Jaypee Brothers
In Current Chapter
In All Chapters
X
Clear
X
GO
Normal
Sepia
Dark
Default Style
Font Style 1
Font Style 2
Font Style 3
Less
Normal
More
Textbook of Ear, Nose and Throat
Amandeep Singh, BS Tuli, Isha Preet Tuli, Navneet Kaur Tuli
SECTION 1: DISEASES OF EAR
CHAPTER 1:
Surgical Anatomy of Ear
INTRODUCTION
DEVELOPMENT OF EAR
External Ear
Middle Ear
Inner Ear
ANATOMY OF EAR
External Ear
Pinna
External Acoustic Meatus
Internal Acoustic Meatus
Middle Ear Cavity (Tympanum)
Walls of Tympanic Cavity (Figures 1.4A and B)
Surgical Anatomy of Mastoid Antrum
Eustachian Tube
Auditory Ossicles
Muscles of the Tympanic Cavity
Compartments and Spaces of Middle Ear
Prussak's Space
Mucous Membrane of Middle Ear
Blood Supply of Tympanic Cavity
Nerves
Internal Ear
Bony Labyrinth
Membranous Labyrinth
Cochlear Duct (Scala Media)
Vestibulocochlear Nerve
Cochlear Nerve
Vestibular Nerve
Arteries of Labyrinth
Veins
CHAPTER 2:
Physiology of Hearing and Equilibrium
INTRODUCTION
VARIOUS AUDIOLOGICAL TERMS
TRANSMISSION OF SOUND WAVES
Sound-conducting Mechanism
Air Conduction Sounds
Bone Conduction Sounds
Sound Perception Mechanism
THEORIES OF HEARING
Helmholtz Resonance Theory (Place Theory)
Rutherford's Telephone Theory
George von Bekesy's Traveling Wave Theory
ELECTRICAL POTENTIALS OF COCHLEA
Cochlear Microphonic Potentials
Summating Potential
Endolymphatic Potentials
Cortilymph Potential
Action Potential
PHYSIOLOGY OF EQUILIBRIUM
Functions of Vestibular Apparatus
How These Functions are Performed?
Otolithic Organs of Maculae and Saccule
CHAPTER 3:
History Taking and Physical Examination of Ear
INTRODUCTION
HISTORY TAKING OF EAR PATIENT
Chief Complaints
Discharge from Ear
Hearing Loss
Vertigo
Noises in the Ear
Earache
Otalgia
Diplacusis
Other Symptoms of Complications
METHOD OF LOCAL EXAMINATION OF EAR
Important Points for Examination of the Ear
Examination of Ear
Classification of Retracted Tympanic Membrane
INVESTIGATIONS
CHAPTER 4:
Functional Assessment of Hearing and Vestibular Function Tests
TESTS OF HEARING
VARIOUS TESTS
Finger Friction and Watch Tests
Whisper and Conversation Tests
Tuning Fork Tests
VARIOUS TUNING FORK TESTS
Rinne's Test (Sir Adolf Rinne, 1853)
Procedure
Weber's Test
Procedure
Interpretation
Schwabach's Test
Remember
Absolute Bone Conduction Test
Procedure
Conclusion
Gelle's Test
Bing Test
Other Tuning Fork Tests
SPECIAL TESTS OF HEARING
Pure Tone Audiometry
Advantages
Procedure
Conclusion
Speech Audiometry
Advantages
Speech Reception Threshold
Speech Discrimination Score or Optimum Discrimination Score
Results
Bekesy's Audiometry
Tests for Recruitment
ABLB Test of Fowler for Recruitment
Short Increment Sensitivity Index Test
Carhart's Tone Decay Test (Nerve Fatigue Test)
Interpretation of the Test
Impedance Audiometry
Tympanometry
Advantages of Impedance Audiometry
Stapedial Reflex or Acoustic Reflex
Evoked Response Audiometry
Otoacoustic Emission
Types of OAE
Uses of OAE
Advantages
Disadvantages
VESTIBULAR FUNCTION TESTS
Degrees of Nystagmus
Types of Nystagmus
Central
Ocular
Vestibular
VARIOUS TESTS
Galvanic Stimulation Test
Barany's Rotational Test
Caloric Test
Fitzgerald and Hallpike Technique
Dundas Grant Method of Cold Air Caloric Test
Kobrak's Cold Caloric Test
Fistula Test
Romberg's Test
Unterberger's Test
Gait Test
Hallpike Maneuver Test
Electronystagmography
Optokinetic Nystagmus
Craniocorpography
CHAPTER 5:
Diseases of External Ear
CLASSIFICATION
Congenital Conditions
Preauricular Sinus
Congenital Swellings of Pinna
Collaural Fistula
Congenital Anomalies of Pinna
Treacher Collins Syndrome
Atresia of External Auditory Meatus
Acquired Atresia
Congenital Atresia
Congenital Tumors of External Auditory Meatus
Treatment
Inflammatory Conditions of the Pinna
Erysipelas
Perichondritis
Infective Conditions of External Auditory Meatus
Furunculosis
Otitis Externa
Malignant Otitis Externa or Necrotizing Otitis Externa
Clinical Features
Common Pathogens
Differential Diagnosis
Diagnostic Work Up Includes
Treatment
Primary Cholesteatoma of External Auditory Canal
Otomycosis
Clinical Features
Diagnosis
Treatment
Viral Infections
Herpes Zoster Oticus
Bullous Myringitis Hemorrhagica
Retracted Tympanic Membrane
Treatment
Reactive Conditions
Eczematous Otitis Externa
Neurodermatitis
Seborrheic Otitis Externa
Traumatic Conditions
Hematoma of Pinna
Frostbite
Pseudocyst Pinna
Tumors of External Ear
Benign
Malignant Tumors
Miscellaneous Conditions of External Ear
Wax
Keratosis Obturans
Foreign Bodies of Ear
CHAPTER 6:
Acute Otitis Media
ACUTE SUPPURATIVE OTITIS MEDIA
Definition
Etiology
Causes of Acute Otitis Media
Routes of Infection
Bacteriology
Pathology
Stage of Tubal Catarrh or Congestion
Stage of Exudation
Stage of Suppuration
Stage of Resolution
Stage of Complications
Diagnosis
Differential Diagnosis
Management
Complications of Acute Otitis Media
ACUTE NECROTIZING OTITIS MEDIA
MASTOIDITIS
Masked or Latent Mastoiditis
Coalescent Mastoiditis
Acute Mastoiditis
Pathology
Clinical Features
Management
Complications of Acute Mastoiditis
Differential Diagnosis
Abscesses in Relation to Mastoid
PETROSITIS
Clinical Features
Symptoms
Diagnosis
Treatment
CHAPTER 7:
Chronic Suppurative Otitis Media
DEFINITION
Types
TUBOTYMPANIC TYPE OF CHRONIC SUPPURATIVE OTITIS MEDIA
Types of Tubotympanic Chronic Suppurative Otitis Media
Etiology
Common Causes of Chronic Otitis Media
Predisposing Factors
Bacteriology
Pathology
Pathological Changes
Clinical Features
Symptoms
Signs
Functional Examination
Investigations
Management
Active Stage
Quiescent Stage
Inactive Stage
ATTICOANTRAL TYPE OF CSOM
Etiology
Pathogenesis of Atticoantral Disease
Cholesteatoma
Definition
Types of Cholesteatoma
Congenital Cholesteatoma
Acquired Cholesteatoma
Theories of Pathogenesis of Cholesteatoma
Effects of Cholesteatoma
Pathogenesis of Cholesteatomas
Clinical Features
Examination
Investigation
Treatment
Surgical Goals for Treatment of Cholesteatoma
Surgical Treatment of Cholesteatoma
Contraindications of Surgery in Unsafe Ear
CHAPTER 8:
Complications of Suppurative Otitis Media
CLASSIFICATION OF COMPLICATIONS
FACTORS LEADING TO COMPLICATIONS
How Infections Spread
EXTRACRANIAL COMPLICATIONS OF SOM
Acute Mastoiditis and Subperiosteal Abscess
Labyrinthitis
Localized Labyrinthitis
Diffuse Serous Labyrinthitis
Diffuse Suppurative Labyrinthitis
Apical Petrositis (Gradenigo's Syndrome)
Facial Nerve Palsy
Clinical Features
Treatment
Osteomyelitis of Temporal Bone
Septicemia or Pyemia
Otogenic Tetanus
INTRACRANIAL COMPLICATIONS OF SOM
Extradural Abscess
Pathology
Clinical Features
Treatment
Complications
Subdural Abscess
Clinical Features
Diagnosis
Treatment
Otogenic Meningitis
Mode of Infection
Types
Clinical Features
Diagnosis
Treatment
Otogenic Brain Abscess
Routes of Infection
Bacteriology
Pathology
Clinical Features
Investigations
Treatment
Lateral or Sigmoid Sinus Thrombosis
Etiology
Pathology
Bacteriology
Clinical Features
Lemierre's Syndrome
Investigations
Treatment
Complications or Sequelae
Otitic Hydrocephalus
How it Occurs
Clinical Features
Treatment
CHAPTER 9:
Nonsuppurative Otitis Media
OTITIS MEDIA WITH EFFUSION
Etiology
Pathogenesis
Clinical Features
Investigations
Treatment
Medical Management
Surgical Management
Otitis Media with Effusion in Children: Causes
Complications or Sequelae of Glue Ear
CHRONIC ADHESIVE OTITIS MEDIA
Causes
Clinical Features
Symptoms
Signs
Treatment
AERO-OTITIS MEDIA
Otitic Barotrauma
How it Occurs
Clinical Features
Treatment
TUBERCULOUS OTITIS MEDIA
SYPHILITIC OTITIS MEDIA
Diagnosis
Treatment
CHAPTER 10:
Otospongiosis
INTRODUCTION
OTOSPONGIOSIS
Incidence
Types
Clinical Otosclerosis
Histological Otosclerosis
Malignant Otosclerosis
Etiology
Distribution of Otosclerotic Foci
Pathology
Grossly
Microscopically
Clinical Features
Signs
Differential Diagnosis
Treatment
Medical Treatment
Genetic Counseling
Surgical Treatment
CHAPTER 11:
Facial Nerve Disorders
SURGICAL ANATOMY
Nuclei of Facial Nerve
Course of Facial Nerve
BRANCHES OF FACIAL NERVE
BLOOD SUPPLY OF FACIAL NERVE
RADIOLOGICAL DEMONSTRATION OF FACIAL NERVE
Surgical Landmarks
Neck and Face
Vertical Segment
Tympanic Segment
Petrous Segment
Intracranial Portion
IMPORTANT RELATIONS OF FACIAL NERVE
MUSCLES OF FACIAL EXPRESSION
HOW TO PROCEED IN FACIAL NERVE PALSY (WORKOUT)?
