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Diseases of Ear, Nose & Throat
Mohan Bansal
SECTION 1: BASIC SCIENCES
1:
Anatomy and Physiology of Ear
TEMPORAL BONE
AURICLE
EXTERNAL AUDITORY CANAL
TYMPANIC MEMBRANE (FIG. 9)
PARTS OF MIDDLE EAR (TYMPANUM)
BOUNDARIES OF MIDDLE EAR (FIG. 14)
OSSICLES
INTRATYMPANIC MUSCLES
INTRATYMPANIC NERVES(FIG. 21)
MIDDLE EAR MUCOSA
COMPARTMENTS AND FOLDS OF MIDDLE EAR(FIGS 22 AND 23)
MASTOID ANTRUM
TYPES OF MASTOID (FIG. 25)
Mastoid Air Cells (Figs 26 to 28)
KORNER'S SEPTUM
BLOOD SUPPLY
Arterial Supply
Venous Drainage
LYMPHATIC DRAINAGE OF EAR
BONY LABYRINTH
MEMBRANOUS LABYRINTH
INNER EAR FLUIDS
Perilymph
Endolymph
ORGAN OF CORTI
VESTIBULAR RECEPTORS
BLOOD SUPPLY OF LABYRINTH
INTERNAL AUDITORY CANAL
Contents
Vestibulocochlear (Auditory) Nerve
Auricl
External Auditory Canal
Tympanic Membrane
Middle Ear (Fig. 42)
Inner Ear
AUDITORY NEURAL PATHWAYS
CENTRAL VESTIBULAR CONNECTIONS (FIG. 45)
Vestibular Nerve
Vestibular Nuclei
Functions of Efferents from Vestibular Nuclei
Components of Hearing Physiology
CONDUCTON OF SOUND
Pinna
External Auditory Canal
Impedance Matching Mechanism (Transformer Action) of Middle Ear (Figs 47 and 48)
Phase Differential Between Oval and Round Window (Figs 46 and 48)
Natural Resonance of External and Middle Ear
TRANSDUCTION OF MECHANICAL ENERGY TO ELECTRICAL IMPULES
Round Window Reflex
Organ of Corti (Fig. 49)
Transduction
Functions of Hair Cells
Electrical Potentials
MEDIAL GENICULATE BODY AND TEMPORAL LOBE AUDITORY CORTEX
SEMICIRCULAR CANALS FUNTIONS
Nystagmus
UTRICLE AND SACCULE FUNCTIONS
Striola
Sensory Component
Motor Component
Push and Pull System
Diseases and evaluation of vestibular system
2:
Anatomy and Physiology of Nose and Paranasal Sinuses
INTRODUCTION
EXTERNAL NOSE
Osteocartilaginous Framework of Nose
Nasal Musculature
Nasal Skin
Development
INTERNAL NOSE
Vestibule of Nose
Nasal Septum
Middle Meatus and Osteomeatal Complex (Figs 9, 10 and 13)
Linings of Internal Nose
Blood Supply of Nose
Submucosal Vascular Plexus
Nerve Supply of Nasal Cavity (Figs 16 and 17)
Lymphatic Drainage
Maxillary Sinus (Antrum of Highmore) (Fig. 18)
Frontal Sinus
Ethmoidal Sinuses (Fig. 19)
Sphenoid Sinus (Figs 20 and 21)
Mucous Membrane of Paranasal Sinuses
Mucus Drainage of Sinuses
Lymphatic Drainage
Blood Supply
Nerve Supply
Development of Paranasal Sinuses
RESPIRATION
Nasal Cycle
AIR-CONDITIONING OF INSPIRED AIR
PROTECTION OF AIRWAY
Mucociliary Mechanism
VOCAL RESONANCE
NASAL REFLEXES
OLFACTION
Olfactory Pathways
Vomeronasal Organ of Jacobson
FUNCTIONS
VENTILATION OF SINUSES
3:
Anatomy and Physiology of Oral Cavity, Pharynx, and Esophagus
WALDEYER'S RING (FIG.12)
Functionsof Tonsils and Adenoids
Boundaries
Sinus of Morgagni
Passavant's Ridge
Lymphatic Drainage
Functions of Nasopharynx
ADENOIDS
Blood Supply
Lymphatic Drainage
Communications
Boundaries
Lymphatic Drainage (Fig.16)
Functions of Oropharynx
PALATINE (FAUCIAL) TONSILS (Figs 17 and 18)
Site and Extension
Surfaces and Poles
Tonsillar Crypts
Capsule
Bed of the Tonsil (Fig. 17)
Blood Supply (Fig.18)
Lymphatic Drainage
Nerve Supply
Communications
Hypopharynx Subsites
Lymphatic Drainage (Fig. 21)
Functions
Hypopharyngeal Diverticulum
Constrictions
Structure
Nerve Supply
Lymphatic Drainage
Esophageal Sphincters
Gastroesophageal Reflux
Pharyngeal Apparatus (Fig. 23)
Pharyngeal Arches (Fig. 24)
Pharyngeal Pouches and Grooves
Thyroid Gland
Tongue
Face
Palate
4:
Anatomy and Physiology of Larynx and Tracheobronchial Tree
CARTILAGES (FIGS 1, 2 AND 3)
JOINTS
MEMBRANES AND LIGAMENTS (Figs 4 to 6)
Extrinsic
Intrinsic
CAVITY OF THE LARYNX (FIGS 7 AND 8)
MUCOUS MEMBRANE OF THE LARYNX
LYMPHATIC DRAINAGE
SPACES OF THE LARYNX
FUNCTIONAL DIVISIONS OF VOCAL FOLDS
PHASE DIFFERENCE
MUSCLES OF LARYNX
NERVE SUPPLY OF LARYNX
DEVELOPMENT
Infant Larynx
Growth of Larynx
PROTECTION OF LOWER AIRWAYS
PHONATION AND SPEECH
RESPIRATION
FIXATION OF CHEST
TRACHEA AND BRONCHI
TRACHEAL CARTILAGES
MUCOSA
BRONCHOPULMONARY SEGMENTS (Figs 15 to 17)
5:
Anatomy of Neck
SURFACE ANATOMY
TRIANGLES OF NECK
CERVICAL FASCIA
Superficial Cervical Fascia
Deep Cervical Fascia
LYMPH NODES OF HEAD AND NECK
Levels of Cervical Lymph Nodes (Figs 5 and 6)
NECK DISSECTION
Radical Neck Dissection
Modified Neck Dissection
Selective Neck Dissection
Extended Neck Dissection
THYROID GLAND (FIG. 7)
Blood Supply and Related Laryngeal Nerves
Venous Drainage
Lymphatic Drainage
PARATHYROID GLANDS (FIG. 8)
DEVELOPMENT
Thyroid Gland
6:
Bacteria and Antibiotics
STAPHYLOCOCCI
Staphylococcus Aureus
STREPTOCOCCI
Group A β-Hemolytic Streptococci (Streptococcus pyogenes)
Streptococcus Pneumoniae (Pneumococcus)
Oral Streptococci (Streptococcus viridans)
Anginosus-Milleri Group (Streptococcus anginosus or Streptococcus milleri)
CORYNEBACTERIUM DIPHTHERIAE
NEISSERIA SPECIES
MOREXELLA CATARRHALIS
HAEMOPHILUS INFLUENZAE
BORDETELLA PERTUSSIS
PSEUDOMONAS AERUGINOSA
ENTEROBACTERIACEAE
ANAEROBES
MICROAEROPHILIC BACTERIA
MYCOBACTERIA
MYCOPLASMA PNEUMONIAE
CHLAMYDIAE
SPIROCHAETES
Antimicrobial Resistance
Drug Hypersensitivity Reactions
Prerequisites of Antimicrobial Therapy
Surgical Prophylaxis
Sensitivity Testing
Classification
INHIBITORS OF BACTERIAL CELL WALL SYNTHESIS (BETA-LACTAM ANTIBIOTICS)
Penicillins
Cephalosporins
Glycopeptides (e.g. Vancomycin and Teicoplanin)
INHIBITORS OF NUCLEIC ACID SYNTHESIS
Quinolone Antibiotics
Sulphonamides and Trimethoprim (Co-trimoxazole)
Rifamycins
Metronidazole
INHIBITORS OF BACTERIAL PROTEIN SYNTHESIS (RIBOSOMAL)
Tetracyclines
Chloramphenicol
Macrolides (Erythromycin and Azithromycin)
Fusidic Acid
Aminoglycosides
Streptogramins
Oxazolidinones (Linezolid)
ANTITUBERCULAR DRUGS
NONSPECIFIC ANTISEPTICS
7:
Fungi and Viruses
PANDEMIC INFLUENZA A H1N1 (SWINE FLU)
Epidemiology
Clinical Features
Investigations
Diagnosis
Treatment
8:
Human Immunodeficiency Virus Infection
HIV/AIDS
Transmission
Human Immunodeficiency Virus
Immunology
Course of Disease
AIDS Indicator Diseases
Diagnosis
Classification
CDC AIDS Case Definitions
Treatment
