EAR , NO

1- Base of tongue
2- Epiglottis
3- Supraglottic
4- Pre-epiglottic space
5- Vallecula (is superior to pre-
epiglottic space)

Acute epiglottitis Croup/ layrngotracheobronchitis

Sudden onset Chronic onset
High grade fever S ign: pencil tip , church tip, steeple
Toxic looking patient sign
Signs - swan neck, thumb sign Low grade fever
Inspiratory cough Nontoxic patient
Cause - streptococcus Expiratory cough
Treatment - i/v antib iotics + ICU Rx : symptomatic

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Layrngocoele
Tr umpet player
Rupture of thyrohyo id
membr ane
Rx: sur gical excision
marsupialization

Layrngomalacia
Omega shaped larynx
Inspiratory dyspnea (if dyspnea then tracheostomy or surgical intervention)
Normal cry
Dyspnea decr eases in prone position
Rx: wait and watch
Congenital Grade HOARSENESS
webs 1 Mild
Involves 2 Moderate Mild
glottis area - 3 Severe Mod
biphasic 4 A honia Severe
dyspnea
Cry abnormal
Rx: CO2 laser
COHEN
classification

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For subglottic stenosis
Biphasic dyspnoea
Preterm criteria = 3mm
Full term delivery = 4mm (F for 4/
full term)
Cry normal
Ex: excision reanastomsis
Cotton Myer classification

U/L polyp 8/ L nodule

Anterior 1/3 and post 2/3 junction Wait and watch
Surgical excision
Mneumonic U-P-5

Rienke's edema Intubation granuloma

Polypoidal degeneration Due to faulty anesthetic technique
Rx: microlaryngeal vocal stripping (intubated in trachea instead of
Not a precancerous lesion esophagus)
Trauma to osterior commissure

NNDVT v3 ,;jf NOTESNEXTDOOR

 ml

TB larynx
Weakness of voice
Loss of adduction (m/c)
Hyperemia of posterior commissure
Mouse bitten vocal cord
Turban epiglottis
Pseudo edema due to cellular infiltrate
Small microscopic ulcers on vocal cord

Knob like epiglottis - leprosy

Leather wash appearance - syphilis

-
Juvenile multiple recurr~nt papillomatosis Senile single papillomatosis
It resolves and reoccurs Don't resolve and don't recover

HPV papillomatosis 11 > 6

Contraindications - intubation
DOC - cidovof ir
ROC - CO2 laser

flt"-" l.::t I

Pooling of saliva

~/
... ! '
\,..
' , •f

\ is

'
-. d
\
•••
Left Vocai'Cor~ Midlinc
-
U/L recurrent laryngeal nerve palsy U/L superior laryngeal nerve
Asymptomatic Askew glottis sags during
hoarseness inspiration bulges during expir ation
No treatment Weak voice

NNDVT v3 NOTES NEXT DOOR

 !ENT)

TB larynx
Weakness of voice
Loss of adduction (m/ c)
Hyperemia of posterior commissure
Mouse bitten vocal cord
Turban epiglottis
Pseudo edema due to cellular infiltrate
Small microscopic ulcers on vocal cord

Knob like epiglottis - leprosy

Leather wash appearance - _syphilis

-
Juvenile multiple recurr~nt papillomatosis Senile single papillomatosis
It resolves and reoccurs Don't resolve and don't recover

HPV papillomatosis 11 > 6

Contraindications - intubation
DOC - cidovof ir
ROC - CO2 laser

t
.::-:'lm!I_ "'._-•.
•I!""eft cnt LarynJ!eal_
...
.,,._;
,; .....~ ,.
Pooling of saliva

'
./
.
\ \,..
.
I :..:
-.
Left Yocai'Cor~ Midlinc

U/L recurrent laryngeal nerve palsy U/L superior laryngeal nerve

Asymptomatic Askew glottis sags during
hoarseness inspiration bulges during expiration
No treatment Weak voice

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 B/L RLN palsy
Dyspnea Uncommon
Tracheostomy Traumatic/ diphtheritic
Rx: Lateralisation Tracheostomy
Rxt Epiglotopecy