History
Local Examination
Investigations
TYPES OF NERVE LESIONS
Nature of Injury
Neurapraxia
Axonotmesis
Neurotmesis
Wallerian Degeneration
ASSESSMENT OF FACIAL NERVE PALSY
History and Clinical Examination
Radiological assessment
Assessment of Motor Functions
House-Brackmann Facial Nerve Grading System
Electrodiagnostic Tests
Minimal Nerve Excitability Test
Electromyography (EMG)
Maximal Stimulation Test (Strength Duration Measurement)
Denervation Potential
Polyphasic Motor Unit Potential
Electroneuronography (ENoG)
Anatomical Diagnosis
Schirmer's Test of Lacrimation
Stapedial Reflex
Hyperacusis
Electrogustometry
Salivary flow Test
Magnetic Evoked Neuromyography
FACIAL NERVE PALSY
Etiology
Intracranial Lesions
Intratemporal Causes
Extracranial Causes
Other Conditions
Management of Facial Nerve Palsy
General Management
Complications of Facial Nerve Palsy
Specific Management
BELL'S PALSY
Pathology
Clinical Features
Differential Diagnosis
Investigations
Treatment
Reassurances
Role of Vasodilators
Role of Steroids
Role of Vitamins
Care of the Eye
Physiotherapy
Decompression of Facial Nerve
Facial Reanimation
Facial Palsy in Acute or CSOM
Postoperative Facial Nerve Palsy
Management of Traumatic Facial Palsy
Head Injury and Facial Nerve Palsy
Management
Ramsay Hunt Syndrome
Tumors of Temporal Bone with Facial Nerve Palsy
Other Miscellaneous Conditions
Melkersson's Syndrome
Heerfordt's Syndrome
Bilateral Facial Paralysis
Antoni's Palsy
Facial Hemispasm or Clonic Spasm
CHAPTER 12:
Tumors of Ear
INTRODUCTION
CLASSIFICATION OF TUMORS OF EAR
Tumors of External Ear
Pinna
Tumors of External Auditory Meatus
Tumors of Middle Ear and Mastoid
Tumors of Internal Ear
TUMORS OF EXTERNAL EAR
Pinna
Squamous Cell Carcinoma of the Pinna
Basal Cell Carcinoma (Rodent Ulcer)
Malignant Melanoma
TUMORS OF EXTERNAL AUDITORY MEATUS
Benign
Adenomas
Malignant
Squamous Cell Carcinoma of the Meatus
Basal Cell Carcinoma and Adenocarcinoma
TUMORS OF MIDDLE EAR
Glomus Tumors
Etiopathogenesis
Histopathology
Types (Oldring and Fisch classification)
Clinical Features
Investigations
Management
OTHER BENIGN TUMORS
Conditions Simulating Benign Tumors
Lipoid Dystrophies
Wegener's Granuloma
Fibrous Dysplasia
MALIGNANCIES OF MIDDLE EAR AND MASTOID
Symptoms and Signs
Investigations
Treatment
Multiple Myeloma
TUMOR OF INTERNAL EAR
Acoustic Neuroma
Symptoms and Signs
Auditory Symptoms
Vestibular Symptoms
Cranial Nerve Lesions
Clinical Features
Audiovestibular Tests
Neurological Tests
Radiological Tests
Differential Diagnosis of Acoustic Neuroma
Meningioma
Arachnoid Cyst
Others May Be
Treatment of Acoustic Neuroma
Surgical Removal of Tumor
Gamma Knife Surgery
Conventional Radiotherapy
CHAPTER 13:
Vertigo and Ménière's Disease
INTRODUCTION
VERTIGO
Definition
Physiology
Causes of Vertigo
Classification
Another Classification
Classification: Alphabet
How to Find the Cause of Vertigo? Diagnosis of Vertigo
Investigations
Treatment
Reassurance
General Treatment
Medical Treatment
Surgical
Labyrinthine Exercises
Epley's Maneuver
MÉNIÈRE'S DISEASE
Ménière's Syndrome
Causes
Pathophysiology
Clinical Features
Investigations and Diagnosis
Staging of Ménière's Disease
Variants of Ménière's Disease
Treatment of Ménière's Disease
General Measures
Conservative Treatment in Acute Attack
Treatment of Chronic Case
Surgical Treatment
Adaptation Exercises
Vestibular Neuronitis
Clinical Features
Management
Benign Paroxysmal Positional Vertigo
Pathology
Clinical Features
Diagnosis
Treatment
CHAPTER 14:
Deafness and Various Rehabilitative Measures
IMPAIRMENT OF HEARING
Classification
Comparison Between Conductive and Sensorineural Hearing Loss
WORK OUT OF A CASE OF DEAFNESS
HEARING TESTS FOR CHILDREN
Preschool Children
Simple Tests
Diagnostic Tests
Differential Diagnosis
MANAGEMENT OF DEAFNESS
Management of Conductive Deafness
Management of Sensorineural Deafness
Children Born Deaf
SENSORINEURAL HEARING LOSS (ADULTS)
Comparison between Cochlear and Retrocochlear SNHL
Special forms of SNHL
Presbycusis
Toxic Deafness
Noise Trauma
SUDDEN DEAFNESS
Etiology
Treatment
Prognosis
PSYCHOGENIC DEAFNESS
Functional Deafness
Diagnosis
Special Diagnostic Tests
Treatment
MALINGERING (SIMULATED DEAFNESS)
Treatment
TRAUMATIC DEAFNESS
Head Injury and Deafness
Longitudinal Fracture
Transverse Fracture
Deafness due to Atmospheric Pressure Changes
Treatment
INFECTIONS AND SNHL
DEAFNESS IN CHILDREN
Syndromic Form of Deafness
Waardenburg's Syndrome
Pendred Syndrome
REHABILITATIVE MEASURES
Hearing Aids
Types of Hearing Aids
Situation where Aids are Required
Situation where Aids are not Indicated
Cochlear Implants
Benefits of Cochlear Implants
Parts of Cochlear Implant
Indication for Cochlear Implants
Investigations
Procedure
CHAPTER 15:
Tinnitus
DEFINITION
TYPES
CAUSES
Causes of Subjective Tinnitus
Causes of Objective Tinnitus
Important Causes of Tinnitus
Local Causes
Measurement of Tinnitus
INVESTIGATIONS
TREATMENT
SECTION 2: DISEASES OF NOSE AND PARANASAL SINUSES
CHAPTER 16:
Anatomy and Physiology of Nose
DEVELOPMENT OF NOSE
Commonest Anomalies of Nose
ANATOMY OF NOSE
External Nose
Soft Triangle
Muscles of External Nose
Blood Supply of External Nose
Veins
Nerve Supply
Lymphatics
Nasal Vestibule
Nasal Cavity
Nasal Valve
Roof of Nasal Cavity
Floor
Medial Wall (Septum)
Lateral Wall of Nose
Superior Meatus
Middle Meatus
Inferior Meatus
Pterygopalatine Fossa
Infratemporal Fossa
Contents
Mucous Membrane of Nose
Olfactory Nerves
Blood Supply of Nasal Cavity
Venous Drainage
Nerve Supply
Lymphatic Drainage of Nasal Cavity
FUNCTIONS OF NOSE
Olfaction
Introduction
Olfactory System
Olfactory Bulb and Olfactory Cortex
Olfactory Transduction
Classification of Olfactory Disorders
Various Theories of Olfaction
Causes of Olfactory Dysfunction
Clinical Evaluation of Olfactory Function
Treatments
CHAPTER 17:
History Taking and Method of Examination of Nose and Paranasal Sinuses
HISTORY TAKING
Biodata of the Patient
Chief Complaints with Duration
History of Present Illness
