue such as a cochlear nerve; sound isn’t transmitted as electrical signals to your brain
acoustic hearing loss
happens around acoustic nerve
hearing loss is so profound
nothing really helps to augment sound;cochlear implants were invented (like a bionic ear)
outer ear problems
otitis externa (swimmer's ear) cerumen impaction skin cancer trauma congenital deformities
middle ear problems
otitis media cholestreatoma cancer TM perforation conductive hearing loss
inner ear
sensorineural hearing loss
acoustic neuromas
noise injury
vertigo
cochlear implants
used for bilateral profound hearing losee
cochlear implants in inner ear
well is placed in bone for the implant that has a wire that goes directly through the cochlea
after cochlear is in inner ear,
a headpiece will be placed on the skin—> electrical signal—> stimulates electrical nodes along the wire which stimulates diff nerves along the cochlea
hair cells in cochlear die off causing no hearing
everything else works such as the nerve (nerve is still intact)
if a tumor is in the ear instead, would a cochlear implant work?
no
nose + paranasal sinuses
epistaxis polyps allergic rhinitis sinusitis neoplasms
epistaxis
nose bleeds
what acts as a shock absorber on the face
midface
where do polyps grow
within the nose
kiesselbach’s plexus
where many arteries coalesce; prone to drying when it’s cold ; medication like warfare may have more epistaxis; those with hypertension;
artery associated with epistaxis
external and internal carotid artery
90% epistaxis bleeding from where?
kiesselbach’s plexus
What can cause epistaxis?
coagulopathy
digital trauma
hypertension
epistaxis
ID site cautery pack ligate blood vessels embolization
what cauterizes blood vessels?
silver nitrate
what burns the vessels that are bleeding?
electrocautery
pack
nasal tampons
posterior pack
water is used to add pressure
embolization
inject materials that will coagulate the location of bleeding
nose should be kept moist during epistaxis
prevention
nasal saline spray
vaseline at night
nasal polyps
edematous nasal mucosa
usually allergic
unilateral risk of neoplasm
if polyp is only on one side, it is probably not an allergy but a
neoplasm!
nasal polyps have fleshy interiors instead of
fluid
nasal polyps symptoms
nasal obstruction
anosmia
infection
anosmia
inability to sense smell
infection can back up sinuses and lead to
sinusitis
nasal polyp treatment
observation allergy evaluation nasal and systemic steroids surgery usually recur
who usually gets nasal polyps
teens and 20s if you’ve had lifelong history of allergies as a kid
nasal sprays can be used
chronically
allergic rhinitis and sinutsitis
seasonal or constant nasal discharge-initially clear sneezing itchy eyes -allergy evaluation -allergy shots -avoidance -antihistamines -nasal systemic steroids
sinusitis
- pain
- malaise, nasal obstruction, headache, purulent rhinorrhea
- usually after URI or allergic rhiintis
rhinitus
runny nose ect, allergic rhinorrhea would be clear instead of purulent
sinusitis vs. rhinitis
sinusitis has pain
black in CT
air
gray in CT scan
density
unilateral maxillary sinusitis
neoplasm or dental origin
organisms that cause sinusitis
strep, staph, H. influenza
sinusitis treatment
- antibiotics for 3 wks
- decongestant
- rhinitis medicamentosa
- surgery
decongestant
oxymetazaline spray, 3 days
nasal sprays for allergic rhinitis, use
whenever needed
oxymetazaline spray
- fast acting sprays
- be wary of rhinitis
medicamentosa
-only use for 3 days at a time or else= vasodilation and nose gets very stuffy
sometimes surgery for sinusitis is required to
open sinuses
complications of sinusitis
orbital cellulitis
abscess
meningitis
brain abscess
orbital cellulitis is a result of
sinusitis
neoplasms
- rare
- juvenile nasopharyngeal angiofibroma
- hard wood, heavy metal adenocarcinomas, SCCa
neoplasm risk
malignancy
nasopharyngeal neoplasms common in males from
canton province in China
nasopharyngeal angiofibroma
