Otolaryngology Review

Guideline

1. Focus on Solving (All / None)

2. Focus on Solving (T/F)

3. Focus on Solving Subject by Subject

Moderate Allergy Tx

(C)

Aphyxia

->(ER Tracheostomy)

Larynx Abd

->(C-A-P)

Allergy

-> Pale mucosa!

Septal Resection Does Not Cause

-> Nasal Polyp

Photoan

-> Weak VC

Contact Ulcer

-> Vocal abuse!

VC Lateral

-> Paralysis

VC Constriction

-> Functional aphonia!

Bullous Myringitis

-> PS Aeruginosa!

Normal Skin

-> Except diphtheria!

Swelling of Inner Orbital

-> ALL

Sinuses

• Posterior Ethmoid -> (Superior meatus)
• Max sinus -> Middle meatus
• Max sinus -> at nose level

Tonsillitis

• Acute (NOT) Nasopharyngeal obstruction
• Chronic (Not) -> bad smell!
• Hypertrophy (compli) -> Otitis media + Hearing loss
• Chronic (except) -> systemic features!
• Not Acute Tonsillitis -> epistaxis!
• 1st Line Non Allergic Child with Acute -> Penicillin V
• Paratonsilitis Dx (NOT) -> CT scan

Pharyngitis

• Chronic (not Dx) -> Oral Cavity exam
• Acute Viral (NOT) -> Plaques on tonsil
• Chronic Hypertrophic -> Lymphadenopathy...posterior pharyngeal wall
• Chronic Etiology (NOT) -> Deviated Septum
• Acute Cause -> (All)

Rhinitis

• Acute -> red nasal mucosa, mucopurulent
• Allergic -> obstruct nasal breathing (longest)
• Allergic -> Pale Mucosa!
• Allergic -> All of the above!
• Allergic mild Tx -> systemic H1
• Moderate Allergic Tx -> (C)
• Allergic (non-specific) -> tearing!
• Medicomatosa -> Intranasal Steroid!
• Acute (Cause) -> Rhino/Coro
• Acute Viral Tx -> Decongestant
• Hormonal rhinitis -> Pregnancy!
• Chronic Hypertrophic (except) -> Impaired sense of smell
• Chronic Hypertrophic (except) -> Anterior + posterior ends...
• Atrophic (Except) -> common in children
• Atrophic Rhinitis -> more in males!
• Atrophic (Tx) -> Adm of Systemic estrogen!
• Vasomotor -> (None)
• Hyperplastic -> chemical irritation!
• Chronic Tx -> Long term use of Topical Decongestant
• Dry stage of Acute (DON'T give) -> OP Ax!
• Not used for Dx -> rhinometry
• Moderate allergic Tx -> local (nasal steroid)

Laryngitis

• +GERD affects -> VC
• Chronic Forms -> 3 (cat/atrophic/hypertrophic)
• TB -> (C)
• Larynx abd -> (C-A-P)
• Larynx - (100-1000 HZ)
• Larynx TB -> All
• Cancer mts -> Glottis?
• Cysitis -> any region!

Cyst

• Larynx -> Any part of it!
• VC cystitis -> Any region of larynx!
• Maxillary sinus -> dental origin!

Polyp

• Ethmoidal polyp -> Idiopathic
• Ethmoidal polyp -> Rate of recurrence high!
• Ethmoidal polyp -> multiple + bilateral!
• Location -> Anterior 1/3
• A-C polyp -> Single + unilateral
• Laryngeal polyp -> Both
• Nasal (except) -> Sensitive to touch

Ménière's Disease

• Except -> Renner Test -ve
• Tx -> Shunt operation

VC

• 1 VC in paramedian -> unilateral incomplete
• 1 VC in cadaveric -> unilateral incomplete
• Both VC in paramedian -> bilateral incomplete

Cancer

• Larynx (False) -> = in both sexes!
• Larynx -> 3rd + 4th decade!
• Larynx Sx -> Hoarseness!
• Larynx site -> glottis!
• Larynx mts -> hypopharyngeal! / Cervical LN (2Q)
• Larynx mts -> Cervical LN
• Commonest Larynx tumor -> Squamous cell Carcinoma
• Subglottic Cancer (except) -> is Most common Type of cancer...
• Larynx Stage I + II (atypical) -> Inspiration dyspnea!
• Larynx recommended -> hemilaryngectomy with Regional LNtomy
• Larynx Min state of mts -> III
• VC pathology + Precancer -> Chronic Hypertrophic L + K...
• Subglottic -> A + D (Respiratory Difficulty + SCC)

Nerve

• Unilateral Laryngeal Tx -> I + M
• Unilateral (except) -> cricothyroid
• Bilateral Tx -> lateralization of VC
• Bilateral Caused -> Tracheostomy!
• Superior Laryngeal -> cricothyroid!

