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Surgical Specialties > ENT > Flashcards

ENT Flashcards

1
Q

Which antibiotic when given for pharyngitis of an EBV origin causes a pathogonomic rash?

A

Amoxicillin

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2
Q

Centor criteria:

The presence of 3+/4 suggests infection with

A
  • tonsillar exudate
  • tender ant. cervical lymphadenopathy
  • history of fever
  • absence of cough

Streptococcus

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3
Q

What is Lemierre syndrome?

Acute septicaemia and jugular vein thrombosis secondary to infection with

A

Fusobacterium species + septic emboli (to lungs, bone, muscle, kidney, liver)

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4
Q

Don’t do tonsillectomy unless your sure:

Give 3 points

A
  • recurrent sore throat is due to tonsillitis
  • the episodes are disabling and prevent normal functioning
  • > 7 clinically signif adequately treated sore throats in last year
  • > 5 in each of last 2 years or
  • > 3 in each of last 3 years
  • OBSTRUCTIVE SLEEP APNEA
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5
Q

What is laryngomalacia (common cause of chronic stridor in children)?

A

When arytenoids/epiglottis are soft and floppy so as baby breathes they fall in and block the airway

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6
Q

What type of tumour can cause stridor? Related to which virus?

A

Laryngeal papillomata HPV related

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7
Q

What condition is the most common cause of stridor and what is the most common cause?

A

Croup aka laryngotracheobronchitis

Parainflueza virus

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8
Q

What is the treatment for mod/severe laryngotracheobronchitis/croup?

A

single dose dexamethasone 0.15mg/kg (or presnis 1-2mg/kg)

Admit if severe

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9
Q

What is the treatment for mild laryngotracheobronchitis/croup?

A

reassure

usually self-limiting ~48hrs

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10
Q

In an anti-vax adult presenting with a severe sore throat and painful swallowing what emergency must you consider?

A

Acute epiglottitis (Haemophilus Influenzae

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11
Q

85% cases of laryngomalacia resolve by 2yrs, what signs warrent further investigation?

A
  • failure to thrive

- cyanotic episodes

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12
Q

Which surgery is done in severe cases of laryngomalacia?

A

Aryepiglottoplasty

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13
Q

How should you initially manage acute epiglottitis?

A
  • keep pt upright
  • don’t examine throat
  • don’t distress pt
  • summon anesthetist and ENT surgeon
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14
Q

How do you diagnose suspected acute epiglottitis? What should be open and ready in case needed?

A
  • laryngoscopy with pt intubated

- have tracheostomy set and tube prepared

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15
Q

How is acute epiglottitis treated? Give 2

A
  • dexamethasone

- antibiotics

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16
Q

Laryngeal paralysis can be congenital and may affect one or both sides. Signs include:

A
  • hoarse, breathy cry

- feeding difficulties + aspiration

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17
Q

Bilateral Laryngeal paralysis in a baby that is agitated can lead to ___ requiring treatment by___

A
  • respiratory distress
  • urgent airway intervention
  • +/- tracheotomy, surgery
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18
Q

Acute airway obstruction in adults 3 key initial management aspects?

A

-give 02/heliox -reduces work of breathing
-nebulised adrenaline 1ml of 1:1000 with 1ml saline
-monitor obs closely
call on call ENT reg and anaesthetist
-take collateral hx

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19
Q

Acute airway obstruction in adults, 3 options for treatment, in order of escalation?

A
  • Endotracheal intubation
  • Emergency needle cricothyroidotomy
  • Surgical Cricothroidotomy
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20
Q

What does an Emergency needle cricothyroidotomy do?

A
  • works as a temporary measure until tracheostomy can be done
  • it oxygenates but doesn’t ventilate so CO2 builds up
  • lasts only up to 45mins
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21
Q

After how long should you investigate a hoarse voice? What red flag can it be a presentation of? Especially in__?

A
  • 6weeks
  • laryngeal carcinoma
  • smokers
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22
Q

With a hoarse voice, what screening questions should you ask?

A
  • GORD
  • dysphagia
  • smoking
  • stress
  • singing and shouting
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23
Q

What investigations can be done to assess larynx in pt presenting with hoarse voice?

A
  • laryngoscopy (assess cord mobility and mucosa)

- video flex or rigid endoscopy with stroboscopy

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24
Q

5 ddx of hoarse voice

A
  • Laryngeal cancer
  • vocal cord palsy
  • laryngitis
  • reflux laryngitis
  • Reinke’s oedema
  • vocal cord nodules
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25
Q

Laryngitis is often self-limiting and viral but what can it be secondary to?