Various Nasal Symptoms to be Recorded or Enquired in a Nose Case are as Follows
Nasal Obstruction
Nasal Discharge
Headache
Sneezing
Nose Bleeding
Disturbances of Sense of Smell
Snoring
Change of Voice
Other Symptoms
Past History
Personal History
Family History
EXAMINATION OF PATIENTS
General Physical Examination
Systemic Examination
Local Examination of Nose and PNS
Inspection and Palpation of External Nose
Examination of Vestibule of Nose
Anterior Rhinoscopy
Posterior Rhinoscopy
Probe Test
Functional Examination of Nose
EXAMINATION OF PARANASAL SINUS
Clinical Examination
Palpation of Sinuses
Transillumination Tests
INVESTIGATION IN A NOSE CASE
CHAPTER 18:
Diseases of External Nose and Nasal Cavity
CLASSIFICATION
Dangerous Triangle of Face and Nose (Flowchart 18.1)
INFECTIVE CONDITIONS
Acute Conditions
Acute Vestibulitis Nose
Symptoms and Signs
Treatment
Impetigo
Erysipelas
Herpes
Chronic Conditions
Chronic Vestibulitis Nose
Lupus Vulgaris
Syphilis
Rhinophyma/Rosacea
Lupus Erythematosis
NEOPLASTIC CONDITIONS
Neoplasms
TRAUMATIC CONDITIONS
Fracture Nose
Septal Hematoma and Abscess
Treatment
Saddle Nose
Crooked Nose
FOREIGN BODIES IN THE NOSE
Rhinolithiasis
Myiasis
Rhinosporidiosis
Clinical Features
Treatment
CONGENITAL CONDITIONS
Posterior Choanal Atresia
Diagnosis
Treatment
CHAPTER 19:
Diseases of Nasal Septum
DEVIATIONS OF NASAL SEPTUM
Types of Deviations
Causes of Deviation
Symptoms and Signs
On Examination
Effects
Differential Diagnosis
Management
SEPTAL ABSCESS
Signs and Symptoms
On Examination
Treatment
Complications
SEPTAL PERFORATION
Important Causes
Symptoms
Signs
Treatment
CHAPTER 20:
Inflammatory and Other Disorders of Nasal Cavity
CLASSIFICATION
ACUTE INFLAMMATORY CONDITIONS
Acute Rhinitis or Coryza
Clinical Features
Management
Treatment
Acute Nasal Diphtheria
CHRONIC SPECIFIC INFLAMMATORY CONDITIONS
Nasal Syphilis
Treatment
Tuberculosis of Nose
Treatment
Lupus Vulgaris
Treatment
Leprosy of Nose
Rhinoscleroma
Pathology
Symptomatology
Diagnosis
Treatment
Fungal Infections of Nose
Rhinosporidiosis
Other Fungal Conditions
Sarcoidosis
Treatment
Midline Granuloma of Nose
Histopathology
Clinical Features
Diagnosis
Treatment
Wegener's Granuloma
Histopathology
Clinical Features
Investigations
Treatment
CHRONIC NONSPECIFIC RHINITIS
Atrophic Rhinitis
Definition
Types
Causes
Pathogenesis
Clinical Features
Investigations
Treatment
Prognosis
Chronic Hypertrophic Rhinitis
Clinical Features
Treatment
Rhinitis Sicca
Clinical Features
Treatment
Rhinitis Caseosa
Treatment
Rhinitis Medicamentosa
CHAPTER 21:
Nasal Allergy and Allied Conditions
CHRONIC ALLERGIC RHINITIS
What is Allergy?
Types of Allergic Response
Classification
Mechanism of Allergy (Pathogenesis)
Predisposing Factors
Heredity
Infection
Endocrine Factors
Nutritional Factors
pH
Trauma
Meterological and Seasonal Conditions
Geographical Factors
Psychological Factors
Types of Nasal Allergy
Seasonal Allergic Rhinitis (Hay Fever)
Perennial Allergic Rhinitis
Clinical Features of Nasal Allergy
Symptoms
Signs
Investigations
Nasal Provocation Test
Elimination of Allergies
Leukopenic Index
Radioallergosorbent Test
Paper Radioimmunosorbent Test
Treatment
Avoiding the Possibly known Factor of Allergy
Role of Drugs
Role of Hyposensitization or Immunotherapy
Role of Surgery
NON-ALLERGIC RHINITIS
Vasomotor Rhinitis (Intrinsic Rhinitis)
Definition
Factors, which Disturb Vasomotor Balance
Pathology
Clinical Features
Treatment
Rhinitis Medicamentosa
Other Forms of Rhinitis
CHAPTER 22:
Nasal Polypi
POLYPUS
Types
ETHMOIDAL POLYPI
Etiology
Pathology
Clinical Features
Symptoms
On Examination (Signs)
Investigations
Differential Diagnosis
Other Differential Diagnosis
Squamous Papilloma
Meningoencephalocele
Enlarged Turbinate
Malignancy of Nose /PNS
Angiofibroma
Granulomatous Masses
Mucus Plug
Treatment
Medical Treatment
Surgical Treatment
ANTROCHOANAL POLYPI
Etiology
Clinical Features
On Examination
Treatment
CHAPTER 23:
Epistaxis
INTRODUCTION
CAUSES OF EPISTAXIS
Local Causes
Traumatic
Infections
Neoplastic Conditions
Septal Conditions
Systemic Causes
Blood Disorders
Congenital Causes
Systemic Disorders
Drugs
Endocrine Disorders
Idiopathic Causes
Pseudoepistaxis
WORKUP OF THE PATIENT
Investigations
MANAGEMENT OF NOSEBLEED
Aims of Treatment
First Aid Measures
Treatment in Hospital
Role of Sedation
Anterior Nasal Packing
Posterior Nasal Packing
Supportive Measures Undertaken
Treatment of Underlying Cause
Role of Cauterization
Cryosurgery and Embolization
Role of Ligation of Blood Vessel
COMPLICATIONS OF NOSEBLEED
CHAPTER 24:
Anatomy and Physiology of Paranasal Sinuses
INTRODUCTION
DEVELOPMENT
Maxillary Sinus
Ethmoidal Sinus
Frontal Sinus
Sphenoid Sinus
Clinical Application of Development
MAXILLARY SINUSES
Roof
Floor
Posterior Wall
Anterior Wall
Medial or Nasal Wall
Lining of Maxillary Sinus
Blood Supply
Nerve Supply
FRONTAL SINUSES
Important Relations of Frontal Sinus
Anterior Wall
Posterior Wall
Floor
ETHMOIDAL SINUSES
Important Relations of Ethmoidal Sinus
Roof
Floor or Inferior Wall
Lateral or Orbital Wall
Medial or Nasal Wall
Arterial Supply
Nerve Supply
SPHENOID SINUSES
Various Types of Sphenoid Sinuses
Important Relations of Sphenoidal Sinus
Roof
Floor
Anteriorly
Posteriorly
Laterally
Blood Supply
Nerve Supply
Lymphatics
FUNCTIONS OF PARANASAL SINUS
CHAPTER 25:
Acute Sinusitis
INTRODUCTION
ACUTE SINUSITIS
Etiology
Infections
Swimming and Bathing
Trauma to the Sinuses
Mechanical Obstruction
General Diseases
Other Contributing Factors
Bacteriology
Viruses
Bacteria
Specific Infections
Pathology
Acute Catarrhal Type
Acute Suppurative Type
Clinical Features
General Symptoms
Local Symptoms
Signs
Investigations
Differential Diagnosis
Treatment
Prophylactic Treatment
Medical Treatment
Surgical Treatment
CHAPTER 26:
Chronic Sinusitis and Its Complications
CHRONIC SINUSITIS
Introduction
Etiology
Factors Predisposing to Chronic Sinusitis
Pathology
Clinical Features
Simple Chronic Infective Sinusitis
Mixed Infective and Vasomotor Chronic Sinusitis
Fungal Sinusitis
What is fungus?