THYRO PLASTY
Isshikis's functional classification

• Type I: Medialization
• Type II: Lateralization
• Type Ill: Shortening, relaxation (lower pitch)
• Type IV: Lengthening, tension (raise pitch)
SPA S MODIC DY S PH O NIA
Adductor SD - strained, strangled, effortful voice
ABDUCTOR SD - weak/ breathy voice quality
TOC- botox

PH O NA S THENIA
Elliptical space - thyroarytenoid
Triangular - interarytenoid
Key hole - both thyroid and interarytenoid
TOC - complete voice rest (Q)

DYSPHONIA PLICA VENTI CULARI S

Faulty use of vocal cord
Mimicry (key word)
TOC - speech therapy

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MOG IPHONNIA
Abnormal voice in public
TOC - speech therapy

ANDROPH ONIA
Male like voice in female
TOC - type 4 thyroplasty

PUBERPHONIA
GUTTMAN test
High pitch voice at puberty

FUNCTIONA L AP HO NIA
Young female with no voice but normal cough
TOC - psychotherapy

CA LAYRNX
Most important predisposing factor - smoking
Type sec
Site - glottis> supraglottic > subglottic
Glottis tumours: Rx RT (radiotherapy)
Supra/ subglottic - surgery
Metastasis - lungs > liver > TV

Carcinoma in situ CO2 laser

Tl One subunit ( glottis/supra/sub) RT/ partial layrngectomy
T2 2/3 subunit RT/ partial layrngectomy
T3 '5Ps'I paraglottic space, preepiglottic space, TL + RT (total) if deny t hen
pharynx, perichondritis, paralysis of vocal cord concurrent chemoradiat ion (similar
'M:; t o nasophayrnx - cisplatin + 5FU)
T4a '3T' thyroid, tongue, trachea, neck muscles TL + RT (total)
..
" "
T4b Carotid artery, prevertebral space, chest " ii

TRACHEOSTOMY

Cuffed Uncuf f ed Fenestrated

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Best site _ _ _ __ 2nd and 3rd r ing - - - ~ -- ____
2hour deflation of cuff For ever 5 mins
Remove tube Total blocka e
Cuffed tubes Necrosis
Tract 7-10 da s
Horizontal incision Elective
Vertical incision Emer enc
CO2 washout Apnea
Hi h level Malignanc
i--~ -------------------'
Partial Suction
Low level Infections
Bleedin

Bloom singer trachea- Punje voice button Provox

esophageal prosthesis Bif fanged tube with one
w valve

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TONSILLCTOMY

Rose position Dissection and snare Diathermy tonsillectomy

method Tonsillectomy with cautery
Uses temp of 150-400
~------------ ==::==:.e--- -~--------- '--- -------1

·,
· . ..
Cryosurgery - using CO2, N2O and liquid nitrogen
, hes -82 to -189C

Harmonic scalpel
Ultrasonic vibrations
Used to dissect and coagulate tissues
50- 100 C

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 LE@

_Angiof ibroma ___ - -- -- - _ -~---- Nasopha!'_yngeal car~in~m~ ___ - ----

Young male Bimodal, 20 &60 yrs
CT MRI
Hallman miller sign (bowing of posterior wall) EBV
Frog face deformity Chinese
m/ c site - sphenopalatine foramen Fossa of r osenmuller
Dumbell shaped Trotters triad - 5 & 10th nerve palsy
m/ c symptom - epistaxis l U/ L lymph nodes
Surgery Rx: RT+ CT
No biopsy

EPISTAXIS
Internal carotid artery

+
Ophthalmic artery
Stt and lean
fo,ward sllahtly

Anterior Posterior
ethmoidal artery ethmoidal artery

Pinch Breathe tlvough

nostr1ls mouth

,, Branches of
,---;;:=;;~;;;:;:;::;:;::;;:;;;;;;
'•--. sphenopalatine

Branches of
facial artery ··r
Sphenopalatine
artery

i
Greater Lesser palatine

t
palatine artery

arttry
Facial artery Maxillary artery

t External carotid
artery
j
Ar tery of epistaxis - sphenoopalatine artery

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 Anterior 1
Posterior
Incidence Less common
Site Little's area/ anterior part of Posterosuperior part of nasal
nasal ssseptum cavity
~ge
·- - - - ~ - - - - - - Children and young adults >40ys
Cause Spontaneous
Bleeding Severe
m/c/c Nose picking in young Hypertension in old
Brown's area - venous plexus on post part of nasal septum
Woodroff's plexus - lateral wall