Nasal Septum

Abscess -> Traumatic Hematoma!

Rhinosinusitis

• Acute Tx -> Conservative Tx
• Chronic -> (2 option: open + something)
• Not Surgery indication -> preseptal cellulitis!
• Chronic (NOT) -> Cough!
• Complication of acute intercranial -> meningitis + epidural abscess!

Otitis Media

• Supperative sign (except) -> Tragus (+ve)
• Cause -> Strept / Pn / H Influenza!
• Acute Sx -> Ear pain, hearing loss, pain!
• Chronic Tx -> Tympanostomy
• Secretory -> inflammatory effusion /...
• Children -> Strepto / Influenza
• Incision -> Myringotomy / Paracentesis
• Early acute serous Sx -> Autophony!
• Acute Sx (newborn) -> B + C
• Serous (Not) -> bulging ear drum / N + NP are Normal!
• Acute (False) -> Retracted ear drum
• Acute Serous (except) -> Nose + Nharynx are N
• Acute serous (except) -> Purulent discharge present
• Acute serous Tx (Except) -> Topical Decongestant
• Purulent otitis complain -> Bad Hearing / crackles.....
• Middle phase -> purulent discharge)
• Exudative otitis tympanogram -> Type B
• Acute otitis NOT perform? -> Audiogram!
• Exudative characteristic -> TM rupture perforation!
• Intercranial complication (except) -> Peritonitis!

L Nerve

• Superior Injury
• Inferior Injury paralysis (except) -> cricothyroid!

Pharyngitis

Chronic Atrophic Tx -> Both (Oil + Kines)

Laryngitis

Chronic forms -> 3 Catarrhal, atrophic + hypertrophic!

Case

1-5 yo + III palate hypertrophic + OMAS -> Bilateral tonsillectomy!

Sinusitis

• Maxillary -> middle meatus!
• Chronic (Not) -> Cough!
• Headache -> Aggravated by stooping / exertion!
• Chronic -> > 12 W
• Not Complication -> Epistaxis!
• Acute non-complicated (Not) -> Proptosis!

Adenoiditis

• Except -> (anorexia)
• 2nd degree -> cover 2/3 choana!
• Not Sx - (Diarrhea (E))
• Grades during mirror exam (4)
• Not Sx -> headache

Tonsillectomy

• Except (2W)
• Ind (Pn after Peritonsillar abscess!)
• Ind (ALL)
• Ind (All Except C)
• Ind (freq > 4/year!)
• Not Ind (Meningitis after Peritonsillar abscess)
• is (Removal of palatine tonsils)

Epiglottitis

• Children -> Influenza B
• Ax of choice -> ampicillin!

Otosclerosis

• Sx -> intact Tympanic membrane... -> Gradual hearing loss & Tinnitus
• (except) -> Common in males!
• Not True -> No Relationship with puberty!
• Absorption of -> Spongy bone
• Sx -> Deafness without tinnitus!
• Audiometry -> Negative Pressure Normal Compliance!

Mucocele

Frontal sinus (except) -> Swelling elastic!

Suppraglottis

-> Fold / Arytenoid!

Tx

-> Ampicillin!

Ménière's Disease

(Except) -> hyperactive caloric response!

Sx -> Cochlear sx before vestibular!

Mastoiditis

• Acute Types -> ALL
• Radiological Finding -> All
• Except -> low Fever / Purulent drainage?
• Finding in surgical mastoiditis -> erosion of dural sinus!
• Dx -> Temporal CT
• Dx (Except) -> X-ray of paranasal sinus!
• Except -> ↑ Earache!
• Types -> All
• Acute (except) -> Auricle is Normal
• Surgery radio finding -> rarefaction and loss of distinction...
• X-ray Reveal (COSM) -> sclerotic mastoid!

TMP (Tympanic Membrane Perforation)

Chronic (Not) -> sudden hearing loss!

Normal membrane -> Secretory OM

Tonsillitis

Acute Follicular (Staphylococcus)

Varies

• Carcinoma -> Glottis!
• Intubation -> 3-6 days!
• Intubation (NOT) -> L carcinoma!
• Mucocele -> Frontal Sinus!
• Children Hearing -> 0-20!
• Myringotomy -> bulging stage AOM
• Hair line otoscopy -> Serous otitis media
• Congenital anomaly -> aryngomalacia
• Epiglottis (Long + tube) -> Children
• Piriform fossa -> Lowest part of laryngopharynx!
• High pitch -> Short and thick VC

Maxillary Sinus

• -> Middle
• Floor -> level of nose!

