ENT Dhingra Summary

Cheatsheet Content

### Multiple Choice Questions: Ear - **Otosclerosis:** - Causes conductive hearing loss. - More common in females. - Affects stapes. - **FALSE:** Causes sensorineural deafness initially. - **Earliest sign of acute otitis media:** Ear pain. - **Most common complication of CSOM:** Brain abscess. - **Preferred treatment for OME:** Myringotomy with grommet. ### Multiple Choice Questions: Nose & Throat - **Most common lymph node in carcinoma larynx:** Jugulodigastric. - **Quinsy is another name for:** Peritonsillar abscess. - **Posterior nasal packing is used in:** Posterior epistaxis. - **Simplest method to differentiate sinusitis:** X-ray PNS. ### Multiple Choice Questions: General - **Balanced anaesthesia includes:** All of the above (Muscle relaxant, Analgesia, Loss of consciousness). - **Maximum radiation exposure is caused by:** CT scan. - **Brachytherapy involves:** Radioactive implants. - **Most important prediction of difficult intubation is:** Mallampati Class III & IV. ### Carcinoma Larynx - **Classification:** - **Supraglottic:** Above vocal cords (epiglottis, aryepiglottic folds, false cords). - **Glottic:** Involving vocal cords. - **Subglottic:** Below vocal cords. - **Clinical Features:** - Hoarseness (early in glottic). - Dysphagia/Odynophagia (supraglottic). - Stridor/Dyspnea (advanced). - Neck mass (lymphadenopathy). - Earache (referred pain). - **Diagnosis:** - Indirect/Direct laryngoscopy with biopsy. - CT/MRI neck and chest for staging. - PET scan for distant metastasis. - **Management:** - **Early Stage (T1/T2):** - Radiotherapy. - Endoscopic laser surgery. - Partial laryngectomy. - **Advanced Stage (T3/T4):** - Total laryngectomy with neck dissection. - Chemoradiotherapy. - Targeted therapy/Immunotherapy. ### Injuries due to Foreign Body in Airway (FOBA) - **Acute Injuries:** - **Obstruction:** Partial or complete, leading to choking, dyspnea, stridor, cyanosis. - **Aspiration Pneumonia:** If foreign body enters lower airway. - **Laryngeal edema/spasm:** Due to irritation. - **Tracheal/bronchial trauma:** During aspiration or removal attempts. - **Chronic Injuries:** - **Granulation tissue formation:** Around the foreign body. - **Chronic inflammation/infection:** Recurrent cough, fever, purulent sputum. - **Bronchiectasis or lung abscess:** Due to prolonged obstruction and infection. - **Air trapping/Atelectasis:** Depending on location and type of foreign body. - **Erosion into surrounding structures:** Rare, but serious. ### Very Short Answer Questions - **Types of hearing aids:** Behind-the-ear (BTE), In-the-ear (ITE), In-the-canal (ITC), Completely-in-canal (CIC), Bone-anchored hearing aids (BAHA), Cochlear implants. - **Mastoiditis:** Inflammation/infection of the mastoid air cells, typically a complication of acute otitis media, leading to pus accumulation and bone destruction. - **Rinne's test:** Compares bone conduction (BC) to air conduction (AC). A vibrating tuning fork is placed on the mastoid bone (BC) and then near the ear canal (AC). Normally, AC > BC (positive Rinne). In conductive hearing loss, BC > AC (negative Rinne). In sensorineural hearing loss, AC > BC, but both are reduced. - **Deformities seen in DNS (Deviated Nasal Septum):** C-shaped deviation, S-shaped deviation, Spurs, Ridges, Thickening. - **Tracheostomy:** Surgical procedure to create an opening in the trachea (windpipe) to provide an alternative airway for breathing, typically below the vocal cords. - **Cholesteatoma:** A destructive and expanding growth in the middle ear and/or mastoid, consisting of keratinizing squamous epithelium. **Clinical feature:** Foul-smelling ear discharge (otorrhea). ### Short Answer Questions - **Vertigo:** - **Definition:** An illusion of movement, either of oneself or the surroundings, often described as spinning or swaying. Can be peripheral (inner ear) or central (brain). - **Management:** - **Pharmacological:** Vestibular suppressants (e.g., meclizine, dimenhydrinate), antiemetics (e.g., prochlorperazine), anxiolytics (e.g., benzodiazepines). - **Rehabilitation:** Vestibular rehabilitation therapy (VRT) for chronic vertigo. - **Specific maneuvers:** Epley maneuver for BPPV. - **Surgical:** Labyrinthectomy, vestibular neurectomy (for severe, intractable cases). - **Treatment of underlying cause:** Antibiotics for infection, tumor removal. - **Complications encountered in tonsillectomy:** - **Immediate:** Hemorrhage (primary/reactionary), pain, dehydration, airway obstruction, anesthesia complications, injury to adjacent structures. - **Early:** Secondary hemorrhage (5-10 days post-op), infection, otalgia (referred pain), velopharyngeal insufficiency (temporary). - **Late:** Scarring, taste disturbance, dental injury, glossopharyngeal nerve injury. - **Endoscopic Sinus Surgery (ESS) technique and indications:** - **Technique:** Minimally invasive surgical procedure performed using an endoscope to visualize and remove diseased tissue or bone in the nasal and sinus cavities. Involves widening natural ostia, removing polyps, and correcting anatomical abnormalities. - **Indications:** - Chronic Rhinosinusitis (CRS) refractory to medical treatment. - Nasal polyposis. - Recurrent acute rhinosinusitis. - Fungal sinusitis. - Sinus mucoceles. - Orbital decompression for thyroid eye disease. - Cerebrospinal fluid (CSF) leaks repair. - Pituitary tumor removal (transnasal transsphenoidal approach).