Types of Fungal Infections
Organisms
Clinical Features
Investigations
Treatment of Fungal Sinusitis
Complications of Antifungal Therapy
Clinical Features of Chronic Sinusitis
Signs
Anterior Rhinoscopy
Posterior Rhinoscopy
Examination of Pharynx
Investigations
Transillumination Tests
X-ray Examination of Sinuses
CT Scan of Nose/PNS
Sinus Sounding or Puncture of the Sinus
Diagnosis and Assessment
Treatment
Conservative Treatment
COMPLICATIONS OF CHRONIC SINUSITIS
Methods of Spread of Infection
Complications of Anterior Group
Complications of Posterior Group
Other Secondary Effects
Orbital Complications
Clinical Features
Treatment
Mucocele of the Paranasal Sinus
Clinical Features
Radiology
Treatment
Osteomyelitis
Pathology
Clinical Features
Radiology
Treatment
Cavernous Sinus Thrombosis
Symptoms
Treatment
CHAPTER 27:
Faciomaxillary Injuries
MAXILLOFACIAL FRACTURES
Care of Patient in Emergency
CLASSIFICATION
FRACTURES OF UPPER THIRD OF FACE
Main Features
Management
FRACTURES OF MIDDLE THIRD OF FACE
Central (Nasomaxillary) Fractures
Fracture Nasal Bones
Lateral Fracture of the Middle Third (Malar Maxillary)
Clinical Features
Treatment
FRACTURES OF LOWER THIRD OF FACE
Clinical Features
CHAPTER 28:
Tumors of Nose and Paranasal Sinus
INTRODUCTION
CLASSIFICATION
CONGENITAL TUMORS OF NOSE
Gliomas
Encephalocele
Dermoid Cyst
BENIGN TUMORS
Rhinophyma
Treatment
Papillomas
Hemangioma
Fibromas and Neurofibromas
Treatment
Fibrous Dysplasia
Treatment
Adenomas
Osteomas
Treatment
Retention Cysts
Treatment
MALIGNANT TUMORS OF NOSE
Basal Cell Carcinoma of Nose
Sarcomas
Carcinoma of Nose
Melanoma
Treatment
Plasmacytoma and Lymphoma
TUMORS OF PARANASAL SINUS
CARCINOMA OF MAXILLARY SINUS
Symptoms and Signs
On Examination
Diagnosis
Staging of Tumor
Ohngren's Classification
Lederman's Classification
Treatment
Radiation Therapy
Surgical Treatment
MALIGNANCY OF OTHER SINUSES
SECTION 3: DISEASES OF ORAL CAVITY AND SALIVARY GLANDS
CHAPTER 29:
Surgical Anatomy of Oral Cavity
ORAL CAVITY
Embryology
Anatomical Consideration
Vestibule
Gingivae (Gums)
Oral Tongue
Floor of Mouth
Retromolar Trigone
Salivary Glands
Parotid Gland
Submandibular Gland
Sublingual Salivary Gland
Functional Tests of Salivary Gland
Teeth
Tongue
Taste Pathways
Applied Anatomy
Hard Palate
Soft Palate
CHAPTER 30:
Diseases of Oral Cavity
LESIONS OF ORAL CAVITY
Aphthous Stomatitis
Etiology
Treatment
Infective Stomatitis
Treatment
Treatment
Lichen Planus
Oral Submucous Fibrosis
Causes
Clinical Features
Differential Diagnosis
Investigations
Complications
Treatment
Leukoplakia
On Examination
Treatment
Erythroplakia
Allergic Stomatitis
Treatment
Trismus
Complications
Treatment
LUDWIG ANGINA
Cystic Lesions
Ranula
Other Lesions
Benign Lesions
Malignant Tumors
Clinical Features
Treatment
CHAPTER 31:
Diseases of Salivary Glands
INTRODUCTION
NON-NEOPLASTIC LESIONS
Acute Suppurative Sialadenitis
Predisposing Conditions
Clinical Features
Treatment
Complications
Chronic Sialadenitis
Clinical Features
Investigations
Treatment
Submandibular Gland Excision
Procedure
Complications
Mumps
Clinical Features/Diagnosis
Treatment
Complications
Sjögren's Syndrome (Sicca Syndrome)
Clinical Types
Investigations
Treatment
Sialolithiasis
Clinical Features
Treatment
Sialadenosis
Kussmaul's Disease
Treatment
Ptyalism
Treatment
SALIVARY GLAND TUMORS
Benign Tumors
Pleomorphic Adenoma
Clinical Features
Treatment
Warthin's Tumor
Other Benign Tumors
Malignant Tumors
Clinical Features
Treatment
Parotidectomy
Procedure
Complications
SECTION 4: DISEASES OF PHARYNX
CHAPTER 32:
Surgical Anatomy and Physiology of Pharynx
PHARYNX
Parts of Pharynx
Layers of Pharynx
Muscles of the Pharynx
Extrinsic Muscles
Intrinsic Muscles
Blood Supply of Pharynx
Nerve Supply
Lymphatic Drainage
Functions
NASOPHARYNX
OROPHARYNX
Tonsils (Figures 32.7A and B)
Histopathology
Blood Supply
Veins
Nerve Supply
Lymphatic Drainage
Functions of Tonsil
HYPOPHARYNX OR LARYNGOPHARYNX
Postcricoid Region
Posterior Pharyngeal Wall
CHAPTER 33:
History Taking and Method of Examination of Pharynx
SYMPTOMS AND SIGNS
Symptoms
Pain during Swallowing (Odynophagia)
Dysphagia or Feeling of a Lump in the Throat
Hyponasality
Hawking Sensations or Foreign Body Sensation
Fever
Other Symptoms
Signs
Mallampatti Classification
EXAMINATION OF NASOPHARYNX AND HYPOPHARYNX
Procedure
Investigations
Plain Films
Contrast Films
Computed Tomography Scan
PET Scan
CHAPTER 34:
Inflammatory Diseases of Pharynx
ACUTE INFLAMMATORY DISEASES
Acute Pharyngitis
Clinical Features
Treatment
Acute Nasopharyngitis
Acute Diphtheritic Pharyngitis
Clinical Features
Differential Diagnosis
Investigation
Treatment
Vincent's Angina
Clinical Features
Diagnosis
Treatment
Infectious Mononucleosis
Clinical Features
Diagnosis
Treatment
Complications
Agranulocytosis
Etiology
Clinical Features
Treatment
Fungal Pharyngitis
Causative Organism and Types
Clinical Features
Treatment
CHRONIC INFLAMMATORY DISEASES OF PHARYNX
Keratosis Pharyngis
Clinical Features
Treatment
SPECIFIC INFECTIONS OF PHARYNX
Syphilis of Pharynx
Tuberculosis of Pharynx
Lupus of Pharynx
Scleroma
CHAPTER 35:
Diseases of Tonsils and Adenoids
INTRODUCTION
ACUTE TONSILLITIS
Types
Causative Organism
Predisposing Factors
Clinical Features
Symptoms
Signs
Diagnosis
Differential Diagnosis of Membranous Tonsillitis (Table 35.1)
Treatment
Complications
PERITONSILLAR ABSCESS OR QUINSY
Etiology
Clinical Features
On Examination
Differential Diagnosis
Treatment of Quinsy
Technique
INTRATONSILLAR AND LINGUAL ABSCESS
Treatment
CHRONIC RECURRENT TONSILLITIS
Types
Etiology
Clinical Features
On Examination
Diagnosis
Management
Complications
FAUCIAL DIPHTHERIA
Incidence
Pathogenesis
Clinical Features
On Examination
Diagnosis
Differential Diagnosis
Treatment
Complications
Cardiovascular System
Central Nervous System
Prognosis
TUBERCULOSIS OF TONSILS
DISEASES OF ADENOIDS
Clinical Features
Examination of Child
Treatment
Complications of Adenoids
CHAPTER 36:
Diseases of Nasopharynx
INTRODUCTION
SURGICAL ANATOMY OF NASOPHARYNX
Venous Drainage and Blood Supply
Sinus of Morgagni
Fossa of Rosenmüller
METHODS OF EXAMINATION OF NASOPHARYNX
Posterior Rhinoscopy
Method
Posterior Rhinoscopy Under General Anesthesia
Palpation of Nasopharynx
Procedure
Radiological Studies
X-ray Study of the Nasopharynx
Fiberoptic Nasopharyngoscopy
Endoscopic Examination
DISEASES OF NASOPHARYNX
Congenital
Traumatic
Inflammatory
Acute
Chronic
Treatment
Neoplastic
Benign Lesions of Nasopharynx
Malignant Lesions of Nasopharynx
CHAPTER 37:
Deep Neck Infections
INTRODUCTION
Importance of Neck Spaces
FASCIAE OF HEAD AND NECK
Cervical Fascia
Superficial Cervical Fascia
Deep Cervical Fascia
POTENTIAL SPACES OF THE NECK
Parapharyngeal Space or Lateral Pharyngeal Space
Boundaries or Relations
Prestyloid Compartment (Anterior Compartment)
