HENT Embryology Clinical Correlates

Question 1

What causes the formation of a preauricular pit? Why are they an issue?

Answer 1

the hillocks don’t fuse appropriately so you have pits in the auricle. They are pretty benign, but can get plugged and infected

Question 2

What sort of hearing loss should you check for in a patient with a preauricular tag?

Answer 2

sensorineural , because the external ear and the inner ear form at about the same time, so if there’s an issue with one ther emight be with the other

otherwise preauricular tags are totally benign

Question 3

Why might the ear stick out?

Answer 3

abscende of the antihelical fold, so the ear is just bigger in general and sticks out

otherwise ther emight just be too much cartilage in the conchal bowl

surgery to remove the extra cartilage or create the missing antihelical fold - then pin the air back a bit

Question 4

What type of hearing loss is common wiht microtia?

Answer 4

conductive

Question 5

What are the treatment options for microtia?

Answer 5

surgical repair - you can do a plastic reconstruction of the ear, or just use a plastic prosthetic

a soft band bone-anchored hearing aid will work really well because they only have conductive hearing loss, not sensorineural

Question 6

What will be the signs and symptoms of a choanal atresia?

Answer 6

newborn having difficulty breathing and can’t really breast feed because they’re forced to breath thorugh their mouth

nose will always run because mucous can’t drain into the oropharynx

Question 7

What syndrome should you consider in a newborn with bilateral choanal atresia?

Answer 7

CHARGE syndrome

coloboma eye

heart abnormalitis

retarded development

geintal defects

ear abnormlaities or deafness

Question 8

What membrane fails to rupture in choanal atresia?

Answer 8

nasobuccal membrane

Question 9

What happens if the dural diverticulum slips down through the foramen cecum intot he nose during development?

Answer 9

this means you get dermoid and epidermoid cysts along the course of the ermal sinus tract

or nasal glioma

or frontonasal encephalocele

Question 10

What is ankyloglossia?

Answer 10

when the tongue’s frenulum is too thick and the baby can’t latch onto the nipple because te tongue can’t really move.

Question 11

Why can you somtimes have cleft lip without cleft palate while other time you have cleft lip with cleft palate (or just cleft palate)?

Answer 11

because the lips and the palate develop at slightly different times - week 7 and week 9

Question 12

What nutritional deficiency can lead to cleft lcip or palate?

Answer 12

folate deficiency

Question 13

What do you surgically repair first: a cleft lip or a cleft palate?

Answer 13

you do cleft lip repair at 10 weeks because there are more functional problems with a cleft lip than with a cleft palate oddly enough. With a cleft palate you can cover the space with an obturator so food doesn’t get up into the nose

Question 14

What pharyngeal arch is most commonly involved in branchial cysts?

Answer 14

2nd arch

Question 15

Where will 2nd branchial arch fistulas be?

Answer 15

they’ll be anterior to the SCM and will open into the tonsil fossa

Question 16

If the thyroglossal duct persists, what can happen clincally?

Answer 16

they can become plugged and infected, as in thyroglossal duct cysts

a midline cystic mass in a chlid is usually this

Question 17

What will happens with a thyroglossal duct cyst during tongue protrusion and swallowing?

Answer 17

it will be mobile with th rest of the thyroid

Question 18

What is the treatment for branchial duct cyst

Answer 18

1. treat the infection
2. excise the entire tract and cyst (avoid incision and drainage)
3. You’ll have to follow the tract tot he hyoid bone and remove the central portion of the hyoid bone, otherwise it will recur

Question 19

During what week does the endoerm start thickening to form the thyroid diverticulum? At what week does the thyroid reach it’s native location?

Answer 19

4th week

7th week

Question 20

What arches are affected in GOldenhar Syndrome?

Answer 20

1st and 2nd

Question 21

What are the signs and symptoms of branchiootorenal syndrome?

Answer 21

it’s an issue with the 8th chromosome

you get branchial cysts, renal abnormalitis, ear malformaiton and hearing loss