‫ﻢ ﷲ اﻟﺮﲪﻦ اﻟﺮﺣﲓ‬

ENT Mnemonics
Ear

***

Eustachian Tube Cartilage is:

C-SHAPED
Collapsed under normal conditions, opens during swallowing, yawning,
chewing gums or Valsalva Maneuver.

***

Regarding Congenital Cholesteatoma (E Pidermoid),

Aetiology:

- Persistent Embryonic Squamous Epithelial cells.

Sites: (( Related to Petrous bone ))
Petrous A Pex >> Trigeminal Facial Pain
Cerebello – Pontine angle >> Facial tics then Paralysis
Tym Panum (Middle ear) >> CHL
 ***

In cholesteatoma,

if suspected COMPlications , ask for COMPuted Tomography

(CT )

***

Gra Denigo’s triad of Petrositis:

Can be encoded by 3 D
- Discharging Ear.
- Diplopia & squint due to cranial nerve VI affection, while passing in
Dorello Canal.

- Deep Facial pain, due to affection of Trigeminal “Gasserian” ganglion at

the petrous apex.

***

Grie SINger’s sign is characteristic for Lateral SINus thrombosis

(Edema & Tenderness over the posterior border of Mastoid process,
resulting from Septic Thrombosis of the Mastoid Emissary vein 2ry to
Lateral sinus Thrombophlebitis.)

***
 Otosclerosis

The golden Letter for Otosclerosis is

F
-It’s a Familial “Hereditary” disease.
-More common in Females in Fertility period “Related to Pregnancy”.
- Characterized by Replacement of normal compact bone by Spongy

Hypervascular “ Fragile” Bone, then Sclerotic Bone.

- Most commonly occurs around the Footplate of Stapes, leading to its
Fixation. (Stapedial Type).
- In active stage of the disease, Otoscopy may show a Flamingo-Red
tympanic membrane (Schwartz sign).

Treatment:

- Surgical:

Stapedectomy: (The treatment of choice)

- Removal of Stapes & replacement by Te Flon piston or Wire & Fat.

(This operation may be complicated by Perilymph Fistula, which’s treated
by Temporalis Fascia graft).
- Medical:
 Sodium Fluoride.
***

MENieRE’s Disease:
Using its name, we can encode:

Membranous Labyrinth with

- Definition: distension of the

ENdolymph, characterized by REcurrent attacks of the triad: Vertigo,

Deafness & tinnitus.

-Incidence: More common in Males around the age of 50.

- Usually U Nilateral (Bilateral in 25 %)
***

In congenital causes of SNHL,

MONdini’s disease: Partial aplasia of the Cochlea, so it’s MONo-

turn (Single Turn).

***

Benign Paroxysmal Positional Vertigo:

The Golden Letter is

S
- Vertigo of Sudden onset.
 - Short Duration (30 Seconds).
- When the patient takes a Specific Position.
- Cause: debris in posterior Semicircular canal.
- Self-limiting within Six months & improved with Epley Maneuver,
(A specific sequence of head positions that would result in movement of the
debris out of the posterior canal, through the common crus and into the
vestibule.)

- Resistant cases are Surgically treated by Singular Nerve Neurectomy.

***

Vestibular investigations (for Vertigo cases), can be encoded by the

Word:

CAROTiD
(But we’ll use E instead of i :)

CAloric test
ROTating chair test
Electronystagmography
Dynamic posturography
 ***

Nystagmus can be observed by:

D, E, F, G
- Direct looking at the eye.
- Electronystagmography.
- Frenzle Glasses.
***

In Tympanometry, to remember what each curve means, let’s think &

remember that:

Tympanometry = Measurement of Middle ear pressure, through measuring

the TM Compliance (Mobility).

***

A = The Best (always class A is the Best).

So, A = Normal
A = Normal ME Pressure
A Alone means also Normal TM Compliance
***
 As =A+s
A = Normal ME Pressure
s = stunted = stiffness (Reduced Compliance)
s
e.g. Oto clerosis.

***

Ad=A+D
A = Normal ME Pressure
D = D ynamic = Hypermobility (Increased compliance)
e.g. Ossicular chain D isruption or D islocation.
***

B curve:
B for Buildup of FLuid in Middle ear (Otitis Media with Effusion).
FLuid >> FLat curve.
***

C curve = Normal Compliance,

but –ve ME Pressure.
 - In Eustachian Tube Dysfunction.

***

Oscillating Tympanogram
=

Pulsatile Pressure = Pulsatile mass = Glomus Tumor

***

Mc Ewen’s triangle is the surgical Landmark for Mastoid Antrum

***

Nose

***

When the normal ciliary action is inhibited, the cilia stop & become

STILL
This can occur due to

STILL
Smoking
Temperature changes (Excessive heat or cold)
ILLness (Infection)
 ***

Cyclic Asphyxia is characteristic for

Bilateral Choanal Atresia
***

Traumatic diseases of the Nose are 4 F:

Fracture Nasal Bones.
Foreign Body in the Nose.
Oroantral Fistula.
CS F Rhinorrhea.
***

CSF Rhinorrhea increases by CSF

Coughing
Straining
Forward leaning (Tea Pot Sign)
 ***

CSF Biochemical analysis shows the following Characteristics:

Clear & Colorless
Sugar more than 30%
Reduces Fehling’s solution
F
Contains B2 Trans errin (Diagnostic) (B2 only in CSF)

***

Investigations of CSF Rhinorrhea can be encoded by CSF

- CT Scan with intrathecal Omnipaque.
- Intrathecal Fluoresciene, then detect it in the Nasal Cavity by Nasal
endoscope.

- CSF Biochemical Analysis (Mentioned before)

***
 Treatment of CSF Rhinorrhea can be encoded by CSF
Conservative :
-Most traumatic cases heal spontaneously.

- Bed rest in semi-setting position with head-up.

- Avoid CSF (Coughing, Straining &Forward leaning)

- Avoid Blowing of Nose.

- Avoid Nasal Medications (Drops or Packs)

- Prophylactic antibiotics to prevent Meningitis.

Surgical: If conservative failed

- Covering the defect by a graft (Temporails Fascia) or Flap (Muco-
periosteal septal flap.

***

Traumatic surgical causes of Oro-antral fistula can be coded by:

DR. X
Dental Extraction.
Radical Antrum Operation.
EXcision of dental or dentigerous Cyst.
***
 To remember the sequence stages of Rhinoscleroma, remember that

Rhino = Nose = ‫أﻧف‬

ANF = ‫أﻧف‬
- Atrophic stage.
-Active Nodular stage (Hypertrophic).
- Fibrotic stage
***

LuPus Vulgaris affects the Anterior CartiLagenous part of the Nasal

septum, causing the characteristic APPLe Jelly nodules.

***

3ry Syphilis affects the Posterior Bony part of the Nasal Septum, causing
Saddle Nose.
***

Complications of Septal Abscess:

- Supratip depression: due to Necrosis of septal cartilage & septal
perforation.
 - Cavernous Sinus Thrombosis: due to spread of infection via emissary
veins (Dangerous area of the face).

***

In management of Epistaxis:

First aid:

- The patient is seated with the head flexed forwards & Apply:

-Direct Compression: pinching the nose between 2 fingers.

- Cold Compresses.
- Constrictors. (Introduce cotton piece soaked with Vasoconstrictor into
the nose for 10 minutes).

***

Investigations to detect the cause of Epistaxis:

- Coagulation Profile.
- Complete blood count.
- Computed Tomography (CT).
± Biopsy (If tumor is suspected).

***

Best Wishes

dr R.M