CERVICAL ADENOPATHY
NEOPLASMS
Kaposi's Sarcoma
Non-Hodgkin's Lymphoma
Lymphoepithelial Cysts of Parotid Gland
NOSE AND SINUSES
NASOPHARYNX
EAR
ORAL CAVITY
OCCUPATIONAL EXPOSURE
Management of Needle stick injury
Prevention
Care of Endoscopes
9:
History and Examination
OTORHINOLARYNGOLOGY
HISTORY TAKING
PHYSICAL EXAMINATION
General Survey
Local Examination
General Examination
GENERAL SET-UP
Bull's Eye Lamp
Head Mirror
SWELLINGS AND ULCERS (FIG. 5)
History
Examination of Swelling
Examination of Ulcers
EXAMINATION OF CRANIAL NERVES
HEADACHE
Definition
Etiology
History and Examination
Tension-type Headache
Depression Headache
Cluster Headache
Post-traumatic Headache
Cough Headache
Giant Cell (Temporal or Cranial) Arteritis
FACIAL PAIN
Trigeminal Neuralgia (Tic Douloureux)
Atypical Facial Pain
Glossopharyngeal Neuralgia
Post-herpetic Neuralgia
TEMPOROMANDIBULAR (CRANIOMANDIBULAR) DISORDERS
Etiology
Clinical Features
Myogenic (Masticatory Muscles) Disorders
Meniscal Displacement
Imaging Studies
Treatment
SECTION 2: EAR
10:
Otologic Symptoms and Examination
ASSESSMENT (BOX 4)
History
Examination
Investigations
Treatment
Etiology
History and Examination
Investigations
Treatment
Classification
Etiopathology of Nonpulsatile Subjective Tinnitus
History and Physical Examination
Pulsatile Tinnitus
Radiological Imaging
Tinnitus Management Program
Acoustic Therapies
Lifestyle Changes (Box 10)
Surgical Management
11:
Hearing Evaluation
AUDIOLOGY AND ACOUSTICS
Sound
Frequency and Pitch
Pure Tone and Complex Sound
Overtones and Timbre
Intensity and Loudness
Decibel
Sensation Level
Loudness Discomfort Level
Dynamic Range
Noise
TYPES OF HEARING LOSS
Conductive Hearing Loss
Sensorineural Hearing Loss
Mixed Hearing Loss
NEED OF HEARING EVALUATION
METHODS OF HEARING EVALUATION
Traditional Screening Tests
Voice Tests
Conversation and Whisper
TUNING FORK TESTS
Tuning Forks
Methods
Rinne Test
Interpretations
Masking
Weber Test
Interpretations
Absolute Bone Conduction (ABC) Test
Interpretations
Schwabach's Test
Bing Test
Gelle's Test
PURE TONE AUDIOMETRY
Method
Masking
Uses of PTA
Interpretations
Recruitment
Fowler's Alternate Binaural Loudness Balance Test
Interpretations
Short Increment Sensitivity Index Test
Interpretations
Carhart's Tone Decay Test
SPEECH AUDIOMETRY
Speech Reception Threshold
Speech Discrimination Score or Speech Recognition Score
Interpretation:
Modifications
Uses
IMPEDANCE AUDIOMETRY
Tympanometry
Acoustic Reflex
ELECTROCOCHLEOGRAPHY
Method
Uses
BRAINSTEM EVOKED RESPONSE AUDIOMETRY
[Auditory Brainstem Response (ABR) or Auditory Nerve and Brainstem Evoked Potentials (ABEP)]
OTOACOUSTIC EMISSIONS
Types
Uses
AUDITORY STEADY STATE RESPONSE (ASSR)
Method
Advantages
12:
Conductive Hearing Loss and Otosclerosis
CLASSIFICATION OF HEARING LOSS
CONDUCTIVE HEARING LOSS
Etiology
History and Physical Examination
Treatment
OTOSCLEROSIS
Pertinent Anatomy
Etiology
Types
Pathology
Clinical Features
Audiometry
Differential Diagnoses
Treatment
STAPEDECTOMY
Selection Criteria
Contraindications
Anesthesia
Operative Steps
Postoperative Care and Follow-Up
Complications
13:
Sensorineural Hearing Loss
SENSORINEURAL HEARING LOSS
Etiology
History, Examination and Investigations (Fig. 1)
Treatment
Prophylaxis
LABYRINTHITIS
SYPHILIS
Pathology
Clinical Features
Diagnosis
Treatment
Prognosis
OTOTOXICITY
Pathology
Clinical Features
CISPLATIN
AMINOGLYCOSIDE ANTIBIOTICS
Risk Factors
Prophylaxis
Histopathology
Clinical
NOISE TRAUMA
Acoustic Trauma
Noise-Induced Hearing Loss
Factors Affecting Noise Trauma
Pathology
Clinical Features
Pure Tone Audiogram
Prophylaxis
SUDDEN SENSORINEURAL HEARING LOSS
Etiology
Clinical Features
Investigations
Treatment
Prognosis
PRESBYCUSIS
Predisposing Factors
Pathology and Audiometry
Clinical Features
Treatment
GENETIC SENSORINEURAL HEARING LOSS
Features
Familial Progressive Sensorineural Hearing Loss
Immune-Mediated Sensorineural Hearing Loss
Clinical Features
Laboratory
Treatment
NON-ORGANIC HEARING LOSS
Malingering
Stenger Test
Diagnosis
DEGREE OF HEARING LOSS
WHO Classification
Department of Personnel, Government of India
Degree of Hearing Handicap
THE ONLY HEARING EAR
Precautions
14:
Hearing Impairment in Infants and Young Children
INTRODUCTION
ETIOLOGY
Prenatal Causes
Perinatal Causes
Postnatal Causes
CLINICAL FEATURES
Meningitis
Syndromes with Genetic Hearing Loss (Table 1)
HIGH-RISK REGISTRY
UNIVERSAL NEWBORN HEARING SCREENING (UNHS)
Interpretations
Limitations
Brainstem Evoked Response Audiometry
Evoked Otoacoustic Emission
EVALUATION OF UNIVERSAL NEWBORN HEARING SCREENING REFER INFANTS
History
Physical Examination
Hearing Tests
OTHER HEARING TESTS
Ancillary Laboratory Testing
Screening for Maternally Transmitted Infection (TORCH and Syphilis)
Clinical Features
Genetic Testing
Temporal Bone Imaging
TREATMENT
Hearing Aids
Cochlear Implants
REHABILITATIVE MEASURES
Parental Guidance
Development of Speech and Language
Total Communication
Education and Vocation of Deaf
15:
Hearing Aids and Cochlear Implants
INTRODUCTION
TRAINING
HEARING AIDS
Parts
Types
Electroacoustic Properties
Shapes and Sizes
Contralateral Routing of Signals
Monaural/Binaural Amplification
Hearing Aids in Children
Analog, Hybrid and Digital Hearing Aids
Evaluation of Hearing Aid Candidates
ASSISTIVE DEVICES
IMPLANTABLE HEARING AIDS
Bone-Anchored Hearing Aid (BAHA)
Vibrant MED-EL Soundbridge
COCHLEAR IMPLANTS
Available Devices
Components and their Functioning
Outcomes
Indications for Cochlear Implant Evaluations
Evaluation of Cochlear Implant Candidates
Selection Criteria
Surgical Procedure
Postoperative Complications
Postoperative Mapping
AUDITORY BRAINSTEM IMPLANT
16:
Diseases of External Ear and Tympanic Membrane
INTRODUCTION
CONGENITAL DISORDERS
Preauricular Sinus and Cyst
TRAUMATIC DISORDERS
Frostbite
ERYSIPELAS
PERICHONDRITIS AND CHONDRITIS
Etiology
Clinical Features
Treatment
Complications
CHONDRODERMATITIS NODULARIS CHRONICA HELICiS
RELAPSING POLYCHONDRITIS
CONGENITAL DISORDERS OF EXTERNAL AUDITORY CANAL
