ENT surgery incorrects Flashcards
episodic vertigo with nystagmus triggered by pressure changes eg clapping, vasalva maneuvre PLUS hearing loss following head trauma is most likely due to?
A perilymphatic fistula
Hearing loss, no ear pain or discharge. Pregnant woman. Webber tests = sound louder in affected ear. And bone conduction greater than air conduction in affected ear. What type of hearing loss is this? Most likely cause?
Conductive hearing loss! = otosclerosis
Conductive hearing loss caused by disorders of external canal, tympanic membrane eg perforation, middle ear (otitis media, cholesteatoma) or otosclerosis
Aminoglycoside antibiotics, Menieres, Shawnnoma, presbycusis, Alport syndrome all cause sensorineural hearing loss
Must distinguish causes of conductive vs sensorineural hearing loss
34 yo woman with hearing loss in left ear. No other symptoms. increased speech understanding in noisy rooms (sign of conductive hearing loss).positive family history of hearing loss. Most likely diagnosis?
Otosclerosis = bony overgrowth of ossicles, stiffening of stapes
Excessive bone resorption may expose underlying blood vessels = red hue behind tympanic membrane
Voice hoarseness and irregular exophytic growths on vocal cords most likely due to what type of infection?
VIRAL
Hpv
Patient has recurrent respiratory papillomatosis
Contrast to fungal infection which typically causes thickened white patches
First line management of acute barotrauma resulting in tympanic membrane rupture?
Reassurance and follow up !!
Tympanoplasty only if it doesn’t resolve
Ear pain with normal ear exam + cervical lymphadenopathy! in old patient a history of smoking! is most likely due to? Next step in management?
Cancer of the base of tongue/hypopharynx/larynx
Flexible laryngopharyngoscopy
Note - other more common causes of refereed ear pain = dental disease, temporomandibular joint disorder
What is ludwig angina? Cause? Symptoms
Lower jaw cellulitis
Typically an infected molar
Dysphagia, odynophagia, drooling
Retropharyngeal abscesses present with neck pain, odynophagia and fevers following penetrating trauma to pharynx what is the feared complication of this?
Acute necrotising mediastinitis - cxr shows widened mediastinum
Cavernous sinus thrombosis symptoms, causes?
Headache, fever, cranial nerve deficits = diplopia, proptosis. Spread of infection from sinuses teeth
First step in management of suspicious thyroid nodule after ultrasound (even in pregnancy)
Fine needle aspiration biopsy.
This will determine if and when a thyroidectomy is needed eg before or after surgery
An enlarged ulcerated tonsil with cervical adenopathy is most likely what diagnosis?
In absence of smoking and alcohol greatest risk factor?
Squamous cell carcinoma head and neck
HPV!!
A patient w a history of rhinos from Asia. However, now experiencing congestion w epistaxis, headaches. Mass in posterior nasal cavity. Most likely diagnosis? Risk factor?
Nasopharyngeal cancer
Epstein Barr virus
(May also cause cranial nerve palsies, otitis media)
Unilateral rhinorhea increasing at times of raised ICP eg bending over is most likey what ?
CMost commonc cause?
CSF fluid rhinorrhea
Head trauma!! Especially base of skull
Can cause meningitis - inpatient management
Child with URTI, 1 week later lump in anterior left side of neck draining mucopurulent fluid. Most likely diagnosis
Branchial cleft cyst