SINUSITI S
Cause: rhinovirus (m/c) >
streptococcus > fumigatus
Adult - involve maxillary
sinus
'.Paediatric involve ethmoid
sinus
IOC = TOC = endoscopy
. RADIO roe= HRCT
Fever +pus in meatus
Office headache in
frontal sinus
Check/ dental/ lower
eyelid pain - maxillary
sinus
Both eyelids pain in
1· ·~ -~·-.'
ethmoid sinusitis
Complication : mucocoele, .. 4
• ·J1·
- - -·
.,
.

pyocoele, osteomylelitis
and fistula in frontal
sinusitis
Orbital complication in
ethmoid
~ 7-,T"---;:;-~ 'iijjjjiuflh[I'"""--.. . .

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 Table 1: Bent and Kuhn diagnostic criteria for allergic fungal
rhinosinusitis (AFRS).
Major criteria Minor criteria
1. Evidence of type I 1. Asthma
Ig E-med iated hypersensitivity 2. Unilateral predominance
2. Nasal polyposis 3. Radio ra hie bone erosion
3. Characteristic CT findings 4. Fun al culture
4. Eosinophilic mucus 5. Charcot-Leyden crystals
5. Positive fungal smear 6. Serum eosinophilia

Bulla ethmoidalis Haller cell in the floor of 0nodi cell - most posterior cell/
orbit close to o ric nerve

OLF ACT0RY SENS I NG

UPSIT - university of Pennsylvania identification test, scrath and
sniff booklets, each
containing 10 odorants
Cross - cultural smell identification, variant UPSIT, comprises of 12 items
Used in parkinsons and a/zhimers

Linear Turbulent flow in

flow expiration
inspiration Sinus ventilation
in expiration

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 Mucormycosis
Love for blood vessels
No pain
No bleeding/ epistaxis
DOC liposomal amphotericin B

foul smell ing nasal

dischar e

with merciful with woody

•

L_L_
anosmia nose

L rhinoscleroma

.. A TROPHIC RHINITIS

I
,.
,. • -I'

,
'
I
..
..

;
f •
I '•
'

•
.,
'

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ALLERGIC RHI NITIS
Organism - klebsheilla ozaenae
Symptom - roomy cavities ( Q), merciful anosmia, nasal obstruction
Young's operation/ lautenslager surgery - injection of Teflon in lateral wall

HY PERTROPHI C RHINI TIS

Mulberry like mucosa
Drug induced rhinitis - by vasodilators
Rhinitis medicomentosa - due to withdrawl of vasoconstrictors
Vasomotor rhinitis - treatment is cutting thee vidian nerve

R HI NOSCLEROM A
Associated with subglottic stenosis
Woody nose
Atrophic stage - carpenter glue
Granulomatous stage - hebra nose
Cicatricial stage - tapir nose

Seen In adolescents & children Adult

Et iology Is infection Allergic

Multiple
Single

BIiaterai
'-
Unil ateral A
A.
Shape Is trl-fobed (dumb-bell) Grape llko
.
Grows backward

Treatment Is surgical

Recurren ce is uncom mon

Forward

Medlcal + Surglcal

Com mon
'
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CSf RHINORRHOEA
Causes - endoscopic trauma in roof of nose
Glucose concentration > 30 (in sinusitis it is < 10)
IOC - electrophoresis, HRCT
TOC - wait and watch and after 2 weeks - endoscopic removal
- Similar to superior semicircular canal syndrome

SKULL FRACTURES

Feature Longitudical fractures Transverse fractures

incidence -------- - --
- --
80% •••
Mechanism Temporal/ parietal trauma Frontal/ occipital trauma
CSF otorrhoea Common Occasional
Tympanic membrane perforation Common Rare
.Facial nerve damage- - - - -
------ - - - -
20% (delayed) 50%, immediate
Hearing loss Common , conductive Common, sensorineural
Less intense More intesnse