TRAUMA OF EXTERNAL AUDITORY CANAL
FOREIGN BODIES OF EAR
Types and Features of Foreign Bodies
Treatment
Complications
EAR MAGGOTS
OTITIS EXTERNA
Microorganisms
Treatment
Acute Otitis Externa
Predisposing Factors
Clinical Features
Chronic Otitis Externa
Types
Complications of Otitis Externa
OTOMYCOSIS
Clinical Features
Treatment
Aspergillus Niger
Candida Albicans
Fungal Infection of Temporal Bone
FURUNCULOSIS
Clinical Features
Treatment
KERATOSIS OBTURANS
Clinical Features
Treatment
EAR WAX
Anatomy and Physiology
Components of Ear Wax
Factors Facilitating Ear Wax Problem
Clinical Features
Treatment
EAR SYRINGING
Method
Cautions
HERPES ZOSTER OTICUS-RAMSAY HUNT SYNDROME (VARICELLAZOSTER VIRUS)
BULLOUS OTITIS EXTERNA AND MYRINGITIS
Clinical Features
Treatment
GRANULAR MYRINGITIS
MALIGNANT OR NECROTIZING OTITIS EXTERNA
Clinical Features
Investigations
Treatment
RETRACTED TYMPANIC MEMBRANE
Atrophic Tympanic Membrane
Retraction Pockets and Atelectasis Tympanic Membrane
TYMPANOSCLEROSIS
PERFORATION OF TYMPANIC MEMBRANE
TRAUMATIC RUPTURE OF TYMPANIC MEMBRANE
17:
Disorders of Eustachian Tube
ANATOMY
Parts
Openings
Muscles in Relation to Eustachian Tube
Mucosa of Eustachian Tube
Nerve Supply
Differences between the Infant and Adult Eustachian Tube
PHYSIOLOGY
Ventilation and Regulation of Middle Ear Pressure
Protective Functions
Clearance of Middle Ear Secretions
Ventilation of Middle Ear Cleft
EXAMINATION OF EUSTACHIAN TUBE
TESTS FOR EUSTACHIAN TUBE FUNCTION
Maneuver Building Positive Pressure in Nasopharynx
Maneuver Building Negative Pressure in Nasopharynx
Tests for Mucociliary Drainage/Clearance
Sonotubometry
OBSTRUCTION OF EUSTACHIAN TUBE
Etiology
Adenoids
Cleft Palate
Down's Syndrome
After-effects of Eustachian Tube Obstruction
Clinical Features
Retraction Pockets and Atelectasis
PATULOUS EUSTACHIAN TUBE
Etiology
Clinical Features
Treatment
18:
Acute Otitis Media and Otitis Media with Effusion
INTRODUCTION
Risk Factors
Prophylactic Measures
ETIOPATHOLOGY
Routes of Infection
Predisposing Factors
Causative Microorganisms
CLINICAL FEATURES
Pathology and Clinical Features (5 Stages)
DIAGNOSIS
Differential Diagnoses
TREATMENT (FIG. 2)
Medical Treatment
Surgical Treatment
RECURRENT ACUTE OTITIS MEDIA
Treatment
ACUTE NECROTISING OTITIS MEDIA
ETIOLOGY
CLINICAL FEATURES
Otoscopy/Microscopy (Fig. 3)
DIAGNOSIS
TREATMENT
Medical
Surgical
SEQUELAE AND COMPLICATIONS
Adverse Effects of Chronic Hearing Loss in Children
AERO OTITIS MEDIA (OTITIC BAROTRAUMA)
Etiopathology
Clinical Features
Treatment
Prophylaxis
19:
Chronic Suppurative Otitis Media and Cholesteatoma
INTRODUCTION
MASTOID PNEUMATIZATION
ATELECTASIS AND ADHESIVE OTITIS MEDIA
Sade Classification
Sequelae
Treatment
CHRONIC SUPPURATIVE OTITIS MEDIA
Epidemiology
Types of CSOM
Microbiology
ATTICOANTRAL CSOM OR CHRONIC OM WITH CHOLESTEATOMA
Structure of Cholesteatoma (Fig. 6)
Types of Cholesteatoma
Pathogenesis of Acquired Cholesteatoma
Spread of Cholesteatoma
Destruction of Bone
Clinical Features
Complications
Investigations
Surgical Treatment
Conservative Treatment
TUBOTYMPANIC CSOM OR CHRONIC OM WITHOUT CHOLESTEATOMA
Etiology/Predisposing factors
Clinical Features
Investigations
Treatment
20:
Complications of Suppurative Otitis Media
INTRODUCTION
FACTORS INFLUENCING DEVELOPMENT OF COMPLICATIONS
PATHWAYS OF SPREAD
CLINICAL FEATURES
ACUTE MASTOIDITIS
Etiology and Predisposing Factors
Pathology
Clinical Features
Investigations
Differential Diagnoses
Treatment
Complications
MASKED (LATENT) MASTOIDITIS
EXTRATEMPORAL COMPLICATIONS (ABSCESSES)
Bezold's Abscess (Fig. 4)
PETROSITIS OR PETROUS APICITIS
Pertinent Anatomy
Clinical Features
Treatment
FACIAL NERVE PARALYSIS
Acute Otitis Media
Chronic Suppurative Otitis Media
LABYRINTHITIS
EXTRADURAL (EPIDURAL) ABSCESS
Pathology
Clinical Features
Diagnosis
Treatment
Follow-Up
SUBDURAL ABSCESS OR EMPYEMA
Pathology
Clinical Features
Diagnosis
Treatment
MENINGITIS
Causes
Pathways of Infection
Microbiology
Clinical Features
Diagnosis
Treatment
OTOGENIC BRAIN ABSCESS
Route of Infection
Bacteriology
Pathology and Four Stages
Clinical Features
Investigations
Treatment
LATERAL SINUS THROMBOPHLEBITIS
Etiology
Pathology
Bacteriology
Clinical Features
Investigations
Complications
Treatment
OTITIC HYDROCEPHALUS
Mechanism
Clinical Features
Diagnosis
Treatment
21:
Evaluation of Dizzy Patient
INTRODUCTION
Indications for Immediate Referral to Otoneurologist
Diseases Needing Urgent Treatment
EVALUATION–GENERAL OUTLINE
DESCRIPTION OF DIZZINESS
ONSET, DURATION AND PROGRESSION
PROVOKING FACTORS
ASSOCIATED SYMPTOMS
PERSONAL, FAMILY AND PAST HISTORY
SPONTANEOUS NYSTAGMUS
Method of Eliciting Nystagmus
Interpretations
Degree of nystagmus (Alexander Law for Peripheral Vestibular Nystagmus)
Ewald's Law
DYNAMIC OCULAR EXAMINATION (Fig. 1)
Vergence
Saccades
Smooth Pursuit
Optokinetic Tracking
Vestibulo-ocular Reflex
Vestibulo-ocular Reflex Cancellation
FISTULA TEST
Principle
Method
Interpretation
VALSALVA MANEUVER
DIX-HALLPIKE MANEUVER
Method for Posterior Canal BPPV
Interpretations
Modified Dix-Hallpike Maneuver for Lateral Canal BPPV
OPTOKINETIC TEST
ROTATION TESTS
CALORIC TEST
Gitzgerald-Hallpike Bithermal Caloric Test
Interpretations
TANDEM WALKING
ROMBERG'S TEST
CEREBELLAR TESTS
HYPERVENTILATION
ORTHOSTATIC HYPOTENSION
SPECIAL VESTIBULAR INVESTIGATIONS
DIFFERENCES BETWEEN CENTRAL AND PERIPHERAL VERTIGO
22:
Peripheral Vestibular Disorders
INTRODUCTION
BENIGN PAROXYSMAL POSITIONAL VERTIGO
Incidence
Etiological Factors
Pathogenesis
Clinical Features
Types
Diagnosis
Differential Diagnoses
Treatment
Repositioning Maneuvers
Surgical Treatment
ACUTE VESTIBULAR NEURITIS
Etiology
Clinical Features
Prognosis
Differential Diagnoses
Treatment
MÉNIÈRE'S DISEASE (IDIOPATHIC ENDOLYMPHATIC HYDROPS)
Incidence
Etiology
Pathogenesis
Clinical Features
Nystagmus
Audiogram (Fig. 5)
Differential Diagnoses
Investigations
Medical Treatment
Surgical Treatment
DELAYED ENDOLYMPHATIC HYDROPS
RECURRENT VESTIBULOPATHY
Clinical Features
Treatment
MIDDLE EAR EFFUSION
LABYRINTHINE FISTULA