A
  • staph/strep bacterial infection
  • GORD
  • autoimmune e.g. RA disease
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26
Q

What are the symptoms of laryngitis?

A
  • hypopharngeal pain
  • dysphagia
  • pain on phonation
  • hoarseness
  • fever
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27
Q

Reflux laryngitis is chronic laryngeal symptoms associated w GORD, suggest 3 treatments:

A
  • PPI
  • diet/lifestyle change/ weight loss
  • elevate head of bed
  • surgical fundoplication
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28
Q

What is Reinke’s oedema? In whom is it commonly seen?

A
  • chronic cord inflamm. from smoking/voice abuse -> gelatinous fusiform enlargement of cords
  • hypothyroid, elderly female smokers
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29
Q

The deep gruff voice from Reinke’s oedema can be treated by…

A
  • quitting smoking
  • SALT
  • laser therapy ()
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30
Q

Where do vocal cord nodules occur (often due to voice abuse –> husky voice)?

A
  • junction of anterior 1/3rd and posterior 2/3rds of cord

- this is the middle of the membranous cords (posterior is cartilage)

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31
Q

Vocal cord nodule treatments:

A
  • speech therapy (early)

- surgical excision

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32
Q

Name some Vocal cord nodule causes ddx..

A
  • hyperkeratosis 2* to alcohol, smoking, pollution)
  • leukoplakia
  • granulomata
  • papillomata (from HPV)
  • polyps, cysts
  • high dose ICS inhalers
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33
Q

RLN supplies the ___ muscles of the larynx except ____ which is supplied by the ___

A
  • intrinsic
  • cricothryoid
  • external branch of superior laryngeal nerve
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34
Q

RLN is responsible for _ and _ of the vocal cords.

It arises from the __ nerve.

A

abduction and adduction

vagus

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35
Q

Signs of laryngeal nerve palsy:

A
  • weak “breathy” voice + weak cough
  • repeated coughing/aspiration
  • exertional dyspnoea
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36
Q

Explain why you can get exertional dyspnoea with a laryngeal nerve palsy:

A
  • at rest contralat. cord can compensate by increased abduction
  • on exertion narrow glottis reduces air flow
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37
Q

State the stepwise investigations into a laryngeal nerve palsy:

A
  • CXR (if no recent surgery history)
  • if normal do CT
  • +/- US thyroid
  • +/- OGD
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38
Q

For non-malignant laryngeal nerve palsies, treatments include:

A
  • injections/throplasty to support compensating cord

- reinnervation e.g. ansa-cervicallis to RLN

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39
Q

Name 3 speech articulation disorders that can result in a hoarse voice?

A
  • spasmodic dysphonia
  • muscle tension dysphonia
  • functional speech disorders in children
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40
Q

What is spasmodic dysphonia?

A

A focal laryngeal dystonia of unknown cause, involuntary spasms of larynx cause strained strangled breaks in connected speech

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41
Q

How can spasmodic dysphonia treated?

A

Botox injections

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42
Q

Muscle tension dysphonia is a functional disorder, what do patients complain of?

A

Husky, hoarse voice that tires easily
Globus symptoms
Frequent clearing of throat

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43
Q

What is Muscle tension dysphonia associated with?

A
  • voice missuse

- psychological stress

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44
Q

What are the 2 most common causes of a RLN palsy? other causes ?

A
  • cancer (30%)
  • iatrogenic (surgery-25%)
  • CNS: polio, syringomyleia
  • TB
  • aortic aneurysm
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45
Q

What are the 4 stages in the natural history of acute otitis media?

A
  • pre-suppuration
  • suppuration
  • tubal occlusion
  • resolution
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46
Q

What is the treatment for AOM? Generally what would warrant abx? Which abx?

A
  • analgesia and anti-pyretics
  • if persists >4days
  • Amoxicillin/Clarithromycin
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47
Q

In what groups/presentations of AOM should Abx always be given?

A

<2yrss old
bilateral
Perforated

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48
Q

If mastoiditis arises as a complication of AOM, what should you do? (3)

A
  • urgent ENT review, admit
  • IV Abx
  • Myringotomy +/-grommets
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49
Q

What is the commonest cause of acquired hearing loss in children?