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 LENT]

FACIAL BONES FRACTURE

m/c nasal bone
reduce immediately
If edema present then reduce after 5 days
Close reduction within 3 weeks of trauma after
that open reduction
2 nd M/c zygomatic bone
Zygomatic bone - tripod/ tar drop sign '2Ts'

UPRIGHT

-·~ L
.:,: i Lateral

'
Asch forceps - for septal
cartilage
Walsham for lateral wall
Leforte classification - based on
direction of fracture line
- I - low maxillary and floating
palate
- II - pyramidal
- III - craniofacial disjunction
Guerin sign (expected Q)
- Ecchymosis of palate, B/L greater palatine
foramen
- Seen in Leforete I

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 Le Foct I Le Fort II Le Fort Ill

A- Class I B - class 2 fracture

Chevallet fracture J arjaway fracture
Trauma from below Trauma from front

damage to
maxillary wall
Papilloma

+ = inverted absent= SCC Nasal scptal tumors based on

papilloma their colours

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INVERTED PAPILLOMA
At lateral wall
a/k/a Ringertz tumours - U/L premalignant
M>F
Age - 40-60yrs

Lateral rhinotomy for nose

Weber fergusson incision

A

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 [ENT]

Onghren classification

Suprostruc1vre
Ohngr6n'S
line

ln&os1ruekir6

- Below line - good ·prognosis

- Above line - bad prognosis

Lederman's Classification.

Ethmold. ~phcnoitl, rrunul

0i'hi iinw'-'3 & olbrtory .are.l of
1 I\OSt'.

M~ Ul.iry & ruplratory

p~rt or not.c..

COVID manifestations
- m/ c ENT - sore throat
- non ENT fever

NNDVT v3 F:if NOTES NEXT DOOR

 f.ENT]

WATER'S VIEW CADWELL'S VIEW

' Left Inferior
Frontal "'- nasal concha
sinus

Maxillary
Ethmold )
sinus
I ). \
Nasal
\, Zygom
eptum
(bony)
/
\
Zygomatic
arch

....
"t
-
' ~--~ ,..._
Best for · :
Best for frontal/ ethmoid
< Nev ' ' r ethmoi d • • • ,

Occi ew Occi itofrontal

For
Pneumatisation of sphenoid sinus

B: Presellar C: Sellar

- Concha/ = children
- Sellar - adulta

RHINOSPORIDIOSIS
Protozoa - rhinosporidium seberri
Mulber ry like polyp
Complete excision
Cauterisation of bone
DOC - dapsone

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 One liners

U/L cervical lymph nodes Nasopharyngeal carcinoma

Epistaxis in young boy _ _ _ _ _ _ _........,,......A ,. . .~iofibroma_ _ __
Wood industry _ _.;._;....:...:.i..:.-.----'-'-=-""-=-"=-=.;.;:..;.;__..,L. Ethmoid adeno carcinoma
Nickel indust Maxillar SCC

Bat Ear

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 Malleus
lncus

Stapes

Footplate
Long Process

Tympanic Membrane

1. 1 - malleolus (head is convex

2. 2 - Incus
3. 3 - corda tympani

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 Long process of incus (expected Q)
Middle ear implants attach here
Stapes prosthesis
ml c site of necrosis
> incudomalleolar joint = saddle joint
Incudostapedial joint - ball and socket joint, m/c joint of necrosis and site of trauma
Foot plate of stapes = otosclerosis
Artie

flClal ~

Middle ear
Pollenof

u.cs..1
Mastoid a ir cell$
Middle ear cleft.