Causes
Clinical Features
Investigations
Treatment
SEROUS LABYRINTHITIS
Causes
Clinical Features
Treatment
SUPPURATIVE (PURULENT) LABYRINTHITIS
Routes of Infection
Etiology
Predisposing Factors
Clinical Features (Three Stages)
PERILYMPHATIC FISTULA
Etiology
Clinical Features
Investigations
Diagnosis
Differential Diagnoses
Treatment
23:
Central Vestibular Disorders
INTRODUCTION
MIGRAINE
Basilar Migraine
Treatment of Acute Attacks
Treatment of Vestibular Symptoms
Prophylactic Medications
Lifestyle Changes
VERTEBROBASILAR INSUFFICIENCY
Etiology
Vascular Risk Factors
Clinical Features
Vertebrobasilar Angiography
Treatment
SUBCLAVIAN STEAL SYNDROME
Clinical Features
WALLENBERG'S SYNDROME
Causes
Clinical Features
Characteristic Ocular Motor Abnormalities
CEREBELLAR INFARCTION
Clinical Features
Isolated Cerebellar Infarction
Differential Diagnosis
Management
CEREBELLAR HEMORRHAGE
Causes
Clinical Features
Management
MULTIPLE SCLEROSIS
Etiology
Clinical Features
Differential Diagnoses
Supportive Investigations
Treatment
MOTION SICKNESS
Clinical Features
Aggravating Factors (Visual Vestibular Conflict)
Relieving Factors (Minimizing Visual Vestibular Mismatch)
Treatment
PHOBIC POSTURAL VERTIGO
Clinical Features
Differential Diagnosis
Treatment
HYPERVENTILATION
AGORAPHOBIA
CERVICAL VERTIGO OR WHIPLASH VERTIGO
24:
Facial Nerve Disorders
PERTINENT ANATOMY
Functional Divisions
Motor Nucleus of Facial Nerve (Fig. 1)
Course of Facial Nerve
Branches of Facial Nerve
Blood Supply
SURGICAL LANDMARKS
Middle Ear Cleft
Parotid Gland
CLINICAL EVALUATION OF FACIAL PALSY
House-Brackmann System of Grading Facial Nerve Palsy
PATHOPHYSIOLOGY OF NERVE INJURY
SUNDERLAND CLASSIFICATION (FIG. 5)
DIFFERENCES BETWEEN UPPER AND LOWER MOTOR NEURON PAlSY
Upper Motor Neuron Facial Paralysis
Lower Motor Neuron Facial Paralysis
INVESTIGATIONS
Electrical Tests
Nerve Excitability Test (NET)
Maximal Stimulation Test (MST)
Electroneurography
Electromyography
Nerve Conduction Velocity (NCV)
Topodiagnostic Tests
Imaging
CAUSES OF FACIAL NERVE PARALYSIS
Bilateral Facial Nerve Paralysis
SEQUELAE/COMPLICATION OF FACIAL nerve PALSY
BELL'S PALSY
Etiology
Clinical Features
Diagnosis
Differential Diagnoses
Treatment
Prognosis
RECURRENT FACIAL PALSY
MELKERSSON'S SYNDROME
RAMSAY HUNT SYNDROME OR HERPES ZOSTER OTICUS (VARICELLA-ZOSTER VIRUS)
TEMPORAL BONE FRACTURE
Types
Transverse Temporal Bone Fracture (Usually Otic Capsule Disrupting)
Clinical Features
Longitudinal Temporal Bone Fracture (Usually Otic Capsule Sparing)
Clinical Features
Management of Temporal Bone Fracture
LYME DISEASE (BANNWARTH'S SYNDROME)
Clinical Features
Diagnosis
Treatment
SARCOIDOSIS
Clinical Features
Investigations
Treatment
MOBIUS SYNDROME
IATROGENIC OR SURGICAL TRAUMA
Prophylaxis
HYPERKINETIC DISORDERS OF FACIAL NERVE
Hemifacial Spasm
Blepharospasm
SURGICAL TREATMENT OF FACIAL NERVE PALSY
25:
Tumors of the Ear and Cerebellopontine Angle
BENIGN TUMORS OF EXTERNAL EAR
Cysts
Hemangiomas
Papilloma
Keratoacanthoma
Neurofibroma
Osteoma
Exostoses
Ceruminoma
Keloid of Auricle
MALIGNANT TUMORS OF EXTERNAL EAR
Squamous Cell Carcinoma of Auricle
Clinical features
Treatment
Basal Cell Carcinoma of Auricle
Treatment
Melanoma of Auricle
Treatment
TUMORS OF MIDDLE EAR AND MASTOID
Glomus Tumors (Paragangliomas)
Pathology
Sites
Spread
Clinical Features
Differential Diagnoses
Investigations
Treatment
Carcinoma of Middle Ear/EAC
Etiology
Pathology
Spread
Clinical Features
Investigations
Treatment
Rhabdomyosarcoma
Clinical features
Leukemia
INTERNAL AUDITORY CANAL AND CEREBELLOPONTINE ANGLE (FIG. 5)
Contents of Internal Auditory Canal
Boundaries of Cerebellopontine Angle
Relations of CPA
Acoustic Neuroma
Growth
Genetic Association and von Recklinghausen Disease
Clinical Features
Audiometry
Caloric test
Gadolinium-enhanced MRI
Vertebral Angiography
Differential Diagnoses
Treatment
Surgery for CPA Tumors
Translabyrinthine Approach
Retrolabyrinthine Approach
Middle Cranial Fossa or Transtemporal Supralabyrinthine Approach
Suboccipital/Retrosigmoid Approach
Perioperative Care
Postoperative Sequelae/Complications
SECTION 3: NOSE AND PARANASAL SINUSES
26:
Nasal Symptoms and Examination
INTRODUCTION
EXTERNAL NOSE
VESTIBULE
ANTERIOR RHINOSCOPY (EXAMINATION OF NASAL CAVITY)
Thudicum nasal speculum
Examination
Infant's Examination
POSTERIOR RHINOSCOPY
PATENCY OF NASAL CAVITIES
SENSE OF SMELL
PARANASAL SINUSES
Tenderness
Transillumination
Endoscopic Examination
SMELL
Factors Affecting Olfactory Testing
Causes of Olfactory Disorders
Tests for Smell
MEASUREMENT OF MUCOCILIARY FLOW
NASAL OBSTRUCTION
Causes of Nasal Obstruction
Differential Diagnosis (Fig. 11)
Measurement of Nasal Obstruction
NASAL VALVES DISORDERS (Figs 12A and B)
RADIOLOGICAL IMAGING
DIAGNOSTIC ANTRUM PUNCTURE
ALLERGIC TESTS
27:
Diseases of External Nose and Epistaxis
INFECTIONS
Cellulitis of Nose
Furuncle or Boil of Nose
Nasal Vestibulitis
DEFORMITIES OF EXTERNAL NOSE
Saddle Nose (Depressed Nasal Dorsum)
Hump Nose
Crooked and Deviated Nose
Stenosis and Atresia of Nares
TUMORS OF EXTERNAL NOSE
Dermoid Cyst of Nose
Extranasal Encephalocele or Meningoencephalocele
Extranasal Glioma
Nasolabial (Nasoalveolar, Klestadt's) Cyst
Rhinophyma or Potato Tumor
Papilloma or Wart of Nose
Basal Cell Carcinoma (Rodent Ulcer) of External Nose
Squamous Cell Carcinoma (Epithelioma) of External Nose
Melanoma Nose
PERTINENT ANATOMY
Retrocolumellar Vein
CAUSES
EVALUATION
HISTORY
Examination
SITES OF EPISTAXIS
Anterior Epistaxis
Posterior Epistaxis
INVESTIGATIONS
TREATMENT
A. General Measures
B. Nasal Cautery
C. Anterior Nasal Packing (Fig. 8)
D. Posterior Nasal Packing
E. Arterial Embolization
F. Arterial Ligation
G. Surgical Treatment
28:
Infectious Rhinosinusitis
INTRODUCTION
CLASSIFICATION
Sinusitis
VIRAL RHINOSINUSITIS (COMMON COLD)
Etiology
Clinical Features
Treatment
Course
Complications
PANDEMIC INFLUENZA A H1N1 (SWINE FLU)
ACUTE BACTERIAL RHINOSINUSITIS
Microbiology
Predisposing Factors
Pathology
Clinical Features
Investigations
Course