A

-glue ear: chronic middle ear inflammation with accumulation of fluid but no sign of infection

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50
Q

How does the ear look on exam in a child with glue ear?

A
  • dull and retracted tympanic membrane
  • loss of light cone
  • air bubbles/fluid level behind TM
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51
Q

Glue ear that is unilateral in adults should be investigated for what? with? esp in whom?

A
  • nasopharyngeal cancer
  • nasoendoscopy
  • chinese and >40yrs
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52
Q

What is suppurative otitis media? how does it present? for how long? What kind of hearing loss?

A
  • chronic inflamm of middle ear and mastoid cavity

- painless otorrhoea >2weeks and conductive hearing loss

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53
Q

What is the treatment for suppurative otitis media?

A

ENT referral
Aural toilet
Topical abx
+/-myringoplasty/tympanoplasty

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54
Q

What is a cholesteatoma? What type of epithelium? Where most common?

A

-expanding destructive growth of keratinised squamous epithelium in middle ear especially the “attic”

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55
Q

How does cholesteatoma erode bone?

A
  • local expansion

- releasing enzymes e.g. alkaline phosphatase

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56
Q

Symptoms of cholesteatoma:

A

ottorhoea, conductive hearing loss, ostitis

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57
Q

If cholesteatoma is untreated, what complications can arise?

A
  • facial nerve palsy
  • labyrinthitis
  • meningitis
  • extra/sub-dural abscess
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58
Q

Management of cholesteatoma?

A

-always surgery:: mastoidectomy

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59
Q

Name3+ RFs for otitis externa:

A
  • cotton bud use
  • swimming
  • hot climate
  • immunocompromised
  • diabetes
  • eczema
60
Q

How may otitis externa present?

A

severe otalgia
discharge, aural fullness
decreased hearing

61
Q

What is the management for otitis externa? Which abx?

A
  • swab for MC&C
  • microsuction
  • pope wick insertion
  • steroid drops
  • abx drops: ciprofloxacin/ofloxacin
62
Q

Name 2 complications of untreated otitis externa:

A
  • perichrondritis

- pinna cellulitis

63
Q

What is Necrotising Otitis Externa?

A

-OE with bone involved (osteomyelitis of ear canal and temporal bone)

64
Q

How may Necrotising Otitis Externa present?

A

-severe otalgia +/- CN palsies

65
Q

What is the most common organism causing Necrotising Otitis Externa?

A

Pseudomonas

66
Q

Management for Necrotising Otitis Externa? Which abx? Dose is 500mg BD

A

-admit for IV abx
-Piperacillin/Tazebactam for 2 weeks
-or Ciprofloxacin for 6 weeks
then do microsuction

67
Q

Name 5 causes of conductive hearing loss:

A
  • wax
  • infection
  • trauma -> e.g. stenosis, ext damage
  • foreign body
  • absence of ossicles (congenital)
  • ossisclerosis (fixation)
68
Q

Name 3 causes of sensioneural hearing loss?

A
  • age related presbycusis
  • tumour of CNVII, VIII
  • tumour at CPA e.g. acoustic neuroma
  • ototoxic drugs
  • cochlear pathology
69
Q

Name 3 ototoxic drug:

A

Vancomycin, loop diuretics-ferosemide, quinine, cisplatin,

70
Q

What is the definition of SSNHL: sudden sensorineural hearing loss? dB loss? How many frequencies? Time frame of loss?

A
  • 30dB+ sensorineural loss over at least 3+ contiguous audiometric frequencies
  • occurring in less than 3 days
71
Q

SSNHL management? Note only 60% recover.

A
  • high dose steroids (60mg prednisolone/day for a week) or dexameth injections intra-tympanically
  • do a scan to rule out causes
72
Q

98% of acute sinusitis is of viral cause post-URTI, how should it be treated? When should abx be considered, which ones?

A
  • analgesia, nasal douches and decongestant

- if symptoms >1week give amoxicillin/doxycycline oral

73
Q

What is a possible cause of recurrent acute sinusitis that can be ruled out via a referral to ENT with imaging? If present what is mainstay of treatment?

A

A polyp in the middle meatus

Intranasal or oral steroids

74
Q

you get referred pain to the ear with tonsillitis because the tonsillar fossa is supplied by the ___, and pain is referred along the __ branch of this nerve

A 
Glossopharyngeal nerve (CN IX)
Tympanic branch of CN IX
75
Q

Name 3 viral causes of tonsillitis and 3 bacterial:

A

Viral: rhinovirus, parainfluenza, adenovirus, EBV
Bacterial: strep pneumo, strep pyogenes, staph aureus, haemophilus influenza

76
Q

What group of organisms does streptococcus pyogenes belong to?