Retrostyloid Compartment (Posterior Compartment)
Communications
Submandibular Space
Retropharyngeal Space (Space of Gillete)
Relations
SPECIFIC DEEP NECK INFECTIONS
Parapharyngeal Abscess
Etiology
Microbiology
Signs and Symptoms
Management
Complications
Retropharyngeal Space Abscess
Acute Retropharyngeal Abscess
Management
Chronic Retropharyngeal Abscess
Ludwig Angina
Etiology
Microbiology
Clinical Features
Management
Incision and Drainage
Complications
CHAPTER 38:
Tumors of Oropharynx
INTRODUCTION
CLASSIFICATION
BENIGN TUMORS
Hemangioma
Treatment
Other Forms of Treatment
Papilloma
Treatment
Pleomorphic Adenoma
Treatment
Mucous Cyst
Treatment
MALIGNANT TUMORS
Types
Squamous Cell Carcinoma
Adenocarcinoma and Adenocystic Carcinoma
Lymphoepithelioma
Lymphomas
Carcinoma Tonsil
Etiology
Clinical Features
On Examination
Diagnosis
Differential Diagnosis
Investigations
Tumor Classification
Lymph Node Classification
Nodal (AJC Classification)
Treatment
Carcinoma of Posterior One-third of Tongue or Base of Tongue
Symptomatology
Diagnosis
Treatment
Carcinoma of Palatine Arch
Symptoms
Treatment
Carcinoma of Posterior and Lateral Pharyngeal Wall
Treatment
Lymphoma of the Oropharynx
Investigations
Treatment
CHAPTER 39:
Tumors of Hypopharynx
SURGICAL ANATOMY
Pyriform Sinus
Postcricoid Region
Posterior Pharyngeal Wall
TUMORS OF HYPOPHARYNX
Classification
Benign
Malignant Tumors
MALIGNANT TUMORS OF HYPOPHARYNX
Epithelial Malignant Tumors
Malignant Mesodermal Tumors
CARCINOMA OF PYRIFORM SINUS
Spread of the Tumor
Staging of Tumors of Hypopharynx
Clinical Features
Clinical Examination
Indirect Laryngoscopic Examination
Investigations
Radiology
Laboratory Investigations
Treatment
Radiotherapy
Surgery
Combined Surgery and Radiotherapy
CARCINOMA OF THE POSTCRICOID REGION
Spread
Clinical Features
Diagnosis
Indirect Laryngoscopic Examination
Radiography
Direct Laryngoscopic Examination
Laboratory Investigations
Treatment
CARCINOMA OF POSTERIOR PHARYNGEAL WALL
Clinical Features
Diagnosis
Indirect Laryngoscopy Examination
X-ray Soft Tissue Neck
Direct Laryngoscopy
Treatment
Radiotherapy
Surgery
SECTION 5: DISEASES OF LARYNX AND TRACHEA
CHAPTER 40:
Anatomy and Physiology of Larynx
LARYNX
Framework of Larynx
Cartilages
Spaces of Larynx
Pre-epiglottic Space
Paraglottic Space
Reinke's Space
Joints of Larynx
Ligaments and Membranes of Larynx
Conus Elasticus
Thyrohyoid Membrane
Quadrangular Membrane
Mucous Membrane
Muscles of Larynx
Extrinsic Muscles
Intrinsic Muscles
Nerve Supply of Muscles
Recurrent Laryngeal Nerve
Nonrecurrent Laryngeal Nerve
Sensory Nerve Supply
Cavity of Larynx
Saccule of Larynx
Vestibular Folds
Vocal Folds
Laryngeal Compartments
Blood Supply of Larynx
Lymphatics
PHYSIOLOGY OF LARYNX
CHAPTER 41:
History Taking and Method of Examination of Larynx
HISTORY TAKING
Past History
GENERAL PHYSICAL EXAMINATION
Local Examination
CHAPTER 42:
Laryngotracheal Infections and Stridor
ACUTE INFECTIONS
Acute Laryngitis
Causes
Clinical Features
Treatment
Acute Epiglottitis
Clinical Features
Treatment
Acute Laryngotracheobronchitis
Causative agents
Clinical Features
Treatment
Acute Allergic Disorders
Clinical Features
Treatment
Diphtheria of Larynx
Clinical Features
Differential Diagnosis
Management
FOREIGN BODIES OF LARYNX
Clinical Features
On Examination
Treatment
CHRONIC INFECTIONS
Chronic Laryngitis
Types
Clinical Features
Treatment
SPECIFIC INFECTIONS OF LARYNX
Tuberculosis of Larynx
Clinical Features
Investigation
Treatment
Syphilis of Larynx
Symptoms
Signs
Treatment
Scleroma of the Larynx
Leukoplakia of Larynx
Cause
Clinical Features
Treatment
OTHER CONDITIONS CAUSING SPEECH DISORDERS
Reinke's edema
Etiology
Examination
Treatment
Vocal Cord Nodule
Causes
Pathogenesis
Clinical Features
Differential Diagnosis
Treatment
Laryngocele
Clinical Features
Treatment
Vocal Cord Polyp
Treatment
Vocal Cord Cyst
Clinical Features
Treatment
Laryngeal Web
Contact Ulcer
Stridor
Causes of Stridor
Assessment of Patient with Stridor
History of the Patient
Clinical Examination
Diagnostic Tests
Treatment
CHAPTER 43:
Hoarseness
INTRODUCTION
History
General Physical Examination
Local Examination
Laboratory Investigations
Radiological Examination
CAUSES
Laryngeal Causes
Extralaryngeal Causes
MANAGEMENT
Role of Injection Teflon Paste
Role of Thyroplasty Operation
CHAPTER 44:
Speech and Language Disorders
INTRODUCTION
TYPES OF SPEECH DISORDERS
Phonological Disorders
Causes of Phonological Disorder
Clinical Features
Diagnostic
Course and Prognosis
Management
Stuttering
Definition
Associated Features
Effects of Stuttering
What are the Causes of Stuttering?
Diagnosis
Clinical Features
Course and Prognosis
Management
OTHER SPEECH AND LANGUAGE DISORDERS
Dysgrammatism
Dyslalia
Developmental Dyslalia
Rhinolalia
Types
Diagnosis
Treatment
Puberphonia
Hysterical Aphonia
Aphasia
Etiopathogenesis
CHAPTER 45:
Neurological Disorders of Larynx
RELEVANT ANATOMY AND PHYSIOLOGY OF LARYNX
Nerve Supply
Vagus Nerve
Superior Laryngeal Nerve
Recurrent Laryngeal Nerve
Muscle Actions
Semon's Law
Wagner-Grossman Theory
NEUROLOGICAL DISEASE OF LARYNX
Etiology
Clinical Features
Superior Laryngeal Nerve Paralysis
Recurrent Laryngeal Nerve Paralysis
Investigations in Laryngeal Paralysis
Management
Superior Laryngeal Nerve Paralysis
Recurrent Laryngeal Nerve Paralysis
Phonosurgery
Thyroplasty
Functional Aphonia
CHAPTER 46:
Laryngotracheal Trauma
LARYNGEAL AND TRACHEAL TRAUMA
Etiology
Mechanism of Injury
Symptoms
Signs
Investigations
Treatment
Complications
CHAPTER 47:
Tumors of the Larynx
INTRODUCTION
BENIGN TUMORS OF THE LARYNX
Squamous Papillomatosis
Solitary Papilloma (Adult)
Multiple Papillomatosis (Juvenile Papillomatosis)
Vocal Nodules
Etiology
Clinical Features
Treatment
Other Benign Laryngeal Tumors
MALIGNANT TUMORS OF THE LARYNX
Etiology
Classification and Staging
Classification According to Site
Staging for Glottic, Supraglottic and Subglottic Tumors
Supraglottic Carcinoma
Spread
Pathology
Clinical Features
Glottic Carcinoma
Spread
Pathology
Clinical Features
Subglottic Cancer
Spread
Clinical Features
INVESTIGATION IN CARCINOMA LARYNX
TREATMENT OF LARYNGEAL CANCER
Radiotherapy
Surgery
Conservation Surgery of the Larynx
Total Laryngectomy
Indications (T3 or T4 Carcinoma Larynx)
Radical Neck Dissection
Combined Therapy
VOCAL REHABILITATION AFTER TOTAL LARYNGECTOMY OR POSTLARYNGECTOMY SPEECH
Esophageal Speech
Artificial Larynx
Electrolarynx
Transoral Pneumatic Device
Neoglottis Formation for Tracheoesophageal Speech
CHAPTER 48:
Surgical Anatomy of Tracheobronchial Tree
TRACHEOBRONCHIAL TREE
Surgical Anatomy
Relations of Trachea
Anterior
Posterior
Lateral
Nerve Supply
Blood Supply
Lymphatics
Bronchopulmonary Segments
Right Bronchus
Left Bronchus
Functions of Tracheobronchial Tree
How to Examine Tracheobronchial Tree?