Inner ear detailed model

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 IENT]

Inner Ear Detail Model

1. Cochlea
2. Branch of Vestibular Cochlear Nerve VIII
3. Vestibular Branch of Vestibular Cochlear Nerve VIII
4. Scala Tympani (Perilymph) duct
5. Cochlear Duct (Endolymph)
6. Scala Vestibuli (Perilymph)
7. Vestibular Membrane
8. Basilar Membrane
9. Semicircular Canals
10. Semicircular Ducts
11. Ampulla of Semicircular
12. Utricle
13. Saccule

PURE TONE AUDIOMETRY

Normal < 25dB
-20
I I I I Severe Hearing Loss
....I_,
-10 I I I I F__.,(Hzl
0 12$ 250 500 1000 2000 4000

·•• ""I "'""

I I I _,Y
10
_1.{( >-. I C ./ J I I i
20 . I i I i
J
? 30
I
I
I
I
I
I
I
I
1

.. I I I I
! 40
....... I

.. so ..... .-·
•'
I I

. ...,...
I I
-
] 60
I
. . ... . .....
I I
,· I
I
I
·j ].
I I I
70 I I I I I I
:,:: 80
80
100
I

I
I

I
I

I
I

I F .
•t=-
I
r l .. I
1· r"s: ;:::::r ---.;:
I
I I I I
110 I I I I
1
I I
120 I I I I I
130 "12 I I
125 250 500 1000
F,equency (Hz)
2000 4000 8000
,.. I I

Conductive deafness SNHL

- AB gae - No AB gae,
125 250 500
Freqvency in Hertz
1000 2000 4000 8000 I Hearing Thresholds of a Person with
Noise-induced Hearing Loss

.. I :r:x: I I I
!l
0 -·-- CJ-•.•
10 _....... -..
"I

--· , ,,
.. m .-
_,. /
20 µ
- ,, I
I ti
,#-
.::-,.

~"' I
/j

---
30 >
/
CIC)
-0

-= .!l I
''
---
40

i! .."
_§ ' 32 "
50
C>
C ' '
C
0
:! 70
60 • I ....c .,
I 01 "
80
l J: T ~r..
90 Ii
II
"

'
100 J: ,i>

110 Frequency (Hz)

Carhart notch NIHL - di~ at 4000 Hz

NNDVT v3 NOTES N EXT D OOF

• 10 ·~ 2M) ,,0 •ooo 2'IJOO
- tlOOO
.,o

1-·:
125 2.5 0
Frequency In Hz
500 1000 2000 4000 8000

r ·
0 0 750 1500 3000 6000
,o
20
0 ~--dD---dS> ::::=• 10
20 I
I
I

llO 10 + I I •
I
llO
-0 40
I I
20 I
.,
1'0
X - --*· to
eo
,0
... 30

t 40
l
...'° eo
90
60
.. 60
•oo 100
J 70

J:
110 110
• 20 1:10
• 30 t :IIO
100 r
110
120
Risin curve - mieners Down slo cusis

TYMPANOMET RY

1.5 1.5 1.5

Type A
i Type/u
! Type C
j I §
•

J
j 0.5
1 0.5
1 0.5

-400
-400 -200 0 +200 -400 -200 0 +200
Pressure mm Hz0
Pressure nvn HzO Pressure mm HzO

1.5 1.5
I i
Type B

§
.!!
Q.
0.5
i 0.5
u
J
-400 -200 0 +200 -400 -200 0 +200
Pressure mm Hz0 Pressure mm Hz0

A= normal
B = perforation/ fluid in ME
C = ET dysfunction
As - otosclerosis
Ad - ossicular damage

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 (EWTJ

Highest center - superior olivory nucleus

Seen at 70d8 (S f or st opedial, S for 70)

Acoustic Reflex Arc

- -
,,---~~---(-;M, )~ CNVII

,~
' l Stnpcdius
Nerve
I VCN I ~ oc
._''-I
-.. . _soc____._~ .,\------,
VCN _
I
"-._. L _______ .1 c~ i@)
r i Coehlo, Coehl"

Stapedius Muscle Stapcdius Muscle

Contralateral Pathway

Ipsilateral Pathway

>50%
A

Tone bursts

!kHz >6µV

ECOG - electrocochleography device for sensorineural deafness

Only invasive investigation

NNDVT v3 "ii NOTES NE XT DOOR

 8rain$1~rh EypK@d. Re$gonse
Audiomeby (B.E.R.A.t.---.
8 th nerve (distal+
proximal segments)
,.o-
ii, - - _ . ..