Differential Diagnosis
Treatment
CHRONIC RHINOSINUSITIS
Bacterial Causes
Etiologic and Predisposing Factors
Clinical Features
Investigations
Differential Diagnoses
Medical Treatment
Surgical Treatment
Endoscopic Sinus Surgery
Maxillary Sinus (See chapter Operations of Nose and Paranasal Sinuses)
Frontal Sinus
Ethmoid Sinuses
Sphenoid Sinus
PEDIATRIC RHINOSINUSITIS
Pathophysiology
Clinical Features
Differential Diagnosis
Diagnosis
Treatment
COMPLICATIONS OF RHINOSINUSITIS
MUCOCELE/PYOCELE
Etiology
Maxillary Mucocele
Frontoethmoidal Mucocele
Sphenoethmoidal Mucocele
ORBITAL COMPLICATIONS
Clinical Features
Diagnosis
Treatment
OSTEOMYELITIS/OSTEITIS
Osteomyelitis of Maxilla
Osteomyelitis Frontal Bone
CAVERNOUS SINUS THROMBOSIS
INTRACRANIAL COMPLICATIONS
HYPERTROPHIED TURBINATES
NASAL POLYPS
Etiology
Pathology
Common Sites of Origin
Clinical Features
Staging
Antrochoanal Polyp
Differential Diagnoses
Investigations
Treatment
FUNGAL SINUSITIS
ATROPHIC RHINITIS (OZENA)
29:
Nasal Manifestation of Systemic Diseases
INTRODUCTION
WEGENER'S GRANULOMATOSIS
Clinical Features
Diagnosis
Treatment
PERIPHERAL T-CELL NEOPLASM (NONHEALING MIDLINE GRANULOMA, POLYMORPHIC RETICULOSIS)
Clinical Features
Diagnosis
Treatment
ATROPHIC RHINITIS (OZENA)
Etiology
Pathology
Clinical Features
Treatment
Secondary Atrophic Rhinitis
RHINITIS SICCA
RHINITIS CASEOSA
SARCOIDOSIS
Clinical Features
Diagnosis
Treatment
CHURG-STRAUSS SYNDROME
RHINOSCLEROMA
Etiopathology
Clinical Features
Diagnosis
Treatment
TUBERCULOSIS
LUPUS VULGARIS
NONTUBERCULOUS MYCOBACTERIA
LEPROSY
Clinical Features
Diagnosis
Treatment
SYPHILIS
Acquired Syphilis
Congenital Syphilis
Complications
Diagnosis
Treatment
HISTOPLASMOSIS
RHINOSPORIDIOSIS
Clinical Features
Diagnosis
Treatment
FUNGAL SINUSITIS
Acute Invasive Fungal Sinusitis
Chronic Invasive Fungal Sinusitis
Fungus Balls
Saprophytic Fungal Infection
Allergic Fungal Rhinosinusitis
30:
Allergic and Nonallergic Rhinitis
TYPES OF IMMUNOLOGIC (HYPERSENSITIVITY) MECHANISM
Type I–Immediate (IgE-Mediated Hypersensitivity)
Atopy
Anaphylaxis
Type II–Cytotoxic (Antibody-Mediated Hypersensitivity)
Type III–Immune Complex-Mediated Hypersensitivity
Type IV–Delayed (T Cell-Mediated Hypersensitivity)
ETIOLOGY
Allergens
Pollens
Molds
Insects
Animals
House Dust
Dust Mite
Ingestants
Drugs
Predisposing Factors
Hereditary
Endocrine
Psychological
Physical
Infection
Contacts
Irritants
Pathogenesis
Types of Allergic Response
CLASSIFICATION
CLINICAL FEATURES
Symptoms
Diagnostic
Bilateral Nasal Stuffiness
Severity
Age
Associated Symptoms
Allergens
Examination
Allergy Salute
Inferior Turbinate
Thin Watery Discharge
Polyps
Superadded Infection
Complications/Associated Conditions
Sinuses
Eyes
Ears
Pharynx
Larynx
Bronchial Tree
INVESTIGATIONS
Complete Blood Count
Nasal Smear
Intranasal Provocation Test
Elimination Tests
Specific-IgE Antibody Tests
Skin Tests
In Vitro Tests of IgE Antibody
TREATMENT
Avoidance Therapy
Pollens
Animal Dander
House Dust Mites
Mold Spores
Drug Therapy
Antihistamines
Sympathomimetic Drugs (Nasal Decongestants)
Corticosteroids
Mast Cell Stabilizers (Cromolyn and Nedocromil)
Anticholinergic Agents (Nasal Topical Ipratropium Bromide)
Leukotriene Modifiers
Anti-IgE Antibody Therapy
Macrolides
New Therapies
Immunotherapy
Indications
Immunologic Effects
Clinical Effects
Procedure
Adverse Effects
Surgery
PATHOPHYSIOLOGY
CLASSIFICATION
Nonallergic Rhinitis with Eosinophilia
Drug-Induced Rhinitis
Rhinitis Medicamentosa
Honeymoon Rhinitis
Emotional Rhinitis
Hormone-Related Rhinitis
Gustatory Rhinitis
Non Airflow Rhinitis
Idiopathic or Vasomotor Rhinitis (VMR)
CLINICAL FEATURES
Symptoms
Paroxysmal Sneezing
Excessive Rhinorrhea
Nasal Obstruction
Postnasal Drip
Examination
Nose
Pharynx
Complications
INVESTIGATIONS
TREATMENT
Medical
Surgical
31:
Nasal Septum
FRACTURE OF NASAL SEPTUM
Features
Types
“Jarjavay” Fracture (Fig.1A)
“Chevallet” Fracture (Fig. 1B)
Treatment
Complications
DEVIATED NASAL SEPTUM
Etiological Factors
Accidental Trauma
Natal Trauma
Antenatal
Developmental
Mouth Breathers
Cleft Lip and Palate
Mass in Nose
Types
Anterior Dislocation (Caudal Septal Deviation)
C-Shaped Deformity
S-Shaped Deformity
Spurs
Thickening
Clinical Features
Nasal Obstruction
Headache
External Deformity
Epistaxis
Hyposmia/Anosmia
Complications
Treatment
Submucous Resection
Septoplasty
SEPTAL HEMATOMA
Etiology
Clinical Features
Treatment
Complications
SEPTAL ABSCESS
Etiology
Clinical Features
Treatment
Incision and Drainage
Systemic Antibiotics
Complications
PERFORATION OF NASAL SEPTUM
Etiology
Clinical Features
Diagnosis
Treatment
Medical
Small Perforations
Larger perforations
HYPERTROPHIED TURBINATES
Clinical Features
Treatment
Compensatory Hypertrophic Rhinitis
NASAL SYNECHIA
Etiology
Clinical Features
Treatment
CHOANAL ATRESIA
Clinical Features
Unilateral
Bilateral
Diagnosis
Treatment
Tracheostomy or Endotracheal Intubation
McGovern's Technique
Correction of Atresia (Recanalization)
32:
Maxillofacial Trauma
INTRODUCTION
ETIOLOGY
CLASSIFICATION
GENERAL PRINCIPLES
A. Airway
B. Breathing
C. Circulation
EVALUATION
History and Examination
Radiology
Laboratory
SOFT TISSUE INJURIES
Facial Lacerations
Parotid Gland
Facial Nerve
FRONTAL SINUS
Anterior Wall Fractures
Posterior Wall Fractures
Injury to Frontonasal Duct
SUPRAORBITAL RIDGE
Clinical Features
Treatment
FRONTAL BONE
NASAL BONES AND SEPTUM
Types
Clinical Features
Diagnosis
Treatment
NASO-ORBITAL ETHMOID (NOE)
Clinical Features
Diagnosis
Treatment
ZYGOMA (TRIPOD FRACTURE)
Clinical Features
Diagnosis
Treatment
ZYGOMATIC ARCH
ORBIT (BLOWOUT FRACTURE)
Pure Blowout Fracture
Impure Blowout Fracture (Rim Fracture)
Diagnosis
Treatment
NASO-MAXILLARY COMPLEX
Types
Clinical Features
Diagnosis
Treatment
MANDIBLE
Classification
Factors Affecting Displacement
Mode of Injury
Clinical Features
Diagnosis
Treatment
OROANTRAL FISTULA
Etiology
Clinical Features
Treatment
CEREBROSPINAL FLUID RHINORRHEA
Etiology
Sites and Pathways
Diagnosis
Complications
Localization of CSF Leak (CSF Tracers)
Treatment
