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Important Topics in Otology

Important Topics in Otology



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This E book makes an attempt to cover all important topics in otology. I am sure this book will be of immense use for the students of otology just before their examinations. This will help them to revise otology topics in a rapid manner.
This E book makes an attempt to cover all important topics in otology. I am sure this book will be of immense use for the students of otology just before their examinations. This will help them to revise otology topics in a rapid manner.

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Published by: Dr. T. Balasubramanian on Dec 07, 2009
Copyright:Attribution Non-commercial


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Important topics in ENT
ByDr. T. Balasubramanian M.S. D.L.O.
Deaf mutism
Deaf-mutism is generally due to a loss of hearing before the age of 2 - 3 years whichhinders learning to speak. Most cases result from acute infectious diseases such asmeasles, epidemic meningitis, encephalitis, typhoid, otitis media, toxic effects of drugs, etc. Congenital deaf-mutism is also a possible etiology. Endocrine causes likePendred syndrome involves deafness along with the presence of goitre. The child'sintelligence is normal.For normal speech to develop in a child,the hearing sensation should be intact. Thefirst three years of life is considered to be crucial for the development of speech.Loss of hearing due to any cause during this crucial period of development causesthe development of speech to falter.Congenitally deaf child is also a mute. In congenital deafness there is failure of normal development of cochlea, leading on to deformities i.e. Mondini defect etc.Congenitally deaf and mute child can be identified by the absence of oculovestibular reflex. This is the reflex that makes the eye deviate to opposite side whenthe head is bent to one side. In children with acquired deaf mutism this reflex isintact.Management:Rehabilitation is the only way. In the past these children were taught tocommunicate using sign language. Now a days the children, if they have residualhearing should be provided with hearing amplification devices (hearing aids). Theyshould also undergo a rigorous course of speech therapy.The recent advances in the field of cochlear implant has added another usefuldimension in the management of these patients.
Endolymphatic hydrops
Endolymphatic hydrops is also known as Meniere's disease. This condition is due toswelling up of the endolymphatic sac. This causes fluctuating low tone sensorineural hearing loss, tinnitus and episodic vertigo.Causes:1. Idiopathic (Most common)2. Viral infections3. Allergy4. Syphilis5. Cochlear otosclerosis6. Hormonal imbalances causing water retentionDiagnosis:Is made by performing Glycerol test. Glycerol in doses of 1 - 2ml /Kg is given to thepatient in lemon water. If the patient shows improvement from the symptoms andhearing then the diagnosis is confirmed.Management:1. Bed rest2. Labyrinthine sedatives3. Diuretics4. Salt free diet5. Endolymphatic sac decompression surgery in resistant cases
Furuncle external auditory canal
It is also known as acute localised otitis externa / circumscribed otitis externa.
This is a localised infection usually found to involve the lateral 1/3 of the externalcanal. It also has a propensity to involve the posterior superior aspect of the externalcanal. This is caused due to obstruction of the apopilosebaceous units foundextensively in this area.Etiology:
Trauma to skin in this area followed by infection is commonly attributedcause. The organism responsible is commonly staph aureus.
1. Localised pain
2. Localised itching
3. Purulent discharge if the abscess ruptures
4. If oedema or abscess occludes the external canal hearing loss can occur.
1. Erythema of the skin2. Localised abscess formation
If the abscess is pointing it can be treated by incision and drainage. Oralantibiotics should be used. The preferred drug of choice is penicillin of firstgeneration cephalosporins. Anti inflammatory drugs can be used to reduceinflammation and pain.
These patients must be advised to cut their nails short and to keep their handsclean, since this is the commonest route of infection.

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