Cochlear nerve
Olive (superior
olivary nucleus
Lateral laminiscus
Inferior colliculus
0 2 3 $ 6
I1.0 rns/<ivl

DON E ON I DAY 1
DEFIN ITELY 1 MONTH
DON E BY
COMBIN ED IAt 3 months
WITH BERA
TREATMEN T 6 months
done bY,

SUPERIOR SEMICIRCU LAR CANAL DEHIS CENCE

Symptoms conductive deafness + CNS symptoms
roe VEMP
RX : wait and watch
2 key words - TULIO'S phenomenon (uncomfortable in noisy surroundings) and 3rd
window effect

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PRECIPITATING FACTORS
Head movement BPPV
Foods-caffeine.cheese, wine.Stress /lack of Herpes zoster oticus
sleeF!
CLoud sound.Pressure SSC dehiscence
changes:valsalva,sneez i ng ,coughing Perilymhatic fistula
Enlarged vestibular aqueduct
-
Immunosupression (advanced age.stress) Migraine

Button battery from ear Cauliflower ear/ hematoma of ear

Most dangerous type of t/t - incision and drainage
1
foreign body - b~tton battery
Leads to facial nerve palsy

Generalised otitis
media a/k/a
1. DOE
2. Tropical ear
3. Singapore ear
4. Swimmer ear
5. Telephonic ear

seudomonas
rd
treatment of pseudomonas - 3 generation cephalospor ins

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Malignant otitis externa
Facial nerve palsy
IOC - tech 99 scan
Prognosis - gallium Otomycosis
Lab inv- ESR Wet newspaper appearance
Aspergillosis
TOC - 3rd gen cephalososins (caused by
eseudomonas

Painful hemorrhagic blebs m/c/c or earliest cause of any pathology

Cause · ma

Otitis externa Traumatic perforation

Swimmers/ surfers ear Rx: wait and watch, kee

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 Serous otitis media/ glue ear
Multiple perforation No fever
Always painless No congestion
Maybe colourless TOC - myringotomy with grommet insertion after 3
Maybe odourless months
Maybe red stained
Maybe foul smelling_

Rx ASOM
ASOM- posteroinferior incision High grade fever
Serous OM - anteroinf erior incision Cart wheel appearance - stage of pre-suppuration
Li ht house si n .,. sfoge of su puration

WULLSTEIN CLASSIFICATION OF TYMPANOPLASTY

T e2 PERFORATION OF TM with erosion of malleolus
Type 3 Malleus & incus absent. Graft place directly on stapes head

lace between oval & round window.

Stapes footplate is fixed but round window is functioning.
Another window is created & covered with raft fenestration o eration)

AUSTINE KARTUSH CLASSIFICATION

Group-A Malleus and stapes present (commonly seen status) because of precarious
vascularity of incus
Group-B Malleus and foot plate of stapes present
Group-C Malleus absent and stapes present
Group-D Malleus and staP.es SUP.ra structure absent

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Key words
cholestasis
scanty
discharge
granulations
polyp
foul smelling
blood stained
- attic
- aditus
- antrum
- Pars flacida
If an resent indicates unsafe ear
MASTOIDECTOMY
Canal wall down (CWD) procedures
- Modified radical mastoidectomy - csom
- Radical mastoidectomy - malignancy
- Atticotomy
Canal wall up (CWU) procedures Cortical mastoidectomy (schwartz operation) Combined
approach tympanoplasty

Mastoiditis is Ml c compliation
of unsafe ear
ml I c symptom - ear discharge
ml c sign - tenderness
Earliest sign - ironing of
mastoid
Hallmark sign - sagging

NNDVT v3
F:jf NOTES NEXT DOOR
 Bezold's abscess - along SCM
Cittelli's abscess - along digastric
muscle !
.1-- - - - SfJlddprooe•
Postauricular abscess - m/c
Slemod~
LABRYNTHITIS 'dmutd.
Lateral SCC
Fascia! nerve palsy (tympanic)
Petrous - Gradenigo triad - 5 th and 6 th
nerve palsy
Symptom - discharge, diplopia, deep seated pain