juvenile- benign process in nasopharynx, man has chronic nose bleeds from one side and you see a lesion when you look in
carpenters who breathe in wood
associated with adenocarcinomas
oral cavity/ pharynx
- tonsillitis/pharyngitis
- infections
- cancer
viral tonsillitis / pharyngitis
mononucleosis related to ebstein barr virus
bacterial tonsillitis / pharyngitis
strep group A beta hemolytic or H. influeza, corynebacterium which causes diphtheriae
hypertrophy of tonsils, you want to rule out
acute mononucleosis
white spots off tonsils; can be indication of
strep throat
tonsillitis/pharyngitis symptoms
odynophagia
fever
exudate
tonsillitis / pharyngitis treatment
antibiotics + rehydrate
-make sure children are well hydrated, especially when they have sore throats and don’t want to drink
tonsillectomy
- 4-6 episodes/ yr
- 3-4 episodes each of 2 consecutive years
- 3 episodes each 3 consecutive years
- asymmetric tonsils
tonsillectomy
in top 5 most painful procedures
lingual tonsils
adenoids; potential lymphoma may occur from lymphoid tissue
unilateral peritonsillar abscess
-displacement uvula and tonsil
-secondary glands of weber treatment
treatment= aspiration, I+D, “hot tonsillectomy + antibiotics
pus collection in place next to tonsils, treat with
aspiration
adenotonsillar hypertrophy
- OSAS
- Snoring
- Mouth breathing
- Restless sleep
- respiratory pauses
history of getting mono= severe sore throat can result in
adenotonsillar hypertrophy which will call for a tonsillectomy which will take care of the airway obstruction
head + neck cancer
-head + neck cancer 6% of all cancers
-30% oral cavity
-4th -5th decade
males> females
head + neck cancer
- localized pain
- odynophagia
- dysphagia
- hoarseness
- dyspnea
- bleeding
- EAR PAIN = RED FLAG
dysphagia
difficulty eating
odynophagia
painful swallowing
dyspnea
shortness of breath
ear pain
vagus to ear, when you get a sore throat, you also get ear pain too
risk factors for head and neck cancers
tobacco, alcohol, genetic
treatment for head and neck cancer
(stage I + II) + (surgery + surgery III + IV) combined
what is associated with head + neck cancers
HPV
ear pain associated with
alcohol + tobacco
salivary glands
sialadenitis
sialolithiasis
neoplasms
sialadenitis
inflammation of a salivary gland
sialolithiasis
stones
sialodenitis
viral- mumps, CMV bacterial hypossecretion stasis obstruction
the main cause of bacterial sialadenitis
staph aureus (antibiotics needed)
sialolithiasis
- relapsing sialadenitis
- 20-40% radiolucent
- plain films (occlusal, AP, lateral, CT scan, Sialogram)
stone causes back up of saliva which causes
sialolithiasis
sialolithiasis
(also termed salivary calculi, or salivary stones), is a condition where a calcified mass forms within a salivary gland, usually in the duct of the submandibular gland (also termed “Wharton’s duct”).
sialolithiasis treatment
- E/O stone
- gland excision (when stone is very close to gland)
- antibiotics if you want to remove staph. aureus
salivary neoplasms
parotid
pleomorphic adenoma
submandibular
minor, benign, malignant
percent parotid salivary neoplasms
**80-85%
percent pleomorphic adenoma salivary neoplasms
**85%
% submandibular salivary neoplasms
**50% benign
percent minor salivary neoplasms
**20% benign
75% malignant
what nerve goes through the parotid
facial
main risk of removing a benign tumor of parotid galnd
facial nerve
branches of facial nerve
Temporal Zygomatic Buccal Mandibular Cervical
facial plastic surgery
reconstructive + cosmetic
cosmetic
- aging face
- rhinoplasty
- otoplasty
rhinoplasty
plastic surgery on the nose
otoplasty
surgical + nonsurgical procedures correcting deformities and defects of the pinna and for reconstructing a defetive or deformed or absent external ear
foreign bodies in airway
hypopharynx larynx trachea bronchus esophagus
foreign bodies in airway can lead to
stridor
cough
pneumonia
stridor
harsh or grating sound; someone trying to breathe across an obstruction