FOREIGN BODY NOSE
Clinical Features
Causes of Unilateral Blood Stained Discharge
Complications
Treatment
RHINOLITH
Clinical Features
Treatment
NASAL MYIASIS (MAGGOTS NOSE)
Etiopathology
Clinical Features
Treatment
33:
Tumors of Nose, Paranasal Sinuses and Jaws
INTRODUCTION
Histopathology
NEOPLASMS IN CHILDREN
DIAGNOSIS
ANGIOFIBROMA
INTRANASAL MENINGOENCEPHALOCELE
GLIOMAS
NASAL DERMOID
MONOSTOTIC FIBROUS DYSPLASIA
SQUAMOUS PAPILLOMA
OSTEOMAS
PLEOMORPHIC ADENOMA
CHONDROMA
SCHWANNOMA AND NEUROFIBROMA
OSSIFYING FIBROMA AND CEMENTOMA
ODONTOGENIC TUMORS
INVERTED PAPILLOMA
MENINGIOMAS
HEMANGIOMAS
HEMANGIOPERICYTOMA
PLASMACYTOMA
MALIGNANT NEOPLASMS
Etiology
Clinical Features
Diagnosis
Classification and Staging
MALIGNANCY OF MAXILLARY SINUS
Clinical Features
Treatment
Prognosis
MALIGNANCY OF ETHMOID SINUS
Clinical Features
Imaging
Treatment
Prognosis
MALIGNANCY OF FRONTAL SINUS
MALIGNANCY OF SPHENOID SINUS
ADENOCARCINOMA
ADENOID CYSTIC CARCINOMA
MALIGNANT MELANOMA
Clinical Features
Treatment
OLFACTORY NEUROBLASTOMA
SARCOMAS
RHABDOMYOSARCOMA
INTRODUCTION
MANAGEMENT OF JAW SWELLINGS
Clinical Evaluation
Investigations
Treatment
FISSURAL CYSTS
PERIAPICAL CYSTS
FOLLICULAR (DENTIGEROUS) CYSTS
ODONTOGENIC KERATOCYST
BASAL CELL NEVUS SYNDROME
RETENTION CYST
AMELOBLASTOMA
Malignant Ameloblastoma
OSSIFYING FIBROMA
FIBROUS DYSPLASIA
CHERUBISM
ADENOMATOID ODONTOGENIC TUMOR
SECTION 4: ORAL CAVITY AND SALIVARY GLANDS
34:
Oral Symptoms and Examination
ORAL CAVITY
Symptoms
Examination
Tongue Depressor
EVALUATION OF CANCER LESIONS
History
Examination
Investigations
Imaging
SALIVARY GLANDS
Clinical Features
DIAGNOSTIC IMAGING
Sialography
Radiosialography
Ultrasonography
Computed Tomography
CT Sialography
Magnetic Resonance Imaging
MRI Sialography
FINE-NEEDLE ASPIRATION CYTOLOGY
35:
Oral Mucosal Lesions
INTRODUCTION
ORAL SUBMUCOUS FIBROSIS
Etiology
Pathology
Potential for Malignant Change
Clinical Features
Treatment
LEUKOEDEMA
ORAL LEUKOPLAKIA
Risk Factors
Clinical Features
Clinical Forms
Histopathology
Potential for Malignant Change
Molecular Biology
Management
ORAL HAIRY LEUKOPLAKIA
ORAL LICHEN PLANUS
Clinical Features
Clinical Forms
Treatment
CHRONIC DISCOID LUPUS ERYTHEMATOSUS
CANDIDIASIS (MONILIASIS)
Risk Factors
Clinical Features
Acute Pseudomembranous Candidiasis (Thrush)
Chronic Hypertrophic (Hyperplastic) Candidiasis or Candidal Leukoplakia
Median Rhomboid Glossitis
Other Clinical Forms of Candidiasis
FORDYCE'S SPOTS
NICOTINE STOMATITIS
PEMPHIGUS VULGARIS
Etiopathology
Clinical Features
Diagnosis
Treatment
MUCOUS MEMBRANE PEMPHIGOID OR CICATRICIAL PEMPHIGOID
Etiopathology
Clinical Features
Diagnosis
Treatment
HERPES SIMPLEX VIRUS: HERPETIC GINGIVOSTOMATITIS OR OROLABIAL HERPES
Etiopathology
Primary Herpes Simplex Infection
Laboratory Investigations
Treatment
Secondary Herpes Simplex Infection or Recurrent Herpes Simplex Infection
Clinical Features
Clinical Forms
Diagnosis
Treatment
HAND, FOOT AND MOUTH DISEASE
HERPANGINA
ACUTE NECROTIZING ULCERATIVE GINGIVITIS
RECURRENT APHTHOUS STOMATITIS
Etiology
Clinical Features
Differential Diagnoses
Treatment
BEHÇET'S SYNDROME
ERYTHEMA MULTIFORME
Types
Triggers
Clinical Features
Differential Diagnoses
Treatment
TRAUMATIC (EOSINOPHILIC) GRANULOMA
Treatment
TRAUMATIC ULCERS
RADIATION MUCOSITIS
BLOOD DISORDERS
DRUG-INDUCED ORAL LESIONS
MELANOTIC MACULES
Lesion
Treatment
MELANOMA
Treatment
Prognosis
AMALGAM TATTOO
Lesion and Its Site
Treatment
GEOGRAPHICAL TONGUE OR MIGRATORY GLOSSITIS
HAIRY TONGUE
FISSURED TONGUE (Fig. 15)
TONGUE TIE (ANKYLOGLOSSIA)
36:
Disorders of Salivary Glands
INTRODUCTION
MUMPS
Etiology
Epidemiology
Clinical Features
Investigation
Treatment
Complications
Prevention
ACUTE SUPPURATIVE SIALADENITIS
Predisposing Factors
Causative Microorganisms
Clinical Features
Investigations
Differential Diagnoses
Treatment
PAROTID ABSCESS
Treatment
Complications
NEONATAL SUPPURATIVE PAROTITIS
RECURRENT PAROTITIS OF CHILDHOOD
Proposed Etiologies
Clinical Features
Treatment
CHRONIC SIALADENITIS
Inciting Factors
Clinical Features
Treatment
Complications
Benign Lymphoepithelial Lesion
Kuttner's Tumor
TUBERCULOUS MYCOBACTERIAL DISEASE
Routes of Infections
Clinical Features
Differential Diagnoses
Investigations
Treatment
NONTUBERCULOUS MYCOBACTERIAL DISEASE
Causative Organisms
Portal of Entry
Clinical Features
Investigations
Treatment
ACTINOMYCOSIS
Causative Organism
Predisposing Factors
Clinical Features
Diagnosis
Treatment
Prognosis
CAT SCRATCH DISEASE
Causative Organism
Clinical Features
Diagnosis
TOXOPLASMOSIS
Causative Organism
Clinical Features
Biopsy
Treatment
HIV
HIV-Associated Salivary Gland Disease
SIALOLITHIASIS
Etiology
Composition
Clinical Features
Investigations
Treatment
HISTOGENESIS OF NEOPLASMS
Etiology
Prophylaxis
PLEOMORPHIC ADENOMA
WARTHIN'S TUMOR OR ADENOLYMPHOMA (PAPILLARY CYSTADENOMA LYMPHOMATOSUM)
ONCOCYTOMA
HEMANGIOMAS
LYMPHANGIOMAS
MUCOEPIDERMOID CARCINOMA
Staging
Treatment
ADENOID CYSTIC CARCINOMA (CYLINDROMA)
Treatment
ACINIC CELL CARCINOMA
SQUAMOUS CELL CARCINOMA
MALIGNANT MIXED TUMOR
ADENOCARCINOMA
LYMPHOEPITHELIAL CARCINOMA OR UNDIFFERENTIATED CARCINOMA
SJÖGREN'S SYNDROME
Types
Epidemiology
Etiology
Clinical Features
Oral Findings
Eye Findings
Systemic Manifestations
Laboratory Investigations
Treatment
DIFFUSE INFILTRATIVE LYMPHOCYTOSIS SYNDROME
FREY'S SYNDROME (GUSTATORY SWEATING)
Treatment
37:
Neoplasms of the Oral Cavity
INTRODUCTION
PAPILLOMA
PLEOMORPHIC ADENOMA
HEMANGIOMA
LYMPHANGIOMA
GRANULAR CELL TUMOR
AMELOBLASTOMA
TORUS
Clinical Features
Treatment
PYOGENIC GRANULOMA
IRRITATION Fibroma
MUCOCELE
RANULA
Treatment
DERMOID CYSTS
Epidemiology
Risk Factors
Molecular Biology
Premalignant Lesions
Subsites of Oral Cavity
Clinical Evaluation and Investigations
Staging
Histopathology
Treatment
Prognosis
CARCINOMA LIPS
Clinical Features
Treatment
CARCINOMA GINGIVA/ALVEOLAR RIDGE
Clinical Features
Treatment
CARCINOMA ORAL TONGUE
Gross Pathology
Clinical Features
Treatment
CARCINOMA FLOOR OF MOUTH
Clinical Features
Treatment
CARCINOMA BUCCAL MUCOSA