LATERAL S IN US THR O MBOPHLEBITIS

Contrast outlines a triangular filling defect which represent thrombus seen on
CECT/ MRI and not on non contrast
Hectic picket fence type of fever
Griesinger sign - edema at mastoid
. Crowe beck sign -edema at eyes
Tobey Ayer test - no change in CSF pressure on change pressure with IJV

BPPV (benign paraoxysmal

positional vertigo)
CaC03 bodies
Posterior canal Olslodpd
c.ryst,1 in
No CSN symptoms, no hearing loss posterior
unvdm,l,r

roe - Hallpicks maneuvers "'"°'

TOC epleys

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SUl)l>EN SNHL
30dB.. 3 freq uency. 3 days
Steroid t herapy
Inhalation of carbogen ( 95% carbon +

FISS URE ANTE FENES TR AM/ O TO S CLER O S I S

Usually B/ L, painless. progressive deafness
Pregnancy + soft voice
Paracusis willi - patient comfortable in noisy
surrounding
Mild deafness - 40dB
Carhart notch
Air bone gap
Impedence audiometry
Weber's - lateralised to worst ear
Stapedotomy > stapedectomy
Swartz is a C/I to surgery
Medical - sodium floride

D E

COCH L EAR O TOS CL EROSI S

Double ring effect (on CT scan) - d/t
spongiosis within thickened capsule

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MENIER E' s DI SE AS E IMgno5is ronfwmed
TVS - t init is, vertigo, se.nsorineural Alpattent:s
deafness
Lowsaltciet.
L - lermoy's syn<rome ~cl~
T - tumarkins phenomenon dloco&ate. alrohol.
tobacco procMtS
R - recrui~nt phenomenon
T - tulio's phenomvion
mond'I trill AQrtltattacb
SISI - BIL (short incre~nt sensitivity
index) Oral. Intramuscular. °'
lntntympank steroids
ABV- U/ L (alternobar ic vertigo)
Treatmentfailuft
Meniere's disease
MeniettclM:e
Trutmentfailuft
~ t i c sac enhancement suge,y

Treatmentfailuft
Gentamidn perfusion

Treatment failuft

Vfflkular neurectomy

Tl'eltment failure

SILVERSTEIN MICROWICK
ubyrinth«tomy

\ - - - - ~ ~~ - - latetal
-ldro,iar C8M
r~ ~ ::ll~f:7~ --Posi.ino,
somiorrutw car.1
_ .;....:;..:::,__ _ _ Slgmoldsnus

EuetaclllMTutle

AC OUS TIC NEURO MA

Antoni classification
Ice cone appearance

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 SAHA
Indications- canal atresia

CROS

Contralateral rooting for profound deafness

> BOdB

ft
)»~
BiCROS
CROS
. :h

)» ((<
Transmil!t< HI
~onstrils sound
Micropl>one ·on·

•
Poorear
~HJ

-
Ind
sound
l.liaopllone

0
Better ear
·or

.
Poor ear --
--.
HI
an,plfies

Micrcphono ·on·

Poor ear with

mlld-to-severo
hearing loss

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 --Vibrating Osslcuiar Proshtesls
(VORP) Implant
Audio
Processor/
Receiver

Conductor
Link

Middle ear implants

Pneumatic otoscopy
Negative -
normal
Positive -
cholestoma
False negative -
extensive
cholestoma
False positive -
Meniere's,
Hanbert's sign

EPISODIC VERTIGO
H/o trauma,ear surgery,Hennbert's Sign,._T- u~l~lio_'_s~ ~ ~ - - - Peri lymehatic fistula
Severe unilateral throbbing pain or a pulsing sensation, unilateral. Migraine
It's often accompanied by nausea, vomiting, and extreme sensitivity
to Ii ht and sound
Hearing loss since childhood , Progresses with minor head trauma, EVAS
Vertig_o_
Episodic vertigo,interstitial keratitis, malformed teeth (Hutchinson Otosyphilis
incisors and mulberry molars), and eighth nerve deafness
B/L rapidly progressive SNHL, (monthly intervals),Recurrent vertigo , Autoimmune inner ear
Ocular inflammat ion, Depigmentation, Recurrent thrombosis, late onset-adulthood
s ontaneous abortions(APLA) disease

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