CHAPTER 49:
Diseases of Tracheobronchial Tree and Foreign Bodies in Air Passages
DISEASES OF TRACHEA AND BRONCHI
Acute Tracheitis
Laryngotracheobronchitis
Lung Collapse
Treatment
Lung Abscess
Clinical Features
Treatment
Growths of Tracheobronchial Tree
Causes
Symptomatology
Treatment
Tracheoesophageal Fistula
Congenital Tracheoesophageal Fistula
Acquired Tracheoesophageal Fistula
FOREIGN BODIES IN TRACHEOBRONCHIAL TREE
Predisposing Factors
Types of Foreign Bodies
Clinical Features
Diagnosis
Differential Diagnosis
Treatment
SECTION 6: DISEASES OF ESOPHAGUS
CHAPTER 50:
Anatomy and Physiology of Esophagus
DEVELOPMENT
Congenital Atresia
Esophageal Stenosis
Short Esophagus with Hiatus Hernia
Dysphagia Lusoria
SURGICAL ANATOMY OF ESOPHAGUS
Constrictions in the Esophagus
Walls of Esophagus
Mucous Membrane
Submucosa
Muscular Coat
Fibrous Coat
PHYSIOLOGY OF DEGLUTITION
Oral Phase
Pharyngeal Phase
Esophageal Phase
NERVOUS CONTROL OF DEGLUTITION
SYMPTOMATOLOGY OF DISEASES OF ESOPHAGUS
Difficulty in Swallowing
Regurgitation
Pain
Bleeding
Respiratory Symptoms
General Symptoms
PHYSICAL EXAMINATION OF PATIENT
DIAGNOSTIC HELPS IN DYSPHAGIA
Radiological Techniques
Endoscopy
Hematological Investigations
Manometry
pH Measurement
Other Tests
CHAPTER 51:
Disorders of Esophagus
FOREIGN BODIES IN ESOPHAGUS
Clinical Features
Examination
Radiological Examination
Treatment
Complications
CORROSIVE BURNS OF ESOPHAGUS
Treatment
Management of Stricture
GASTROESOPHAGEAL REFLUX DISEASE
Clinical Features
Diagnosis
Treatment
PERFORATION OF ESOPHAGUS
Iatrogenic
Endoscopy
Esophageal Dilatation
Biopsy
Foreign Bodies
Suicidal
Clinical Features
Management
Conservative Management
Surgical Management
Complications
HIATUS HERNIA
Various Types
Sliding Type (85%)
Rolling Type (5%)
Mixed Type (10%)
Clinical Features
Diagnosis
Management
Medical Management
Surgical Management
STRICTURES OF ESOPHAGUS
Benign Strictures
Malignant Strictures
Clinical Features
Investigations
Treatment
DIVERTICULAE OF ESOPHAGUS
Upper Esophageal Diverticulae
Clinical Features
On Examination
Treatment
Mid Esophageal Diverticulae
Low Esophageal Diverticulae
Treatment
SPASMODIC CONDITIONS OF ESOPHAGUS
Plummer-Vinson Syndrome
Causes
Clinical Features
Investigations
Treatment
Nut Cracker Esophagus
Barret Esophagus
Cardiac Achalasia
Clinical Features
Treatment
Globus Hystericus
GROWTHS OF ESOPHAGUS
Benign Growths
Malignant Growths
Clinical Features
Diagnosis
Management
SECTION 7: DISEASES OF HEAD AND NECK
CHAPTER 52:
Thyroid Gland
INTRODUCTION
SURGICAL ANATOMY
Blood Supply
Arterial Supply
Venous Drainage
Lymphatics
Nerve Supply
Functions of Thyroid Gland
HYPOTHYROIDISM
Etiology
Myxedema (Adult Hypothyroidism)
Clinical Features
Signs
Investigations
Treatment
THYROID SWELLING
Classification of Thyroid Swelling
Simple Goiter
Toxic
Neoplastic
Inflammatory
Solitary Nodule
THYROTOXICOSIS
Etiology
Symptoms
Signs
MANAGEMENT OF THYROID SWELLING
Diagnosis
History and Examination
Investigations
Treatment
Medical Treatment
Radioactive Iodine
Surgical Treatment (Subtotal Thyroidectomy)
SUBTOTAL THYROIDECTOMY
Steps of Operation
Postoperative Complications
MALIGNANCIES OF THYROID GLAND
Clinical Features
Investigations
Treatment
Surgical
CHAPTER 53:
Cervical Swellings
SURGICAL ANATOMY
LYMPH NODES OF NECK
Classification
Sloan-Kettering Classification
NECK MASSES
Classification
Congenital Neck Masses
IMPORTANT SWELLINGS
Branchial Cyst
How is it Formed?
Treatment
Thyroglossal Cyst
How it Forms?
Clinical Features
Treatment
Cystic Hygroma
Treatment
Ludwig's Angina
Treatment
Carotid Body Tumor
Subhyoid Bursa or Cyst
Sternomastoid Tumor
Pharyngeal Pouch
Laryngocele
Cervical Rib
Cold Abscess
Thyroid Gland Swelling
Lymph Node Swellings
Lymphadenitis
Specific Infections
Lymphomas
Neoplasms of Lymphoid Tissue
NECK DISSECTION
Radical Neck Dissection
Structures Preserved
Modified Neck Dissection or Functional Neck Dissection
Elective Neck Dissection
Extended Neck Dissection
SECTION 8: RECENT ADVANCES
CHAPTER 54:
Radiology and Imaging in ENT
INTRODUCTION
PLAIN SKIAGRAMS
Nose and Paranasal Sinuses
Salient Features
Occipitomental or Water's View
Occipitofrontal or Caldwell View
Lateral View
Submentovertical or Basal View
Decubitus Water's and Supine (Brow Up) View
Bucket Handle View
Nasal Bones
Lateral View
Temporal Bone
Law's Lateral Oblique View
Lateral (Schüller's) View
Stenver's View (Oblique posteroanterior view)
Half Axial (Towne's) View
Chaussé III View
Perorbital or Transorbital View
Axial or Submentovertical View
Oropharynx, Hypopharynx and Larynx
Lateral View—Soft Tissue Neck
Anteroposterior View
Nasopharynx
Lateral Soft Tissue View
Anteroposterior View
Base of Skull View
BARIUM SWALLOW STUDY
COMPUTED TOMOGRAPHY SCAN
High Resolution CT or Thin Section CT
Spiral CT
Advantages of CT Scan
Disadvantages
Role of CT in Temporal Bone
Role of CT Scan in Nose and PNS
Role of CT Scan in Pharynx and Larynx
MAGNETIC RESONANCE IMAGING
Advantages
Disadvantages
MRI in Temporal Bone
MRI in Nose and PNS
MRI in Pharynx
MRI in Larynx
CHAPTER 55:
Radiotherapy in Head and Neck Cancers
INTRODUCTION
RADIOTHERAPY
MODALITIES OF TREATMENT
Tele Therapy or External Beam Therapy
Brachytherapy
INTENSITY MODULATED RADIATION THERAPY
UNIT OF RADIATIONS
Various Sources of Radiation
MODE OF ACTION
MANAGEMENT OF HEAD AND NECK CANCERS
Curative Radiotherapy/Palliative RT
Combination of Surgery and Radiotherapy
Advantages of Preoperative Irradiation
Disadvantages
Aims of Postoperative Radiotherapy
Timing of Postoperative Radiotherapy
Disadvantages
Palliative Radiotherapy
COMPLICATIONS OF RADIOTHERAPY
General Complications
Local Complications
Focal Complications
Care of Patient during Radiotherapy
Chemoprevention
CHAPTER 56:
Chemotherapy of Head and Neck Cancers
INTRODUCTION
CELL KINETIC CONCEPT
CELL CYCLE
CHEMOTHERAPEUTIC DRUGS
Neoadjuvants/Anterior/Induction Chemotherapy
Adjuvant Chemotherapy
Concomitant Chemotherapy
WORKUP OF THE PATIENT
CHAPTER 57:
Cryosurgery
INTRODUCTION
MECHANISM OF ACTION
PATHOPHYSIOLOGY
INDICATIONS
Nose
Oral Cavity and Pharynx
Ears
Tumors of Head and Neck
Miscellaneous Indications
Hypophysectomy or Pituitary Ablation
ADVANTAGES
DISADVANTAGES
CHAPTER 58:
LASER in ENT
INTRODUCTION
ADVANTAGES OF LASER
DISADVANTAGES
TYPES OF LASERS
Carbon Dioxide (CO2) LASER
Nd:YAG LASER
Argon
Potassium Titanyl Phosphate
INDICATIONS OF LASERS
Oral Cavity (CO2 and Nd:YAG LASERs)
Laryngeal Surgery (CO2 LASER)
Nose and Sinus Surgery (CO2 LASER)
Ear Surgery (KTP, Nd:YAG and CO2 LASERs)
Miscellaneous (Argon and CO2 LASERs)
ANESTHESIA IN LASER
SAFETY MEASURES IN LASERS
USES OF HYPERBARIC OXYGEN IN DISEASES OF ENT
Various Indications
SECTION 9: MISCELLANEOUS DISORDERS
CHAPTER 59:
Proptosis
INTRODUCTION
ENT CAUSES OF UNILATERAL PROPTOSIS
Infective
Traumatic
Neoplastic
Miscellaneous
CLINICAL FEATURES
DIAGNOSIS
TREATMENT
CHAPTER 60:
Cavernous Sinus Thrombosis
INTRODUCTION
COMMUNICATIONS OF CAVERNOUS SINUS
Causes
CLINICAL FEATURES
DIFFERENTIAL DIAGNOSIS
Investigations
Treatment
COMPLICATIONS
CHAPTER 61:
Cerebrospinal Fluid Rhinorrhea
INTRODUCTION
ETIOLOGY
Congenital
Traumatic
Spontaneous
Clinical Features
Diagnosis
Treatment
Conservative Treatment
Surgical Treatment
Complications of Cerebrospinal Fluid Leak
CHAPTER 62:
Cleft Lip and Cleft Palate
INTRODUCTION
TYPES OF CLEFTS
CLINICAL FEATURES
MANAGEMENT
Repair of Cleft Lip
Millard's Repair
Other Methods
Repair of Cleft Palate
Oxford Method (V-Y Pushback)
Four-flap Palatoplasty
Von Langenbeck Palatoplasty
Schweckendick's Primary Veloplasty
Furlow Palatoplasty
Postoperative Complications
CHAPTER 63:
Snoring and Sleep Apnea Syndrome
INTRODUCTION
CAUSES
How Snoring Occurs?
