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Question 1

Treatment of Meniere’s disease

Answer 1

Anti vertigo during attacks

Between attacks: Salt restriction, Diuretics.
-In sever bilateral SNHL: Streptomycin in toxic dose
-Vasodilators

Surgical:
-If Good hearing: Endolymphatic Sac Decompression and if failed Vestibular Neurectomy
-If bad hearing: Injection of Aminoglycosides and Labyrinthectomy

Question 2

Treatment of bilateral stapedial otosclerosis

Answer 2

Stapedectomy and insertion of a synthetic piston
OR
Amplification by hearing AID is alternative

Question 3

Decompression of facial N is done by…

Answer 3

Steroids + deroofing of facial canal

Question 4

Signs of mastoiditis (otoscopic)

Answer 4

Reservoir sign
Sagging of postero-superior meatal wall

Question 5

Investigations of Secretory otitis media

Answer 5

PTA CHL
Tympanometry: Type B curve
X-ray lateral view of nasopharynx

Question 6

Treatment of secretory otitis media

Answer 6

Medical: TTT of cause, antibiotics, steroids, decongestant, mucolytics, Valsalva Maneuver

Surgical: Myringotomy + Ventilation tube insertion

Question 7

In CSF rhinorrhea, CT is done with………

Answer 7

Intrathecal metrizamide

Question 8

Treatment of CSF rhinorrhea

Answer 8

Avoid nasal decongestant and straining and coughing and leaning forwards

Give antibiotics
Bed rest with semi-sitting position

ESS covering defect with flap

Question 9

Causes of offensive nasal discharge 4

Answer 9

Atrophic Rhinitis
Nasal granuloma: Rhinoscleroma, syphilis
Foreign body
Oro-antral fistula

Question 10

Investigations of allergic rhinitis

Answer 10

Cytology shows increase in eosinophils
High Serum IgE
RAST
Nasal challenge Test
Skin Pricking test

Question 11

Treatment of allergic rhinitis

Answer 11

Avoid exposure to antigen
Anti histaminic, mast cell stabilizer, cortisone and decongestant
Hypo sensitization
Surgical reduction of enlarged turbinate

Question 12

Treatment of nasal polyp

Answer 12

Investigate CT

Antibiotics infection and anti-allergic

Ethmoidectomy through ESS

Question 13

Investigations of unilateral vocal cord paralysis

Answer 13

CT from skull base to mid thorax and investigate according to susception

Panendoscopy and biopsies

Blood exams especially sugar

Question 14

Treatment of T3 glottic carcinoma

Answer 14

Total laryngectomy and post-operative radiotherapy

Rehabilitation of voice: Esophageal speech, electric larynx

Permanent tracheostomy

Patient education: Do not swim and Do not do heavy manual work

Question 15

Treatment of bilateral vocal cord abductor paralysis

Answer 15

Tracheostomy

Surgery: Lateralization thyroplasty, Woodman’s operation, Arytenoidectomy and posterior cordectomy

Question 16

Long term management of bilateral vocal cord abductor paralysis

Answer 16

Semi-sitting to facilitate cough
Observe respiration: obstruction if noise or voice appears
Observe bleeding
Antibiotics
Analgesics
Feeding
Extubating after treatment