Most IMP ENT topics for Entrance Exams..

1) "TONSILS---/ TONSILITIS / TONSILLECTOMY --- infec.by group A & B streptococcal / strepto.pyogenes-(common org.)-Rxpenicillin for 10 days, pain in the post 1/3 tongue after tonsillectomy is due to injury to / throat pain radiating to the ear following tonsillectomy is due to IX cr. Nerve, tonsil develop embryologically from 2nd.pharyngeal pouch, Hard elongated swelling in the tonsillar fossa after tonsillectomy --elongated styloid process, Tonsillectomy--indications-(1) F.B. tonsil, (2) unilat.enlargement of tonsil with suspected malignancy, (3) atrophic tonsillitis, (4) Recuurent acute tonsillitis , (5) recurrent quincy, postop. complication hemorrhage--Rx antibiotics + saline wash, sec.hemorrhage(5-8hrs)-is due to- infection,& it is the common postop.compli.,hemorrhage after 6hrs --reactionary H., main blood supply to tonsil is facial artery, tonsillectomy is CI in polioepidemic, Palatine tonsil have Efferents but no afferents, After Quincy interval tonsillectomy is done after 6 wks.,commonest L.N. to enlarge in acute tonsillitis is Jugulodiagastric L.N., tonsil reach their max. size by 5yrs.,"---------((20))

2) "OTOSCLEROSIS / OTOSPONGIOSIS ---A.D. more in Females, affects Oval window/stapes, ConductiveHearingLoss, colour of T.M.=FLAMINGO PINK, Paracusis willisii, Schwartz sign seen, Gelle's test -ve, Carhart's notch/ dip=2 khz, TOC=Stapedectomy with prostesis/Fluorides--cochlear otosclerosis,"-----------((19))

3) "VOCAL CORD(S)---is line by stratified sq. epithelium, REINKI'S layer seen, web form'n. post truamatically can be prevented by MC NAUGHT'S KEEL, unilat.V.C. palsy--commonest cause-Idiopathic, left unilat. V.C. palsy-cause-oesophageal ca., Precancerous lesion in V.C.-leukoplakia, localised nodule vocal cord of sq.cell ca. vocal cord-Rx-Excision, earliest symp.of ca.vocal cord--Hoarseness, MOUSE NIBBLED APP.of V.C.--seen in T.B. of V.C., granuloma of V.C.-is due to Intubation, unilat.complete paralysis of V.C. can be corrected by--Teflon inj.,cricoarytenoid arthrodesis,implant procedures, T1N0M0 CA.of V.C.-Rx--radical radiotherapy, Internal tensor lengthening mucosa of V.C. is Cricothyroid, pri.aetiological factor in contact ulcer of larynx--Vocal Abuse, V.C.paralysis--resp.obst., aphonia by adductor paralysis can be overcomed by Arytenoidectomy, 19yrs.old female with aphonia has bilat.abductor paralysis cause is functional,"----------((19))

4) "CANCER OF LARYNX---Squamous cell cancer of larynx is commonest presentation, it is the commonest cause of Hoarseness of voice in Elderly man of more than 2mths.duration / Laryngeal Stridor in a 60yrs.man, Early fes.of Ca.larynx= Hoarsness of voice, NO neck secondaries-->Rx only Radiation, STAGE-III-->SURGERY+RADIATION,Rx of Glottic cancer-- TOC.-for (T1N0M0)-->EXTRENAL BEAM RADIOTHERPY, Ca larynx with Fully Mobile Cords-TOC.-->RADIOTH.,Rx of Ca.larynx with Stridor-->PLANNED TRACHEOSTOMY,glottic cancer has least chance of Nodal Mets.,Glottic Vocal Cancer has Best Prognosis, Hoarsness Early in Glottic Cancer, INFRAGLOTTIC CA.-->Commonly Spreads to Mediastinal L N'S, Ant.Commissure growth-Rx-->Conservative Laryngectomy, post cricoid growth---"----------((17))

5) "OTITIS MEDIA---CSOM ( CHRONIC SUPPURATIVE OTITIS MEDIA)---attico antral(dangerous type of ear), Schwartze op. done, csom with cholesteatoma with acute onset of vertigo-Rx-immediate exploration, Rx-cholesteatoma-radical mastoidectomy"--------------((10))

6) "ACOUSTIC NEUROMA---Auditory defect, sensory aphasia, changes in audiometry, commonly affects-8 Cr.N. & that too Superior Vestibular Nerve, early symp.-UniLateral hearing loss, it is most common (CPA) Cerebello-Pontine Angle tumours, Numbness of Face, Deafness, Internal Hydrocephalus, Ac.Nr. of 1 cm-IOC/diag.of choice=C.T. SCAN, hypoesthesia of the post. aspect of the ext. auditory canal-this is an early sign, " ----------((9))

7) "MENEIRE DISEASE / ENDOLYMPHATIC HYDROPS--- Ass.with Presbycusis, fes.--Tinnitus, Recurrent Vertigo, Deafness, Low Frequency SNHL/SND.-on pure tone Audiogram, GLYCEROL TEST is done in this, CODYTACK OPERATION is done, Cochlear type M.D.--Cochlear Deafness, Rx--Vasodilators--> increase Endolymph reabsorption, vasodilators of internal ear-is-Nicotinic acid,"-----------((9))

8) "ANGIOFIBROMA (NASOPHARYGEAL)---Juvenile angiofibroma is locally enlarging tumour producing destruction of bony structures without producing distal secondaries, Young Males(10 yrs boys), Bilateral Nasal Obstruction, bleeding from nose/ Intermittent profuse Epistaxis, firm pinkish mass in nasopharynx, Inv.=X-ray base of skull, carotid angiography, C.T.SCAN(IOC), Benign but potentially malignant, "----------------((7))

9) "EPISTAXIS---most common site--AnteroInferior Part of the Nasl Septum ,this is also called as ' LITTLE'S AREA ' ,in Ederly pt.--commonest cause-HTN.,Rx give NTG to decrease B.P., Recurrent epistaxis in a 15 yrs.female--most common cause-Hematopoietic disorder, Epistaxis in a 5 yrs. old Boy is due to Bleeding Disorder, Recurrent Epistaxis=causes--DNS, Atrophic Rhinitis, Maxillary Ca.,"-----------((7))