CLINICAL FEATURES
INVESTIGATIONS
TREATMENT
Conservative Approach
Surgical Approach
COMPLICATIONS
CHAPTER 64:
Signs/Syndromes and Spaces in ENT
VARIOUS SIGNS IN ENT
Battle's Sign
Berry's Sign
Biederman's Sign
Bocca's Sign
Bomb-bay Sign
Bozzolo Sign
Boyce Sign
Bruins's Sign
Brown's Sign
Charcot's Triad
Chvostek's Sign
Crescent Sign
Delta Sign
Griesinger's Sign
Guerin's Sign
Gutzmann's Test
Halo Sign
Hamman's Sign
Hennebert's Sign
Hennebert Phenomenon
Hitselberger's Sign
Horner's Syndrome
Irwin Moore's Sign
Jackson's Sign
Kernig's Sign
Marcus Gunn Pupil Sign
Mecca Sign
Paracusis Willisii
Pemberton's Sign
Rat Tail Sign
Rising Sun Sign
Rosenbach's Sign
Spielberg's Sign
Steeple Sign
Schwartz's Sign
Stellwag's Sign
Tear-drop Sign
Teapot Sign
Teal's Sign
Thumb Sign
Tragus Sign
Trap-door Sign
Tripod Sign
Trousseau's Sign
Tullio Phenomenon
Von Graefe Sign
Wartenberg's Sign
VARIOUS TESTS IN ENT
ABLB Test of Fowler
Absolute Bone Conduction Test
Acoustic Reflex Test
Bing Test
Bosin's Test
Caloric Test
Carhart's Test
Chimani-moos Test
Cottle Test
Crowe-Beck Test
Doerfler-Stewart Test
Erhard Test
Fistula Test
Fluorescein Dye Test
Fraser's Test
Frustenberg Test
Gault Test
Gelle's Test
Glycerol Test
Head Shadow Effect
Kobrak's Cold Caloric Test
Lombard's Test
Müller Test
Otoacustic Emissions (OAEs)
Radioallergosorbent Test (RAST)
Reverse Glycerol Test
Rinne's Test
Romberg's Test
Rosenthal's Test
SISI Test (Short Increment Sensitivity Test)
Schirmer's Test
Schwabach Test
Speech Discrimination Score (SDS)
Speech Reception Threshold Test
Stenger Test
Tobey-ayer Test (Queckenstedt's)
Tone Decay Test (Carhart's Test)
Weber's Test
Whisper and Conversation Test
SYNDROMES
Alport Syndrome
Alström Syndrome
Anterior Ethmoidal Syndrome (Sluder's)
Bannawarth Syndrome
Barany Syndrome
Behcet's Syndrome (Behcet 1937)
Bloom Syndrome
Brun Syndrome
Cogan Syndrome (1945)
Crouzon Syndrome
Costen Syndrome
Cowden Syndrome
Duane Syndrome
Empty Sella Syndrome
Frey Syndrome
Goldenhar Syndrome
Gradenigo Syndrome
Grisel Syndrome
Heerfordt Syndrome
Hunter Syndrome
Kawasaki Syndrome
Kartagener Syndrome (Immotile Cilia Syndrome)
Klippel-Feil Syndrome
Lermoyez Syndrome
Melkersson Syndrome
Ménière Syndrome
Osteogenesis Imperfecta
Patterson-Kelly-Brown Syndrome/Plummer-Vinson Syndrome
Pendred Syndrome
Pierre Robin Syndrome
Ramsay Hunt Syndrome (1907) (Herpes Zoster Oticus)
Refsum Disease
Sjögren's Syndrome (Hadden 1883)
Stickler Syndrome
Sturge-Weber Syndrome
Tolasa-Hunt Syndrome/Superior Orbital Fissure Syndrome
Treacher Collins Syndrome (Franceschetti-Zwahlen) (Figure 64.1)
Turner Syndrome (XO)
Usher Syndrome
Van der Hoeve and de-Kleyn (Osteogenesis Imperfecta)
Wardenburg Syndrome (Figure 64.2)
SPACES
Carotid Space
Facial Recess
Fluid Spaces of the Cochlea
Freeway Space
Importance
Infratemporal Fossa
Hiatus Semilunaris
Paraglottic Space
Parapharyngeal Space
Contents
Paratonsillar Space
Peritonsillar Space
Parotid Space
Postcricoid Space
Preepiglottic Space
Prestyloid Compartment
Prussak's Space
Pterygoid Space
Contents
Pterygopalatine Fossa
Pyriform Sinus
Reinke's Space
Retropharyngeal Space
Retrostyloid Compartment
Sinus of Morgagni
Sinus Tympani
Sublingual Space
Submandibular Space
TRIANGLES
Anterior Cervical Triangle
Antrum Threshold Angle
Beahr's Triangle
Carotid Triangle
Digastric Triangle
Ho's Triangle
Joll Triangle
Kawase's Triangle
Macewan's Triangle
Muscular Triangle
Nasal Valve Area
Sinodural Angle
Simon's Triangle
Soft Triangle of Nose
Solid Angle
Submental Triangle
Trautmann's Triangle
Trotter's Triad
Woodruff's Plexus
SECTION 10: OPERATIVE SURGERY
CHAPTER 65:
Myringotomy and Tympanostomy Tubes
MYRINGOTOMY
Indications
Contraindications
Premedication
Instruments
Anesthesia
Position
Procedure
Posterior Myringotomy
Anterior Myringotomy
Postoperative Care
Complications
MYRINGOPUNCTURE
TYMPANOSTOMY TUBES
CHAPTER 66:
Mastoidectomy
INTRODUCTION
TYPES
SURGICAL APPROACHES AND INCISIONS
How to Decide Technique for Cholesteatoma?
Aims of Operation
SIMPLE MASTOIDECTOMY
Synonyms—Schwartz Operation/Complete Mastoidectomy
Indications
Contraindications
Instruments
Anesthesia
Position
Steps
Postoperative Care
Complications
Immediate
Late
RADICAL MASTOIDECTOMY (SYNONYMS—ZAUFAL'S OPERATION)
Indications
Contraindications
Instruments
Anesthesia
Position
Steps
Postoperative Care
Complications
MODIFIED RADICAL MASTOIDECTOMY
Indications
Anesthesia
Preoperative Preparation
Position
Steps
Postoperative Care and Complications
Bondy Operation
Atticotomy
Atticoantrostomy
Advantages of Canal-wall-up Procedure
Disadvantages of Canal-wall-up Procedure
Contraindications to CWU Procedure
CHAPTER 67:
Myringoplasty and Tympanoplasty
INTRODUCTION
VARIOUS METHODS TO IMPROVE HEARING
MYRINGOPLASTY
Objectives of Myringoplasty
Advantages of Myringoplasty
Indications
Contraindications
Graft Materials
Ossicular Graft Materials
Types of Operation
Overlay or Onlay Technique
Advantages
What is Blunting ?