Pathology
Clinical Features
Verrucous Carcinoma
Treatment
CARCINOMA HARD PALATE
Clinical Features
Treatment
CARCINOMA RETROMOLAR TRIGONE
MINOR SALIVARY GLAND TUMORS
MELANOMA
Treatment
Prognosis
KAPOSI'S SARCOMA
SECTION 5: PHARYNX AND ESOPHAGUS
38:
Pharyngeal Symptoms and Examination
NASOPHARYNX
Symptoms
Examination
OROPHARYNX
Symptoms
Examination
LARYNGOPHARYNX
BARIUM ESOPHAGOGRAPHY (Figs 2 and 3)
Fluoroscopy
Cineradiography
Video Esophagography
Modified Barium Swallow
Esophagogram
Oral Contrast Agents
ESOPHAGEAL MANOMETRY
Indications
AMBULATORY 24-HOURS ESOPHAGEAL pH RECORDING
Indications
ESOPHAGOSCOPY
Odynophagia
Causes
EVALUATION
History
Physical Examination
Investigations
39:
Pharyngitis and Adenotonsillar Disease
INTRODUCTION
PHARYNGITIS
Irritative Pharyngitis
Bacterial Pharyngitis
Viral Pharyngitis
Treatment
INFECTIOUS MONONUCLEOSIS
Clinical Features
Diagnosis
Treatment
STREPTOCOCCAL TONSILLITIS-PHARYNGITI
Etiology
Clinical Features
Symptoms
Physical Findings
Diagnosis
Treatment
Complications
Differential Diagnosis of Membranous Pharyngitis-Tonsillitis
Differential Diagnoses of White Patches on Tonsils
FAUCIAL DIPHTHERIA
Clinical Features
Diagnosis
Complications
Treatment
TONSILLAR CONCRETIONS/TONSILLOLITHS
Clinical Features
Treatment
INTRATONSILLAR ABSCESS
TONSILLAR CYST
KERATOSIS PHARYNGITIS
DISEASES OF LINGUAL TONSILS
Clinical Features
Treatment
Lingual Tonsillar Abscess
CHRONIC ADENOTONSILLAR HYPERTROPHY
Etiology
Clinical Features
ADENOID FACIES AND CRANIOFACIAL GROWTH ABNORMALITIES
Airway Obstruction
Diagnostic Assessment of Tonsils and Adenoids
OBSTRUCTIVE SLEEP APNEA
Clinical Features
Diagnosis
Treatment
40:
Sleep Apnea and Sleepdisordered Breathing
INTRODUCTION
Classifications
PATHOPHYSIOLOGY OF OBSTRUCTIVE SLEEP APNEA
Sleep Patterns in OSA
Factors Aggravating OSA
DIAGNOSIS AND EVALUATION OF OSA
History
Physical Examination
Flexible Nasopharyngolaryngoscopy
Radiography
Polysomnography
Home Sleep Studies
Multiple Sleep Latency Test
SEVERITY OF OSA
COMPLICATIONS OF OSA
NONSURGICAL TREATMENT
Lifestyle Modifications
Nasal Continuous Positive Airway Pressure
Intraoral Devices
SURGICAL TREATMENT OF OSA
Uvulopalatopharyngoplasty
Other Surgical Procedures
SURGICAL TREATMENT OF SNORING WITHOUT OSA
41:
Tumors of Nasopharynx
INTRODUCTION
Benign Tumors of Nasopharynx
Malignant Tumors of Nasopharynx
JUVENILE NASOPHARYNGEAL ANGIOFIBROMA
Etiology
Pathology
Site of Origin
Growth and Extensions
Clinical Features
Diagnostic Radiology
Staging
Diagnosis
Treatment
Recurrence
NASOPHARYNGEAL CARCINOMA
Etiology
Pathology
Spread
Clinical Features
Endoscopy and Biopsy
Serology
Radiology
TNM Classification
Treatment
Recurrent Disease
TERATOMAS
THORNWALDT'S DISEASE (PHARYNGEAL BURSITIS)
Clinical Features
Treatment
PROPTOSIS (EXOPHTHALMOS)
42:
Tumors of Oropharynx
INTRODUCTION
HISTOPATHOLOGY
Grading
RISK FACTORS
Incidence
Prevention
EVALUATION
Clinical Features
Growth Patterns
Imaging Studies
Biopsy
STAGING
TREATMENT
CARCINOMA BASE OF TONGUE
Clinical Features
Spread
Diagnosis
Treatment
CARCINOMA TONSIL (FIGS 2 AND 3)
Spread
Clinical Features
Diagnosis
Treatment
LYMPHOMA
CARCINOMA SOFT PALATE
Clinical Features
Treatment
CARCINOMA POSTERIOR PHARYNGEAL WALL
Spread
Clinical Features
Treatment
Papilloma
Hemangioma
Pleomorphic Adenoma
Mucous Cyst
PARAPHARYNGEAL TUMORS (FIG. 7)
STYLALGIA (EAGLE'S SYNDROME)
Diagnosis
Treatment
43:
MalignantTumors of Hypopharynx
INTRODUCTION
Hypopharynx Subsites
RISK FACTORS
PATHOLOGY
CLINICAL FEATURES
DIAGNOSIS
STAGING
MANAGEMENT
A. Surgery
B. Radiotherapy
C. Chemotherapy.
D. Combined Chemotherapy and Irradiation for Larynx Preservation
CARCINOMA PYRIFORM SINUS
Spread
Clinical Features
Diagnosis
Treatment
CARCINOMA POSTCRICOID
Spread
Clinical Features
Diagnosis
Treatment
Prognosis
CARCINOMA POSTERIOR PHARYNGEAL WALL
Spread
Clinical Features
Diagnosis
Treatment
Prognosis
44:
Disorders of Esophagus
INTRODUCTION
PERFORATION OF ESOPHAGUS
Etiology
Clinical Features
Diagnosis
Treatment
CORROSIVE BURNS
Etiology
Pathology
Clinical Features
Diagnosis
Grading
Management
MALLORY WEISS SYNDROME
FOREIGN BODIES
Common Foreign Bodies in Esophagus
Risk Factors
Common Sites
Clinical Features
Investigations
Management
Complications
PILL-INDUCED ESOPHAGITIS
Etiology
Clinical Features
Diagnosis
Treatment
GASTROESOPHAGEAL REFLUX DISEASE
Etiology
Clinical Features
Diagnosis
Subgroups
Treatment
Complications
BARRETT'S ESOPHAGUS
Pathogenesis
Diagnosis
Treatment
BENIGN STRICTURES
Causes
Clinical Features
Diagnosis
Treatment
HIATUS HERNIA
Types
Diagnosis
Treatment
SCHATZKI'S RING
PLUMMER-VINSON (PATTERSON BROWN-KELLY) SYNDROME
Clinical Features
Potential of Malignant Conversion
Diagnosis
Treatment
INFECTIOUS ESOPHAGITIS
Etiology
Clinical Features
Candida albicans
Cytomegalovirus
Herpes simplex
Treatment
CRICOPHARYNGEAL SPASM
Causes
DIFFUSE ESOPHAGEAL SPASM
Clinical Features
Diagnosis
Treatment
NUTCRACKER ESOPHAGUS
CARDIAC ACHALASIA
Etiology
Pathology
Clinical Features
Diagnosis
Treatment
SCLERODERMA OR PROGRESSIVE SYSTEMIC SCLEROSIS
Clinical Features
Diagnosis
Treatment
ZENKER DIVERTICULUM
Etiology
Pathology
Clinical Features
Diagnosis
Treatment
GLOBUS HYSTERICUS PHARYNGEUS
BENIGN NEOPLASMS
Leiomyoma
CARCINOMA ESOPHAGUS
Risk Factors
Pathology
Spread
Clinical Features
Diagnosis
TNM Staging
Treatment
Prognosis
SECTION 6: LARYNX, TRACHEA AND BRONCHUS
45:
Laryngeal Symptoms and Examination
SYMPTOMS
CLINICAL EXAMINATION
External Examination
Indirect Laryngoscopy with Laryngeal Mirror
ENDOSCOPY
Rigid 90° Fiberoptic Laryngoscope (Telescope)
Flexible Rhinolaryngoscope (Nasopharyngolaryngoscope)
Laryngeal Videoendoscopy
Advantages
Recent Developments in Video Cameras and Recorders
LARYNGOSCOPIC PARAMETERS AND PATIENT'S TASK
Patient's Tasks
Laryngeal Components of Examination (Fig. 8)
Arytenoid and Vocal Fold Motions
Mucous
Vocal Fold Vascularity
Position or Height of Larynx
Supraglottic Activity
Vocal Fold Edges
STROBOSCOPY
Components Examined
Indications
DIRECT LARYNGOSCOPY (MICROLARYNGOSCOPY) and Bronchoscopy
