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ENT-HNS > Nasal Obstruction > Flashcards

Nasal Obstruction Flashcards

1
Q

What are the 3 parts of the nasal septum

A

Septal cartilage
Perpendicular plate of ethmoid
Vomer

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2
Q

Most common site of epistaxis in children

A

Little’s Area or Kiesselbach’s plexus

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3
Q

The ophthalmic artery branches to what artery supplying the Little’s Area?

A

Anterior ethmoid artery

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4
Q

The maxillary artery branches to what arteries supplying the Little’s Area?

A

Sphenopalatine artery
Greater Palatine Artery

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5
Q

The little’s area is supplied by the septal branch of what artery?

A

Superior Labial Artery

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6
Q

This nasal turbinate can cause obstruction

A

Inferior turbinate

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7
Q

This nasal turbinate is where most of the drainage tracts from the surrounding paranasal sinuses drains into

A

Middle turbinate

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8
Q

This nasal turbinate is where the ethmoid roof and cribiform plate are located

A

Superior turbinate

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8
Q

Turbulent flow (speeds up/slows down) the flow velocity, (lessens/prolongs) contact of air with the mucosa

A

slows down
prolongs

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9
Q

T/F: Turbinate hypertrophy periodically alternates between the 2 sides of the nose, causing periodic unilateral obstruction every 1 hour

A

F
every 3 hours

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10
Q

Two methods to directly assess nasal obstruction

A

Routine anterior rhinoscopy
Nasal Endoscopy (rigid, flexible)

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11
Q

Paranasal sinus Xray is indicated to confirm what disease?

What parts are visualized in Occipito-mental projection (Water’s)?

How about in Occipito-frontal projection (Caldwell’s)?

A

Acute Rhinosinusitis

Maxillary sinus, sphenoid sinus

Frontal sinus, ethmoid cells

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12
Q

CT Scan is requested for patients who have ___________

A

nasal obstruction

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13
Q

T/F: CT Scan is used to diagnose chronic sinusitis

A

T

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14
Q

T/F: CT scan is not recommended for reconstructive surgery

A

F
It can be used in sagittal, coronal, and axial planes for 3D reconstruction of masses

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15
Q

T/F: MRI is inferior when visualizing bones

A

T

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16
Q

Preferred imaging modality for viewing paranasal sinuses

A

MRI

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17
Q

What is the CHARGE syndrome in unilateral choanal atresia?

A

Coloboma
Heart Disease
Atresia of the chloanae
Retarded growth, devt, CNS abnormalities
Genital hypoplasia
Ear anomalies or deafness

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18
Q

T/F: Unilateral chloanal atresia is life threatening

A

F - it’s bilateral that’s life threatening

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19
Q

T/F: In bilateral chloanal atresia, perforation of the plate can be done in the first weeks or months of life, whereas surgery can be postponed on unilateral chloanal atresia until school age

A

T

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20
Q

A 6-year-old patient has adenoid hypertrophy. He does not breathe through the mouth, no nasal discharge, does not snore, no anorexia, and normal voice. What treatment shall must be done?

A

NONE
- treated only if they are causing symptoms

21
Q

Adenoid hypertrophy can cause what complication which could lead to conductive hearing loss?

A

Otitis media with effusion Or chronic impairment of the eustachian tube ventilation

22
Q

T/F: Chronic mouth breathers can have maxillary deformity and dental malalignment (adenoid facies)

A

T

22
Q

T/F: Anterior rhinoscopy or endoscopy can be done to diagnose adenoid hypertrophy. Ear evaluation and sharing test should likewise be done

A

F
All are true except Anterior rhinoscopy. Must be POSTERIOR

23
Q

Tx of adenoid hypertrophy

A

Surgery
Myringotomy with ventilation tube insertion if with otitis media with effusion

23
Q

This is the most common bilateral nasal mass

T/F: This disease is rarely observed in children

A

Nasal polyposis

T: except for those who have cystic fibrosis

24
Q

This treatment is done for any deviation of the septum causing subjective complaints and functional impairment

