ENT Atf

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https://youtube.com/@damsdelhi https://t.me/damsdelhi
EPISTAXIS
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• AGGER-NASI • BULLA ETHMOIDALIS
• ONODI CELL HALLER CELL
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Nose Chin Position
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• ǫ
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CALDWELL VIEW
Nose –Forehead position
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ǡ

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Basal view
Submentovertical View
• εε
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ENDOSCOPY
Nasal synechiae (Topical mitomycin)
Csf Rhinorrhoea
Retrobulbar Hematoma(AE)
30 Degree
✓ 1st Pass Inferior Meatus
✓ 2nd Pass Sup/Supreme/Ant part of MM
✓ 3rd Pass Post Part MM
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SINUSITIS
SINUSITIS
FEVER+PUS IN MEATUS
OFFICE HEADACHE----F
CHEEK-DENTAL-LOWER EYELID----M
ROOT-RADIX-DORSUM—E
OCCIPITAL-VERTEX—RETROORBITAL---S
MUCOC/PYO/OM/FISTULA—F
ORBITAL----E
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• Needle-tip wand with contact markers

• Coblation shrinks submucosal tissue
•Hypertrophic rhinitis
ReFlex Ultra™ 45
Plasma Wand
ATROPHIC RHINITIS
•
•
•
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IMMEDIATELY
IF ODEMA----5 DAYS
CLOSED RD--< 3
WEEKS
OPEN >3 WEEKS
SEPTUM LATERAL WALL
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• LOW MAXILLARY • PYRAD
CRANIOFACIAL
• FLOATING PALATE DISJUNCTION
• GUERIN SIGN
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Rhinocerebral
Mucormycosis
• Diabetes
• Foul smell and purulent

discharge from the nose

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RHINOSCLEROMA
KLEB RS
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IRRADIATION
Atrophic stage-------------CARPENTER GLUE
STREPTOMYCIN
Granulomatous stageǤHEBRA NOSE
TETRACYCLINE
Cicatricial stageǤTAPIR NOSE
RIFAMPICIN
ACRIFLAVIN
Kailasa Regime
Carbolic acid
Glacial acetic acid
Glycerine
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• R .SEEBERI
• PONDS
• PROTOZOA
• SURGERY WITH CAUTERY
• DAPSONE
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PYOGENIC GRANULOMA
ȀȀ
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Inverted Papilloma
• Schneidarian tumor • Site of origin → lateral nasal

• Ringertz tumors wall
• Epithelial papilloma • Almost always unilateral (10 %
• Transitional cell papilloma are bilateral)
• Squamous cell papilloma • M:F=4:1
• Premalignant
• Endophytic or inverted growth
pattern → growing into stroma
• Lateral rhinotomy + medial
maxillectomy
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LATERAL RHINOTOMY
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CSF RHINORRHOEA
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Unilateral Cervical lymph nodes

NASOPHARYNX CARCINOMA
Epistaxis Young Boy
ANGIOFIBROMA
Wood Industry
ETHMOID ADENO CA
Nickel Industry
MAXILLARY SCC
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CARHART NOTCH ==BC
WHO—85
INDIAN –90
CITY LIFE--45
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RISING CURVE DOWN SLOPING
MENIERE DISEASE PRESBYCUSIS
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N FLAT FLUID ET DYSFUCTION
PERFORATION
OSSICULAR
OS—OF—TS--TF
DAMAGE
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ECOG-SENSORY DEAFNESS
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ABR Peaks
– ǣȋȌ
ǣ
ǣȋȌ
V: Lateral lemniscus (largest wave)
– ǣ
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1 DAY
1 MONTH
3 MONTHS
6 MONTHS
OAE
HIGH RISK BABY
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Haematoma of the Auricle ( Cauliflower Ear
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GOE
DOE
TROPICAL EAR
SINGAPORE EAR
SWIMMER EAR
TELEPHONIC EAR
PERICHONDRITIS FURUNCLE
(LOCALISED ACUTE O.E.)
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GRANULATIONS +FACIAL PALSY
TC99 SCAN—DIAGNOSIS
GALLIUM SCAN—PROGNOSIS
ESR—2 WKS
DEBRIDEMENT
WET NEWSPAPER APPEARANCE
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BULLOUS MYRINGITIS
PAINFUL HAEMORRHAGIC BLEBS

VIRUS /MYCOPLASMA PNEUMONIAE
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RETRACTED TYMPANIC MEMBRANE

MOST COMMON
EARLIEST CAUSE
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KERATOSIS OBTURANS
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TB EAR
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AFTER 3 MONTHS
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HIGH GRADE FEVER
CART-WHEEL APPEARANCE
STAGE OF PRESUPPURATION
LIGHT HOUSE SIGN