A

Group A B-haemolytid Streptococcus (GABHS)

77
Q

Name 2 of the criteria for admission in tonsillitis?

A
  • unable to eat/drink

- peritonsillar abscess

78
Q

If 3+ centor criteria present what Abx should be administered (2)

A
  • benzylpenicillin

- metronidazole

79
Q

Alcohol and contact sports advice following EBV infection?

A

-avoid alcohol for 2 months and contact sports for 6 weeks

80
Q

Quinsy is a collection of pus between the __

A

tonsillar capsule and the pharyngeal constrictor

81
Q

What is trismus?

A

Jaw muscle spasm so the mouth is tightly closed

82
Q

What is the management of Quinsy (3)

A
  • LA incision and drainage/aspiration of puss
  • IV dexamethasone (8mg)
  • IV benzylpenicillin + metronidazole
83
Q

Management of post-tonsillectomy bleed:

A
  • ABCDE, admit and monitor
  • crossmatch 2 units
  • transexamic acid
  • H202 mouthwash
  • adrenaline soaked guaze
84
Q

OSA is diagnosed when there are more than __ episodes/hour, when the ___ muscles relax during sleep causing upper airway __

A
  • 5
  • pharyngeal
  • obstruction
85
Q

name 2 causes of paediatric OSA and its treatment

A
  • adenotonsillar hypertrophy
  • craniofacial or neuromuscular abnormalities
  • adenotonsillectomy
86
Q

Gold standard rx for adult OSA is __ but not well tolerated, next best is.. :)

A
  • CPAP

- lifestyle change (weight, alcohol, stop sedative meds.)

87
Q

What ear trauma can cause a cauliflower ear? How is it prevented?

A
  • pinna haematoma
  • not drained cartilage necrosis -> deformity
  • must be drained so fluid doesn’t build up
88
Q

In Bell’s Palsy what motor neurone is affected and forehead condition? What must be protected? to avoid?

A
  • lower MN
  • forehead droops too
  • protect eye w drops and bandage
  • to avoid exposure keratitis
89
Q

What is Ramsey Hunt S?

A

-Bell’s palsy with vesicles in Pinna from shingles

90
Q

What 5 vessels make up the Little’s area of Epistaxis

A
  • ant. ethmoidal
  • post. ethmoidal
  • SPHENOPALANTINE
  • greater palatine
  • superior labial
91
Q

From where does the sphenopalatine artery of epistaxis originate from?

A

-maxillary branch of the external carotid artery

92
Q 
Epistaxis management: in escalation
-what should be examined, for what
-cauterise w ? 
-Which abx prophylaxis
Last step?
A

ABC, apply pressure head down

  • ice to neck
  • examine oropharynx & suction visible clots
  • wide bore cannulae, fluid resus to maintain BP#
  • packing or cauterise w silver nitrate
  • coamoxiclav
  • ligate artery
93
Q

Why is septal haematoma an emergency? What is the risk?

A

Saddle deformity from collapse without I&D because septum gets supply from mucopericardium only -> necrosis

94
Q

Why is removal of a nasal foreign body urgent?

A

Risk of aspiration

95
Q

Thumb sign on a lateral x-ray in a child with stridor and odynophagia is suggestive of?

A

Acute epiglottitis

96
Q

Name 3+ non-malignant, non-neurological causes of dysphasia

A
  • benign structures
  • pharyngeal pouch
  • achalasia
  • systemic sclerosis
  • oesophagitis
  • IDA
97
Q

Name 3 neurological causes of dysphagia

A
  • bulbar palsy
  • lateral medullary syndrome
  • myasthenia gravis
  • syringomyelia
98
Q

If pt with dysphagia finds it difficult to make the swallowing movement and has cough on swallowing what dx do you suspect?

A

Bulbar palsy

99
Q

If pts neck bulges and gurgles on drinking, with regurgitated food what is the likely dx?