A

Septoplasty

25
Q

These cells/sinuses are usually involved in nasal polyps

A

Maxillary and Ethmoid

26
Q

T/F: Nasal polyps could cause rhinophonia clausa

A

T (it causes hyponasal speech)

27
Q

This is a mucocele that contains purulent material (superinfection)

A

Pyelocele

28
Q

These adhesions obstruct drainage from the paranasal sinuses system

A

Post-inflammatory
Post-traumatic
Post-operative

29
Q

T/F: Nasal polyps can cause mucocele formation

A

T
Since it can cause obstruction

30
Q

Ranking of most common sinus involved in mucocele

A

Frontal > Ethmoid > Maxillary > Sphenoid

31
Q

What sinus is involved if the orbital contents move inferolaterally?

A

Frontal sinus (Frontal mucocele)

32
Q

What sinus is involved if the orbital contents move superiorly?

A

Maxillary sinus (Maxillary mucocele)

33
Q

What sinus is involved if the orbital contents move laterally?

A

Ethmoid Sinus (Ethmoid mucocele)

34
Q

T/F: Ethmoid mucocele causes headaches radiating to the vertex and occiput

A

F
it’s Sphenoid mucocele

35
Q

T/F: Endoscopy is not useful to detecting mucocele

Best modality for mucocele detection

Tx:

A

T
CT Scan

surgical removal

36
Q

Which of the following tumors of the nasal cavity and paranasal sinuses is benign?

Adenocarcinoma
Inverted papilloma
Adenoid Cystic Carcinoma
Squamous cell carcinoma

A

Inverted papilloma

37
Q

It is the most common cause of unilateral nasal mass

What sinus is usually involved?

A

Inverted Papilloma

Maxillary sinus

38
Q

Inverted papilloma can transform into what malignant disease?

A

Squamous cell carcinoma

39
Q

What pattern in MRI is checked to diagnose inverted papilloma?

Imaging modality adequate for its diagnosis:

A

Cerebriform-columnar pattern

CT Scan

40
Q

T/F: inverted papilloma can be endoscopically removed

A

T

other option: maxillectomy (open approach)

41
Q

This is one of the most common causes of benign tumors in the adolescent/pediatric age group

A

Juvenile Angiofibroma

42
Q

What is juvenile angiofibroma?

A

It is a benign tumor in the nasopharynx that is common among males age 10-18 years old. It is a vascular malformation commonly located in the pterygopalatine fossa

43
Q

T/F: Juvenile angiofibroma can cause middle ear effusion and conductive hearing loss

A

T
other sx: nasal obstruction, recurrent epistaxis, headache

44
Q

A 12yo male patient comes to the clinic with nasal obstruction. On endoscopy, a well-circumscribed vascular mass was found at the posterior nasopharynx. What is the diagnosis?

Should biopsy be performed to confirm its malignancy?

Can angiography be done?

Tx:?

A

Juvenile Angiofibroma

NO- biopsy should not be performed due to uncontrollable bleeding

Yes- to identify feeding vessel; preferred for adolescent males

Tx: Surgical removal or preoperative embolization of feeding vessels (usually the maxillary artery)

45
Q

Osteomas most frequently occur in what sinus?

A

Frontal (80%) > Ethmoid > Maxillary > Sphenoid

46
Q

This syndrome under osteoma has multiple colon polyp, osteoma of the skull, and multiple soft tissue tumore

A

Gardner’s Syndrome

47
Q

T/F: osteomas are highly likely to transform into osteosarcoma

A

F
it rarely transforms to a malignant tumor

48
Q

Main sites of malignant tumors

A

Nasal cavity and maxillary sinus

Followed by ethmoid > frontal > sphenoid

49
Q

When CT is used to diagnose malignant tumors, it should include _________

T/F: Nasal endoscopy can be used to diagnose malignant tumors

A

the neck
- to check for neck node involvement and metastasis

T

ENT-HNS (8 decks)

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