STAGE OF SUPPURATION
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COPIOUS ODOURLESS DISCHARGE
NONE OF 10 WORDS
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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 stapes suprastructure absent
CHOLESTEATOMA
SCANTY DISCHARGE
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POLYP
GRANULATION
FOUL SMELL
BLOOD STAINED
ATTIC ADITUS
ANTRUM PARS FLACCIDA
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MASTOIDECTOMY
Canal wall down (CWD) procedures

Canal wall up (CWU) procedures
ȋ Ȍ

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CITTELI’S ANGLE
LAT SCC
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BEZOLD’S ABSCESS
MOST COMMON SYMPTOM--DISCHARGE
CITTELLI’S ABSCESS
MOST COMMON SIGN--TENDERNESS
EARLIEST SIGN-IRONING POSTAURICULAR ABSCESS
HALLMARK SIGN-SAGGING
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—
—
—GRADENIGO TRAID
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FISSURE ANTE FENESTRAM
USUALLY B/L, PAINLESS, PROGRESSIVE DEAFNESS

PREGNANCY +SOFT VOICE
PARACUSIS WILLISII
OTOSCLEROSIS
MILD DEAFNESS AfraTafreeh.com

40 dB
IMPENDANCE AUDIOMETRY
CARHART NOTCH
AIR BONE GAP
R- WEBER –WORSE EAR
STAPEDOTOMY>STAPECTOMY
SODIUM FLUORIDE
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T---V----S
LERMOYEZ SYNDROMEAfraTafreeh.com
TUMARKIN'S OTOLITHIC
DIPLACUSIS
HENNEBERT'S SIGN
RECRUITMENT
TULLIO PHENOMENON
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MOD DEAFNESS
60 dB
LFHL
NOAIR BONE GAP
R+ WEBER –BETTER EAR
ECOG
MEDICAL TREATMENT
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ACOUSTIC NEUROMA
MC CEREBELLOPONTINE ANGLE TUMOR
Nerve:INF VESTIBULAR NERVE
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HEARING AIDS
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BAHA
CANAL ATRESIA
CANAL STENOSIS
PUS IN CANAL
Contralateral Routing of Signals
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BENIGN PAROXYSMAL POSITIONAL VERTIGO (BPPV).
No hearing loss or other neurologic symptoms.
Posterior semicircular canal .
Consisting of crystals of calcium carbonate.
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SUDDEN SNHL.
30 db 3 freq 3 days
•
• ȋͷΨʹ ΪͻͷΨʹȌ
•
•
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FISTULA TEST
NEGATIVE --NORMAL
POSITIVE --FISTULA
FALSE NEGATIVE –DEAD EAR/EXTENSIVE
FALSE POSITIVE –CONGENITAL SYPHILLIS>>MENIERES
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Ȁ
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ͳͳε͸

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Ȁ

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TB LARYNX
• • KNOB LIKE EPIGLOTTIS
• ȋȌ LEPROSY
• ȋȌ
•
•
• LEATHER WASH APPEARANCE
•
SYPHILIS
•
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• Posterior lamina of the cricoid cartilage
• Lower margin of the laryngeal aspect of the thyroid cartilage or
in arytenoid cartilages.
• Adult age and there is male predominance of 3:1.
• Reinke's edema
• Polypoid Degeneration
• Microlaryngoscopic vocal
stripping
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VOCAL NODULES
BENIGN BILATERAL W/w
VOCAL POLYP UPS
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INTUBATION GRANULOMA
Usually Unilateral Surgically treated
EPIGLOTTIC CYSTS
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✓ Epiglottis (Lingual surface )

✓ Pre-epiglottic space
✓ Aryepiglottic folds.
✓ Surgery is only indicated for
large cysts
✓ Globus sensation
Feeling of a lump in the throat
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Spasmodic dysphonia PHONASTHENIA
• • Elliptical space- Thyroarytenoid
• Ǧǡ • Triangular - InterarytenoidǤ

• Key hole - Both Ǥ
•
• VOICE REST
BOTOX
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VOICE DISORDERS
DYSPHONIA PLICA VENTRICULARIS

FALSE CORD VOICE /SPEECH THERAPY
MOGI PHONIA/ABN VOICE IN PUBLIC

SPEECH THERAPY/PSYCOTHERAPY
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VOICE DISORDERS
DIAGNOSIS
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DIAGNOSIS
TEST
GUTTMANZ TEST
Treatment of Choice:
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UNILATERAL RECURRENT LARYNGEAL NERVE
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UNILATERAL SUPERIOR LARYNGEAL NERVE
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BILATERAL SLN PALSY
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VOICE DISORDERS
•
•
•