A

Pharyngeal pouch

100
Q

Name 4 associations of HNSSC (head and neck SCC)

A
  • alcohol
  • HPV (oropharyngeal)
  • smoking
  • vitamin A & C defiiciency
  • GORD
101
Q

How is suspected H&N SCC investigated (3)

A
  • fibreoptic endoscopy
  • FNA/biopsy of masses
  • CT or MRI to stage neck nodes
102
Q

A smoker with painful persistent ulcers, white patched on mucosa and otalgia is concerning for…

A

Oral cavity/tongue cancer

103
Q

What is the most common cause of oropharyngeal cancer?

A

HPV especially type 16

104
Q

What are the 3 forms of voice restoration available post-laryngectomy?

A
  • oseophageal speech
  • trans-oesophageal puncture
  • artificial larynx (servox)
105
Q

The facial nerve arises from the __ exiting the brianstem at the ___,it passess through the ____ before emerging from the __ foramen to pass into the ___.

A
  • pons
  • pontomedullary junction
  • middle ear
  • stylomastoid foramen
  • parotid gland
106
Q

Name the 3 intracranial branches of the facial nerve and their functions. Clue: tears, ears and tongue

A
  • greater superficial petrosal nerve (lacrimation)
  • branch to stapedius
  • chorda tympani (ant 2/3rd tongue taste)
107
Q

Name as many extracranial facial nerve branches as poss: (3 + 5 in parotid)

A

posterior auricular nerve
nerve to digastric post belly
nerve to stylohyoid
in parotid: Temporal, zygomatic, buccal, marginal mandibular, cervical

108
Q

Facial palsy causes:

give e,g, of intracranial, intra-temporal, infratemporal

A

intracranial: tumour, stroke, polio, MS, CPA lesions
intratemp.:otitis media, Ramsey hunt s, cholesteatoma
Infratemp: parotid tumours, trauma to nerve canal

109
Q

A facial nerve palsy is a __ motor neurone lesion therefore (unlike a stroke) the forehead muscles and closing the eyes ___

A
  • lower MN

- forehead will be paralysed fully

110
Q

Which disease can cause a facial nerve palsy?

Therefore what investigations are useful if suspected?

A

-Lyme’s disease
-Diabetes
do ESR, glucose and Lyme disease serology

111
Q

Name some common causes of bilateral facial nerve palsy:

A 
lyme disease
Guillan-Barre
leukaemia
sarcoidosis
EBV
Myasthenia gravis
Trauma
112
Q

Why do you get hyperaccusis with bells palsy? And what medication has been shown to improve rate of recovery if given within 72hr symptom onset?

A
  • due to stapedius palsy

- prednisolone

113
Q

What is the likely diagnosis of a midline neck lump in an adolescent?

A

Dermoid cyst

114
Q

Cystic hygromas are macrocytic ____ malformations that ____ brightly. Treat by surgery or ___ sclerosant

A

Lymphatic malformations
Transilluminate
Hypertonic saline sclerosant

115
Q

What is sialadenitis? Who does it commonly affect?

A

Acute infection of submandibular/parotid glands.

Elderly/debilitated pts w poor oral hygiene

116
Q

Name something that can cause chronic inflamm ir recurrent attacks of sialadentitis

A
  • strictures from previous infection

- salivary gland stones

117
Q

Sialolithiasis are ____. These usually affect the ____ where secretions are ___ and richer in ___

A

Salivary stones
Submandibular gland
Thicker
Calcium

118
Q 
Complete the stats on salivary gland tumours
80% Are..
80% Are..
80% Are..
50% of submandibular Are..
A 
80%
-occur in parotid 
-benign pleomorphic adenomas 
-in the superficial lobe
50% of submandibular = malignant
119
Q

Warthin’s tumour (adenolymphoma) usually occur in __ most commonly in the ___ gland. Treatment is __

A

Elderly men
Parotid gland
Partial parotidectomy

120
Q

What is the mode of spread of adenoid cystic tumours, these are painful and slow growing

A

Peri neural infiltration (along nerves)

-surgical excision and radiotherapy

121
Q

Vincent’s angina (necrotising ulcerative gingivitis) is associated with ___ and caused by anaerobes e.g. __ +/- spirochetes e.g.___ treat with __ and ___ and dental referral

A

Smoking or HIV
Fusobacteria
Borellia vincentii
Amoxicillin and metronidazole

122
Q

What should you investigate with MRI to rule out in a pt with unilateral tinnitus?

