ENT I Flashcards
what are Aphthous ulcers (canker sores)?
- Single or multiple, shallow, mucosal ulcerations that are common, often recurrent and painful
What causes these canker sores
- Can be associated with immunologic disorders e.g. inflammatory bowel disease
How long to canker sores take to resolve
- Usually self-resolve in a week but may persist for longer especially in immunocompromised patients
What causes oral herpes?
Oral herpes usually caused by HSV-1 but HSV-2 (genital herpes) can also occur
How does herpes simplex virus infection present in children?
In children, usually present as acute herpetic gingivostomatitis (usually between 2-4 yo) with
vesicles and ulceration of the oral mucosa
how does herpes infection present in adults
- In adults, usually presents as acute herpes pharyngitis
What happens after acute herpes infection?
- After acute infection, the virus treks along regional nerves and becomes latent within local ganglia.
what happens when the latent virus reactivates in ganglia?
Reactivation results in recurrent herpetic stomatitis
In immunocompromised pts, herpes can persist as_________________
chronic mucocutaneous infection
What is thrush
Thrush refers to the pseudomembranous form of oral candidiasis: superficial gray-white inflammatory membrane composed of matted organisms in a fibrinosuppurative exudate that can be scrapped off, showing an erythematous inflammatory base
In what case can thrush be invasive?
Immunosuppression
What is Ludwig’s angina?
This is a severe, acute streptococcal cellulitis involving the neck, tongue and back of the throat.
What is Vincent’s angina?
Vincent’s angina is a painful condition of the throat
Characterised by local ulceration of the tonsils, mouth and pharynx.
What causes Vincent’s angina?
Vincent’s Bacillus
What is anotia/atresia?
Total Absence of the auricle and narrowing/absenc of external auditory meatus
What is microtia?
Developmental malformation of the auricle and narrowing/absence of the ext. canal.
What is accessory auricle?
Anomaly of the tragus area
what is a preauricular sinus?
This is a dent, dip, or nodule anywhere adjacent to the external ear. Susceptible to infection
What is another term for laceration of the ear?
Hematoma auris
What is perichondritis of the pinna?
Inflammation of the perichondrium (CT lining the cartilage of the pinna)
What is the cause of perichondritis?
- Can follow trauma to the cartilage, such as hematoma auris, surgery (mastoid surgery), otitis externa and piercing
- It is commonly caused by pseudomonas: Fever, pain, redness, swelling. It causes narrowing and further low hearing level.
What are the complications of perichondritis or trauma?
Cauliflower ear (end stage of untreated hematoma)
How does cauliflower ear form?
hematoma auris»> Ischaemia» necrosis» Ear deformity
What is otitis externa?
Acute or chronic infection of the whole or part of the skin of the external ear canal. Any pathology of the skin can also affect the external ear.
Explain the the pathophysiology of otitis externa
Aggressive washing of wax or retention of water
Microtrauma of the ear canal caused by nails or cotton swabs.
Type of otitis externa where there is a small rounded swelling in the external canal
Localised otitis externa (furuncle)
What is the type of otitis externa where there is general narrowing of the ear canal? (swimmer’s ear)
Diffuse infective otitis externa
What is a fungal infection of the ear canal called?
otomycosis
Describe herpetic otitis externa
Herpes zoster oticus is a form of Herpes zoster that causes pre-eruptive (pre-herpetic) lesions that become reactivated from either the trigeminal or cervical ganglions
What are the characteristics and complications of herpetic otitis externa?
Characterized by Painful vesicles
Complication: Facial n. paralysis
Which types of otitis externa are painless?
Eczematous and seborrheic otitis externa
What is referred earache?
It is pain in the ear caused by a disease in an area supplied by the same nerve that supplies the ear.
nerves associated with referred earache and the diseases commonly affecting areas supplied by these nerves (4)
-Cervical II & III: cervical spondylosis, neck injury (disc, muscle spasm) etc.
○ V (trigeminal) cranial nerve: dental infections, sinonasal diseases etc.
○ IX (glossopharyngeal) cranial nerve (branch of CN 9): tonsillitis, pharyngitis, post-tonsillectomy, carcinoma etc.
○ X (vagus) cranial nerve: tumors of hypopharynx, larynx & Oesophagus
What is Meniere’s disease?
It is a rare disorder affecting the labyrinth of the inner ear, leading to progressive hearing loss.
What are the symptoms of Meniere’s disease?
Vertigo, tinnitus, hearing loss, sensation of pressure in the ear
A benign tumour of the acoustic nerve sheath. Symptoms result from pressure exerted in the tissues surrounding ear. What is it called?
Acoustic neuroma
What is the term for impairment of hearing resulting from old age?
Presbycusis