FUNCTIONAL APHONIA
PSYCHOTHERAPY
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T1 T2
ONE 2/3
SUBUNIT SUBUNITS
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T3
T3
PARALYSIS
PARAGLOTTIC PREEPIGLOTTIC
PHARYNX PERICHONDRITIS OF
SPACE SPACE
VOCAL CORDS
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T4a T4b
CAROTID CHEST
ARTERY

PRE VERT
SPACE
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Carcinoma In Situ C02 Laser
T1 OR T2 RT OR PARTIAL LECTOMY
T3 OR T4 TL + RT
(CONCURRENT CHEMORADIATION)
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HPL
PFT MANDATORY
BOTH VOCAL CORDS NORMAL
Indications:
All cases of T1 Supraglottic
Early Cases of T2 Supraglottic
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VOCAL REHABILITATION

PRIMARY
SECONDARY
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TRACHEOSTOMY
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CUFFED UNCUFFED FENESTRATED
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• 2nd and 3rd ring. • Vertical incision :Emergency
• Cuffed Tubes:Necrosis • Horizontal : Elective
• 2 Hourly deflation of the cuff –5 Mins. • High Level :Malignancy
• Tract establish in 7-10 days • Low Level : Infections
• Co2 Washout • Total Blockage: Remove
• Bleeding (V>A) • Partial :Suction
Ǧ
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Juvenile Nasopharyngeal Angiofibroma
• •

• αͳͷȋͳͲǦ •
ʹͷȌ
•
• ǦǦ ( ǦȌ
• Ǧʹ •

ȋͷ͵ΨȌ
• —
• Endoscopic transnasal
• Transpalatal • —
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DIAGNOSIS
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• BIMODAL DISTRIBUTION
50 YRS
20 YRS
9899664533

• Rosenmüller’s fossa • Unilateral Cervical Lymph nodes
• Squamous Cell Carcinoma (SCC) • Chemoradiation
• EBV infection associated

Trotter Triad
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TONSILLECTOMY
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TONSILLECTOMY
CRYOSURGERY INTRACAPSULAR HARMONIC COBLATION

MICRODEBRIDER SCALPEL TONSILLECTOMY
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DAMSONIANS ALWAYS WIN
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 

• ONODI CELL HALLER CELL

•   

✓ 2nd Pass Sup/Supreme/Ant part of MM

✓ 3rd Pass Post Part MM

• Needle-tip wand with contact markers

SEPTUM LATERAL WALL

• Foul smell and purulent

 ȀȀ 

• Schneidarian tumor • Site of origin → lateral nasal

Unilateral Cervical lymph nodes

HIGH RISK BABY

WET NEWSPAPER APPEARANCE

PAINFUL HAEMORRHAGIC BLEBS

RETRACTED TYMPANIC MEMBRANE

LIGHT HOUSE SIGN

Group B - Malleus and foot plate of stapes present

Group C - Malleus absent and stapes present

Group D - Malleus and stapes suprastructure absent

ANTRUM PARS FLACCIDA

USUALLY B/L, PAINLESS, PROGRESSIVE DEAFNESS

MILD DEAFNESS AfraTafreeh.com

MC CEREBELLOPONTINE ANGLE TUMOR

Nerve:INF VESTIBULAR NERVE

Contralateral Routing of Signals

•   ȋͷΨʹ ΪͻͷΨʹȌ   

FALSE NEGATIVE –DEAD EAR/EXTENSIVE

FALSE POSITIVE –CONGENITAL SYPHILLIS>>MENIERES

VOCAL POLYP UPS

Usually Unilateral Surgically treated

✓ Epiglottis (Lingual surface )

DYSPHONIA PLICA VENTRICULARIS

MOGI PHONIA/ABN VOICE IN PUBLIC

UNILATERAL RECURRENT LARYNGEAL NERVE

UNILATERAL SUPERIOR LARYNGEAL NERVE

CUFFED UNCUFFED FENESTRATED

• 2nd and 3rd ring. • Vertical incision :Emergency

• Cuffed Tubes:Necrosis • Horizontal : Elective

• 2 Hourly deflation of the cuff –5 Mins. • High Level :Malignancy

• Tract establish in 7-10 days • Low Level : Infections

• Co2 Washout • Total Blockage: Remove

• Bleeding (V>A) • Partial :Suction

•   Ǧʹ •  

• Squamous Cell Carcinoma (SCC) • Chemoradiation

• EBV infection associated

CRYOSURGERY INTRACAPSULAR HARMONIC COBLATION

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