A

Acoustic neuroma

123
Q

Acoustic neuroma arises from Schwann cells of the __ nerve. It is a __ tumour but can grow indolently and put __ on cranial nerves _ &_ and can continue to grow into the CPA acting as a ___

A

Superior vestibular nerve
Benign
Pressure CN VII & VIII
Space occupying lesion

124
Q

95% acoustic neuromas are sporadic the other 5% are related to___

A

Neurofibromatosis type 2

125
Q

What type of tinnitus can occur with acoustic neuromas?

A

Unilateral non-pulsatile

126
Q

Slow growing acoustic neuromas can be watched and waited w MRI, what surgical approaches can treat large/fast growing?

A
  • translabyrinthine, middle fossa, retrosigmoid approaches

- stereotactic radiosurgery

127
Q

What conditions match the following durations of vertigo:

  • Seconds-minutes
  • 30min-30hr
  • 30hr-1week
A
  • BPPV
  • Meniere’s, migraines
  • acute vestibular failure
128
Q

Benign paroxysmal positional vertigo are attacks lasting >__ provoked by —

A

30seconds

Head turning/turning over in bed

129
Q

What is the pathophys of BPPV? Displacement of…

A

Displacement of otoconia stimulates the semicircular canals

130
Q

BPPV is usually self limiting, if it persists what can you do that is often effective?

A

Epley manoeuvre (head moved in 4 sequential positions, 30s rest between each to move to otoconia away from sensitive posterior canals)

131
Q

Vestibular migraines cause vertigo attacks what can you treat with/consider?

A
  • vestibular suppressants
  • trip tans for prolonged symptoms
  • consider migraine prophylaxis
132
Q

Ménière’s disease is 2 or more episodes of vertigo lasting 20min-12hr. The cause is an abnormality of ___ production leading to __

A

Endolymph production leading to endolymphatic hydrops in inner ear

133
Q

What is the acute medication of choice for Ménière’s disease? And the prophylactic medication?

A

Acute: Prochlorperazine 3mg/8hr buccal
Prophx: Betahistine 16mh/8hr oral

134
Q

What is acute vestibular failure/labyrinthitis? Often following what? Can last? But full recovery?

A

Sudden attacks of unilateral vertigo and vomiting
Often post-URTI
Lasts 1-2 days but full recovery months

135
Q

Suggest medications for acute symptom control of acute vestibular failure/labyrinthitis

A
  • vestibular suppressants
  • cyclizine
  • prochlorperazine
136
Q

Mild sinusitis that persists >10days can be treated with:

A

intranasal corticosteroids e.g. mometasone

137
Q

Management/investigating acute sinusitis may include:

A
  • nasal endoscopy
  • culture
  • imaging
  • admit for IV abx if severe/surgery
138
Q

Name 4 complications of sinusitis

A
  • orbital cellulitis/abscess (!)
  • intracranial e.g. meningitis, encephalitis, cerebral abscess, cavernous sinus thrombosis
  • mucoceles that can become pyoceles
  • osteomyelitis
139
Q

Pott’s puffy tumour is a complication of sinusitis in which a ___ abscess arises from __

A
  • subperiosteal

- frontal osteomyelitis

140
Q

What is choanal atresia (a cause of nasal congestion in infants)

A

-congenital blockage of one or both nasal passages by bone or tissue

141
Q

Allergic rhinitis can be relieved by:

A
  • avoidance of trigger
  • nasal saline irrigation
  • antihistamine e.g. loratadine
  • intranasal corticosteroid spray e.g. mometasone
142
Q

When is FESS (Functional Endoscopic Sinus Surgery) done?

A

-max. medical rx failed/to treat complications of rhinosinusitis

143
Q

What is/can de done in FESS (Functional Endoscopic Sinus Surgery) ?

A
  • max, ethmoid, frontal and sphenoid sinuses can be opened

- septoplasty and reduction of inf. turbinates

144
Q

What orbital complications may arise in FESS (Functional Endoscopic Sinus Surgery)?

A
  • breach of medial orbital wall ->periorbital bruising or haematoma (!)
  • damage to medial rectus muscle
  • optic nerve bruised or transected (!)
145
Q

What does this make you suspect.. -blood stained nasal discharge, nasal obstruction, cheek swelling ..

A

-cancer of the paranasal sinuses

146
Q

MRI/CT and endoscopy w biopsy can help diagnose a paranasal sinus cancer, what is the most common form? Any others. NB: Rx with radiotherapy and surgery

A
  • Squamous cell (50%)
  • lymphoma
  • adenocarcinoma
  • olfactory neuroblastoma…

Surgical Specialties (6 decks)

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