Rhinology

Question 1

Chandler’s classification

Answer 1

1 - Preseptal cellulitis / Periorbital edema
2 - Orbiltal cellulitis / Periorbital cellulitis
3 - Subperiosteal abscess
4 - Orbital abscess
5 - Cavernous sinus thrombosis

Question 2

Samter’s triad

Answer 2

aspirin sensitivity
asthma
nasal polyposis

Question 3

Bent and Kuhn criteria for AFS

Answer 3

1 - Eosinophilic mucin (Charcot-Leyden crystals)
2 - Noninvasive fungal hyphae
3 - Nasal polyposis
4 - Type 1 hypersensitivity by history, skin tests, or serology
5 - Characteristic radiologic findings
• CT: Rim of hypointensity with hyperdense central material (allergic mucin)
• CT: speckled areas of increased attenuation due to ferromagnetic fungal elements
• MRI: peripheral hyperintensity with central hypointensity on both T1 and T2
• MRI: central void on T2

Question 4

Paranasal malignancy RFs

Answer 4

• Wood dust
• Nickel
• Chromium
• Volatile hydrocarbons
• Organic fibers found in the wood, shoe, and textile industries
• Smoking
• HPV may be involved in the malignant degeneration of inverting papillomas
• CRS - At least one study suggests a 2.3-fold increase in risk compared with the general population

Question 5

Hutchinson rule

Answer 5

Herpes zoster involvement of the nasal tip is associated with a high incidence of herpes zoster ophthalmicus due to retrograde spread via the nasociliary nerve

Early ophthalmology consultation advised