Myringotomy

• Ind -> ALL
• Ind (except) -> Secretory otitis media / Bulbosa
• As otitis media Indicated -> Stage of exudate!
• Complication -> All!

Vincent

• Spirochete
• -> Ulcerative
• Tx -> Penicillin
• Spirochete + fusiform

Left Recurrent

• (around aorta)
• (Not cricothyroid)

Diphtheria

• (Grey membrane)
• (Toxin..Corynebacterium)
• Tx (All)
• Tx (antitoxin)
• Laryngeal - (Bull neck)

Surgery

• -> (P cellulitis)
• -> (O Cellulitis!)
• Surgery for endoscopic resection -> (endoscopic sinus surgery)

Ind Surgery

S.M.R -> Deviated Septum!

Ozaena

• Except -> (Not Unilateral!)
• -> (All)

All/Any

• Posterior Rhinoscopy
• Structure of Ethmoid air cells
• Nasal Turbinate role!
• Retropharyngeal abscess!
• Pharyngeal diphtheria include
• Peritonsillar abscess
• Fibroma of nasopharynx!
• Indication for tonsillectomy!
• Diphtheria Tx (1 of 3 Q)
• Swelling of Inner orbital reflects:
• Allergic Rhinitis (Hay Fever)
• Infection of nose + paranasal sinus
• Ozena characteristics
• Complication of Sinus Disease:
• Choanal Atresia Sx
• Tonsillectomy Ind
• Tonsillectomy method management
• Post Tonsillectomy bleeding provoked!
• Ax for otitis media
• Papillomatosis characteristic!
• Factors for VC closure!
• Myringotomy Indication:
• Tx of Ménière's Disease
• Acute pharyngitis may cause!
• Ear Wax!
• Types of Acute mastoiditis
• Early feature of Acute Otitis media
• Lateral sinus thrombosis Tx!
• Acute infective Laryngo-tracheo-bronchitis!
• True about otitic barotrauma (except)
• Perforation of nasal septum!
• Herpangina
• Ozena
• Swelling of inner disease include:
• Complication of sinus disease!
• Common sx of choanal atresia:

None

• Olfactory area!
• Acute follicular tonsillitis!
• Vasomotor Rhinitis!
• Tx of Mononucleosis Angina!
• Cochlear otosclerosis!
• Internal auditory artery is branch
• Complication of Myringotomy!
• Malignant otitis externa!

Abscess

• Zygomatic -> external auditory canal
• Bezold -> beneath sternocleidomastoid
• Mastoid -> post-aural subperiosteal
• Luc's -> over zygoma!
• Cerebellar (except) -> head tilt!
• Retropharyngeal abscess (ALL)
• Retropharyngeal Except (TB)
• Parapharyngeal -> Jugular vein thrombosis!
• Parapharyngeal Except -> (B) Longest!
• Peritonsillar abscess (except) -> head backward
• Paratonsillar Tx -> Drainage!
• Peritonsillar abscess -> in both fossa

True

• Inferior turbinate is separate bone!
• Incisors + premolar teeth to max sinus
• Tonsil + adenoids have Efferent not Afferent!
• Parapharyngeal abscess -> Necrosis!
• Parapharyngeal abscess -> thrombosis of Internal jugular vein!
• Peritonsillar abscess..Diffuse, Tender, swelling!
• Osteomas are most common benign tumor
• Maxillary sinus carcinoma, rarely produces Sx!
• Most serious complication of maxillary antral wash is embolism!
• Each fiber of auditory nerve ends in one inner cell...
• Tegmen Tympani separates the attic!

False

• VC have no LN
• Middle turbinate is separate bone!
• Laryngeal Cancer is not equal in both Sexes!
• Inflammation / Trauma of olfactory area...temp smell loss
• Septal hematoma causes one side swelling!
• Unilateral nasal discharge is Vasomotor rhinitis
• Malignant tumor from posterior-superior part
• Deafness is rarely produced by lesion in cortex
• Tympanic plexus supplies the tensor tympani muscle

Coryza

• -> viral infection
• Organism -> Rhinovirus
• Prolonged -> Streptococci!

Important Nerves

Vagus + L Sup + L Rec

Recurrent Laryngeal

• -> Around aorta
• -> NOT supplies 'Cricothyroid'
• -> supplies ABDUCTORS
• Tx -> C + M
• Not Motor -> Posterior cricoarytenoid

Superior Laryngeal

Injury -> Cricothyroid!

Retropharyngeal Abscess

• Except -> TB
• -> All of the above!

Parapharyngeal Abscess (Except)

-> Jugular vein thrombosis!!