OTORHINOLARYNGOLOGY

Tympanic mem 90 sq mm ; 1 cm
Cone of light : Right 5 o clock
left 7 o clock

Sharpnell membrane
Occlusion : ASOM

Presuppuration : SOM : glue ear

Suppuration : CSOM

Resolution 90% / complication

Acute suppurative otitis media :
Strep. pneumoniae H. inf Mo. caterrhalis
myringotomy post inf
Pain fever deafness
Entry via eustachian tube
Fluid level
Cart wheel appearance
Pulsatile discharge : light house sign
SOM : retracted tympanic membrane
Air bubbles
Reduced mobility
Myringotomy with grommet

CSOM : chronic pars tensa perforation

MC eroded ossicle : incus
Myringoplasty : MC graft temporal fascial graft
Pseudomonas
Cortical mastoidectomy
Cholesteatoma : keratinised squamous epithelium
collection

Congenital : epithelium trapped behind ear drum

Meniere’s disease : high endolymphatic pressure
Glaucoma of ear
Episodic vertigo
Fluctuating SNHL
Tinnitus idiopathic
AI head trauma measles

Tumarkin crisis : fall without turning conscious

Surgical landmark for endolymphatic sac :

Donaldson’s line
Tullio’s phen : loud noise : vertigo nystagmus

Congenital syphilis
Superior SCC dehiscence syndrome
Meniere’s disease
Gradinego syndrome : V nerve retrobulbar pain
Ear discharge
Diplopia VI N involvement
Ear discharge
Petrositis : petrous apex air cell involvement

Bezoid abscess : SCM

Citelli abscess : digastric
 Sigmoid sinus thrombosis

Unsafe CSOM complication

Fever
Griessenger sign : pitting edema

Empty delta sign

 BPPV

Otoconia : macula CaCO3

MC : sup / post SCC

Dix Hallpike maneuver

Rx : Epley’s maneuver
Carhart’s notch

Otosclerosis
Acoustic dip

Noise induced hearing loss

 Tympanometry

A:N
B : GLUE EAR
C : ET dysfunction
As : otosclerosis
Ad : ossicular
dislocation
Ramsay Hunt syndrome :

Herpes zoster infection

External ear vesicles

VII N LMN palsy
Vth or VIII N palsy

Acyclovir
Steroid
 MELKERSSON ROSENTHAL SYNDROME

Recurrent fascial nerve palsy

Fissured tongue

Swelling of lip

Corticosteroids

Nerve decompression
 OTOSCLEROSIS
Fixation of stapes

Progressive disease

Young female
Oval window

Paracusis willisi : better hearing in noisy

environment

Schwartz sign : flamingo pink appearance behind

tympanic membrane
Acoustic neuroma

Benign tumor of VIII nerve

Inferior vestibular division
CP angle tumor
NF2

U/L SNHL
Tinnitus
Imbalance

Post sup part of EAC sensation loss : Hitzelberger

sign [VII N]
Boxer ear : hematoma pinnae

Syringing direction : post sup

Swimmers ear / telephone ear / Singapore ear

Otitis externa

Surfer’s ear : exostosis

Serous otitis media GLUE EAR sterile collection

school age ;myringotomy : adenoid / NP ca

THANKYOU