To Avoid Blunting
Underlay or Inlay Technique
Other Techniques
Basis for Tympanic Membrane Grafting
Approach
Technique
Postoperative Care
Causes of Failure
Complications
Onlay Technique
Underlay Technique
Success Rate
OSSICULOPLASTY
TYMPANOPLASTY
Types
Type I
Type II
Type III
Type IV (Figure 67.5D)
Type V
Type VI (Sound Inversion)
Aims of Tympanoplasty
Contraindications
Other Methods to Close the Perforation
Types of Myringoplasty
Fat Graft Myringoplasty
Theta Myringoplasty
Endoscopic Myringoplasty
CHAPTER 68:
Stapedectomy/Stapedotomy
INTRODUCTION
STAPEDECTOMY
Aims of the Operation
Indications
Contraindications
Instruments
Anesthesia
Procedure
Complications of Stapedectomy
CHAPTER 69:
Nasal Packing
INTRODUCTION
TYPES
Instruments Required
ANTERIOR NASAL PACKING
Procedure
Indications
POSTERIOR NASAL PACKING
Procedure
COMPLICATIONS
CHAPTER 70:
Antral Wash and Intranasal Antrostomy
ANTRAL WASH
Indications
Diagnostic
Therapeutic
Contraindications
Instruments Required
Position
Anesthesia
Technique
Difficulties and Complications
Postoperative Care
INTRANASAL ANTROSTOMY
Indications
Procedure
Complications
CHAPTER 71:
Radical Operations on Maxillary Sinus
CALDWELL-LUC
Indications
Contraindications
Instruments Required
Anesthesia
Position
Steps
Postoperative Care
Complications
OROANTRAL FISTULA
Causes
Symptoms
Management
CANFIELD'S OPERATION (1908)
DENKER'S OPERATION (1906)
MCNEIL'S OPERATION (1966)
CHAPTER 72:
Operations for Nasal Polypi
POLYPECTOMY
Definition
Instruments
Indications
Contraindications
Anesthesia
How to Obtain Local Anesthesia
Technique of the Operation
Postoperative Orders
Complications
ETHMOIDECTOMY
Indications
Types
Intranasal Ethmoidectomy
External Ethmoidectomy
Indications
Transantral Ethmoidectomy
Complications of Ethmoidectomy
Polypectomy using a Microdebrider
CHAPTER 73:
Functional Endoscopic Sinus Surgery
INTRODUCTION
Relevant Anatomy
Principles of FESS
Advantages of FESS
Indications
Diagnostic
Therapeutic
Contraindications
Instruments
Method
Postoperative Care
Complications
Major
Minor
Mini FESS
Navigational FESS
Baloon Sinuplasty
Revision FESS
Prerequisites for Revision FESS
CHAPTER 74:
Nasal Endoscopic Dacryocystorhinostomy
INTRODUCTION
Endoscopic Anatomy
SURGICAL PROCEDURE
POSTOPERATIVE INSTRUCTIONS
CONCLUSION
CHAPTER 75:
Operations of Nasal Septum
SUBMUCOUS RESECTION OF SEPTUM
Indications
Contraindications
Instruments Required
Anesthesia
Position
Steps of Operation
Postoperative Care
Complications
SEPTOPLASTY
Clinical Indications
Contraindications
Instruments Required, Anesthesia, Position of Patient
Steps
Postoperative Care
Complications
CHAPTER 76:
Adenoidectomy
INTRODUCTION
Indications
Contraindications
Instruments
Methods of Adenoidectomy
Position
Anesthesia
Steps
Postoperative Care
Complications
ENDOSCOPIC ADENOIDECTOMY
Power-assisted Adenoidectomy
CHAPTER 77:
Tonsillectomy
INTRODUCTION
SURGICAL REMOVAL OF TONSILS
Advantages/Myths of Tonsillectomy
Indications
Local Indications
Absolute Indications
Focal Indications
Relative Indications
General Indications
Instruments
Anesthesia
Local Anesthesia
General Anesthesia
Position of Patient
Various Methods
Guillotine Method
Dissection Method
Electrocautery
Coblation Tonsillectomy (Cold Method)
Postoperative Care
Complications
Immediate
Delayed
CHAPTER 78:
Tracheostomy
INTRODUCTION
APPLIED ANATOMY
TYPES OF TRACHEOSTOMY
Other Types
COMPLICATIONS OF ENDOTRACHEAL INTUBATION
INDICATIONS
For the Relief of Upper Respiratory Obstruction
Congenital Causes
Traumatic Causes
Infective Causes
Tumors
Bilateral Nerve Palsies
Miscellaneous Causes
Protection of Tracheobronchial Tree
Treatment of Conditions Leading to Respiratory Insufficiency
Five Most Common Indications
Advantages or Functions of Tracheostomy
Disadvantages of Tracheostomy
ANESTHESIA
Position
Instruments
STEPS OF OPERATION
POSTOPERATIVE CARE
COMPLICATIONS
Immediate
Delayed
Late
Summary of Complications of Tracheotomy
Intraoperative
Early Postoperative
Late
TRACHEOSTOMY IN INFANTS AND CHILDREN
CHAPTER 79:
Direct Laryngoscopy
DIRECT LARYNGOSCOPY
Types
Indications
Diagnostic Indications
Therapeutic Indications
Contraindications
Prerequisites for Direct Laryngoscopy
Position of Patient
Instruments Required
Anesthesia
Steps
Complications
MICROLARYNGOSCOPY (KLEINSASSER 1968)
FIBEROPTIC LARYNGOSCOPY
STROBOSCOPY
CHAPTER 80:
Bronchoscopy
INTRODUCTION
Types of Bronchoscopy
Indications
Diagnostic
Therapeutic
Contraindications
Preoperative Investigations
Instruments
ANESTHESIA
Position of Patient
TECHNIQUE
Flexible Fiberoptic Bronchoscopy
Complications of Bronchoscopy
CHAPTER 81:
Esophagoscopy
INTRODUCTION
ENDOSCOPIC EXAMINATION OF ESOPHAGUS
Types of Esophagoscopy
Advantages of Rigid Esophagoscopy
Advantages of Flexible Esophagoscopy
Indications
Diagnostic
Therapeutic
Contraindications
Instruments Required
Anesthesia
Position
Boyce's Position
Steps
Flexible Fiberoptic Esophagoscopy
Complications
SECTION 11: INSTRUMENTS
CHAPTER 82:
Instruments for ENT Examination
WHY IMPORTANT?
ENT EXAMINATION INSTRUMENTS
ENT Outpatient Department Set Up Trolley
Head Mirror with Adjustable Head Band
Clar's Head Light
Bull's Eye Lamp
Thudicum's Nasal Speculum
Lack's Tongue Depressor
Eustachian Tube Catheter (Rose's)
Laryngeal Mirror
Local Anesthetic Sprayer
Siegel's Pneumatic Speculum
Otoscope
Jobson Horne Aural Probe with Ring Curette
Simpson's Aural Metallic Syringe
Tongue Tie Spatula
Tuning Fork (Hartmann's or Gardiner Brown)
Nasal Dressing Forceps
Tilley Nasal Dressing Forceps
Aural Speculum (Toynbee's)
Posterior Rhinoscopy Mirror (St Clair-Thomsons)
Surgical Blades
CHAPTER 83:
Ear Surgery Instruments
INSTRUMENTS USED FOR EAR SURGERY
Otoendoscopes
Ear Speculum with Cut (Tumarkin)
Ear Speculum with Handle
Self-retaining Mastoid Wound Retractor and Hemostat (Mollison)
Mastoid Gouge (Jenkin's)
Macewen's Scoop with Cell Seeker (Sir William Macewen of Glasgow 1848-1924)
Lempert's Mastoid Curette
Hanging Motor Complete/Electric Drill
Circular Knife
Myringotomy Knife
Fine Curette
Bone Nibbler
Bayonet Knife
Fine Curette (House's)
Angled Fine Elevator
Straight Fine Elevator
Aural Snare (Ballance's)
Crocodile Fine Forceps
Zollner's Knife
Stack's Guide
CHAPTER 84:
Nasal Surgery Instruments
NOSE INSTRUMENTS
Nasal Speculum with Handle
Long-bladed Nasal Speculum (St Clair-Thompson)
Raspatory (Killian's Elevator)
Luc's Forceps
Mucoperichondrium Double Ended Elevator (Freer)
Ballenger's Swivel Knife
Killian's Nasal Gouge
Tilley Lichtwitz Antrum Trocar with Cannula
Higginson's Syringe
Nasopharyngeal Speculum
Antral Rasp and Myle's Nasoantral Perforator
Antral Burr (Tilley)
Antral Harpoon (Tilley)
Citelli's Bone Punch
Glegg or Krause Nasal Snare
Asch's Forceps
Walsham's Forceps
Sinuscope (Hopkins Nasal Endoscope)
Sickle Knife
Weil Blakesley's Straight Forceps
Weil Blakesley's Angled Forceps
Microdebrider
CHAPTER 85:
Throat Surgery Instruments
INSTRUMENTS USED IN THROAT SURGERY
Boyle-Davis Mouth Gag with Tongue Depressor Blade
Draffin Bipod
Denis Browne Tonsil Holding Forceps
Mollison's Anterior Pillar Retractor with Blunt Dissector
Negus Knot Tier and Thread Adjuster
Eve's Tonsillar Snare (Dr Curtis C Eves 1910)
Straight Artery Forceps (Birkett's)
Jenning's Mouth Gag
Doyen's Mouth Gag
Quinsy Knife (St Clair-Thompson) or Quinsy Forceps
Ballenger's Tonsillar Guillotine
Tonsillar Fossa Compression Forceps (Yorke's)
Curved Artery Forceps
Adenoid Curette with Guard (St Clair-Thomson)
Adenoid Curette without Guard
Adenotome
Yankauer's Oropharyngeal Suction Cannula
CHAPTER 86:
Endoscopic Instruments
ENDOSCOPIC INSTRUMENTS
Chevalier Jackson Laryngoscope
Anterior Commissure Laryngoscope
Rigid 90° Endolaryngoscope
Light Source
Negus Laryngoscope
Microlaryngoscope or Kleinsasser Laryngoscope
Laryngeal Crocodile Forceps
Coin Holding Forceps
Hypopharyngoscope (Esophageal Speculum)
Fiberoptic Flexible Hypopharyngoscope and Endoscopes
Chevalier Jackson Bronchoscope
Esophagoscope
Long Crocodile Forceps
CHAPTER 87:
Tracheostomy Instruments
INSTRUMENTS FOR TRACHEOSTOMY
Chevalier Jackson Metallic Tracheostomy Tube
Fuller's Bivalve Tracheostomy Tube
Portex Tracheostomy Tube
Tracheostomy Wound Dilator (Trousseau's)
Double Hook Retractor
Tracheal Hook (Single)
APPENDICES:
APPENDIX 1:
CLINICAL METHODS
HOW TO PRESENT A LONG CASE?
Biodata of Patient
Chief Complaints with Duration
History of Presenting Illness
Past History
Family History
Personal Cum Social History
Examination of the Patient
General Physical Examination
Systemic Examination
Local Examination in an Ear Case
Pinna
Preauricular and Postauricular Region
External Auditory Meatus (With or Without Speculum)
Functional Tests in an Ear Case
Auditory Functions
Investigations in an Ear Case
Management
APPENDIX 2:
MODEL TEST PAPERS (I-VI)
Multiple Choice Questions
EAR
NOSE
THROAT
ANSWERS
Ear
Nose
Throat
INDEX
TOC
Index
×
Chapter Notes
Save
Clear