Etiology
History, Examination and Investigations
Voice and Speech Disorders
Types
Severity of Airway Obstruction
Causes
ASSESSMENT OF PATIENT with stridor
History and Physical Examination of Upper Airway
Characteristic Features
Investigations
Endoscopy
TREATMENT
Acute Airway Obstruction
Chronic Airway Obstruction
46:
Infections of Larynx
INTRODUCTION
Etiology/Risk Factors
ACUTE LARYNGOTRACHEOBRONCHITIS CROUP OR LARYNGOTRACHEITIS
Etiology/Risk Factors
Pathology
Clinical Features
Diagnosis
Differential Diagnosis
Treatment
Complications
BACTERIAL TRACHEITIS
Etiology/Risk Factors
Clinical Features
Diagnosis
Treatment
Complications
PEDIATRIC EPIGLOTTITIS
Etiology/Risk Factors
Clinical Features
Diagnosis
Differential Diagnosis
Complications
Treatment
ADULT SUPRAGLOTTITIS
Etiology
Clinical Features
Diagnosis
WHOOPING COUGH
Etiology
Clinical Features
Treatment
DIPHTHERIA
Clinical Features
Diagnosis
Treatment
CHRONIC NONSPECIFIC LARYNGITIS
Etiology/Risk Factors
Clinical Features
Differential Diagnosis
Biopsy
Treatment
ATROPHIC LARYNGITIS (LARYNGITIS SICCA)
Clinical Features
Treatment
TUBERCULOSIS
Pathology
Clinical Features
Differential Diagnoses
Diagnosis
Treatment
LUPUS
Clinical Features
Treatment
SYPHILIS
LEPROSY (HANSEN'S DISEASE)
Clinical Features
Diagnosis
Treatment
SCLEROMA
Etiology
Clinical Features
Diagnosis
Treatment
EDEMA OF LARYNX
Etiology
Diagnosis
Treatment
47:
Benign Tumors of Larynx
INTRODUCTION
Classification
Risk Factors of Non-neoplastic Vocal Fold Mucosal Disorders
VOCAL NODULES (SINGER'S OR SCREAMER'S NODULES)
Risk Factors
Pathology
Clinical Features
Diagnosis
Treatment
VOCAL POLYP
Risk Factors
Clinical Features
Treatment
REINKE'S EDEMA (BILATERAL DIFFUSE POLY-POSIS)
Risk Factors
Pathology
Clinical Features
Treatment
CONTACT ULCER OR GRANULOMA
Risk Factors
Pathology
Clinical Features
Treatment
INTUBATION GRANULOMA
Risk Factors
Pathology
Clinical Features
Treatment
LEUKOPLAKIA OR KERATOSIS
Risk Factors
Pathology
Clinical Features
Treatment
AMYLOID TUMORS
DUCTAL CYSTS
Common Sites
Clinical Features
Treatment
SACCULAR CYSTS
Types
Clinical Features
Diagnosis
Treatment
LARYNGOCELE
Risk Factors
Pathology
Clinical Features
Diagnosis
Treatment
RECURRENT RESPIRATORY PAPILLOMATOSIS
Etiology
Juvenile Papillomas
Adult-Onset Papilloma
Clinical Features
Treatment
CHONDROMA
HEMANGIOMA
Infantile Hemangioma (Capillary)
Treatment
Adult Hemangiomas (Cavernous)
Treatment
48:
Neurologic Disorders of Larynx
NEUROLOGICAL DISORDERS OF LARYNX
Hypofunctional Disorders
Hyperfunctional Disorders
Mixed Disorders
CLASSIFICATION OF LARYNGEAL PARALYSIS
POSITIONS OF VOCAL CORDS
CAUSES OF LARYNGEAL PARALYSIS
UNILATERAL RECURRENT LARYNGEAL NERVE (RLN) PARALYSIS
Etiology
Clinical Features
Treatment
BILATERAL RECURRENT LARYNGEAL NERVE (ABDUCTOR) PARALYSIS
Etiology
Clinical Features
Treatment
UNILATERAL SUPERIOR LARYNGEAL NERVE PARALYSIS
Etiology
Clinical Features
BILATERAL SUPERIOR LARYNGEAL NERVE PARALYSIS
Etiology
Clinical Features
Treatment
UNILATERAL COMBINED (COMPLETE) PARALYSIS OF RECURRENT AND SUPERIOR LARYNGEAL NERVE
Etiology
Clinical Features
Treatment
BILATERAL COMBINED (COMPLETE) PARALYSIS OF RECURRENT AND SUPERIOR LARYNGEAL NERVE
Clinical Features
Treatment
CONGENITAL VOCAL CORD PARALYSIS
Etiology
Clinical Features
Diagnosis
Treatment
PHONOSURGERY
Microlaryngeal Surgery
Local Injections
Laryngeal Framework Surgery (Thyroplasty)
Laryngeal Reinnervation Procedures
Reconstructive and Rehabilitative Procedure
49:
Voice and Speech Disorders
VOICE AND SPEECH
Phonation
Resonance
Articulation
CLASSIFICATION OF VOICE AND SPEECH DISORDERS
Disorders of Speech
Disorders of Voice
Hyperfunctional Disorders
Stridor
Hoarseness
DYSPHONIA PLICA VENTRICULARIS(VENTRICULAR DYSPHONIA)
Etiology
Clinical Features
Laryngoscopy
Treatment
FUNCTIONAL APHONIA (HYSTERICAL APHONIA)
Laryngoscopy
Treatment
PUBERPHONIA (MUTATION FALSETTO VOICE)
Pertinent Anatomy
Risk Factors
Treatment
PHONASTHENIA
Risk Factors
Clinical Features
Treatment
HYPONASALITY (RHINOLALIA CLAUSA)
Etiology
HYPERNASALITY (RHINOLALIA APERTA)
Etiology
SPASMODIC DYSPHONIA
Synonyms
Types
Clinical Features
Adductor Spasmodic Dysphonia
Abductor Spasmodic Dysphonia
Treatment
VOCAL TREMOR
Clinical Features
Treatment
STUTTERING
Risk Factors
Clinical Features
Factors Relieving Stuttering
Factors Aggravating Stuttering
Treatment
MYOCLONUS
Laryngeal Features
Treatment
Branchial or Oculopalatal Myoclonus
Tinnitus
TOURETTE'S SYNDROME
Clinical Features
Treatment
BOTULINUM TOXIN THERAPY
Types
Needle
Adductor Laryngeal Injections
Abductor Laryngeal Injections
50:
Malignant Tumors of Larynx
INTRODUCTION
RISK FACTORS
Premalignant Lesions
Preventive Measures
EVALUATION
Clinical
Imaging Study
Detection of Recurrent/Residual Disease
Differential Diagnoses
Indirect Laryngoscopy
Direct Laryngoscopy Biopsy under General Anesthesia
Histopathology
STAGING
MANAGEMENT
Radiotherapy
Surgery
Combined Therapy
Palliation Therapy
GLOTTIC CANCER
Spread
Clinical Features
Treatment
SUPRAGLOTTIC CANCER
Spread
Clinical Features
Treatment
SUBGLOTTIC CANCER
Spread
Clinical Features
Treatment
VERRUCOUS CARCINOMA
Histology
Treatment
ORGAN PRESERVATION THERAPY
PHOTODYNAMIC THERAPY
POST-LARYNGECTOMY VOCAL REHABILITATION
Esophageal Speech
Artificial Larynx
Tracheoesophageal Fistula Speech
51:
Management of Impaired Airway
INTRODUCTION
Functions
Indications
Timings
Level and Site
Anesthesia
Position
Steps of Operation (Figs 1 and 2)
Tracheostomy in Infants and Children
Postoperative Care
Decannulation
Decannulation in Infant and Young Child
Causes of Failed Decannulation
Complications
CRICOTHYROTOMY (LARYNGOTOMY OR CONIOTOMY)
Indications
Contraindications
Technique
PERCUTANEOUS DILATIONAL TRACHEOSTOMY
Preoperative Criteria
Contraindications
Advantages
Disadvantages
Technique
LARYNGOMALACIA
Clinical Features
Treatment
CONGENITAL VOCAL CORD PARALYSIS
CONGENITAL SUBGLOTTIC STENOSIS
Clinical feature
Direct laryngoscopy and Bronchoscopy
Treatment
LARYNGEAL WEB/ATRESIA
Clinical features
Treatment
SUBGLOTTIC HEMANGIOMAS
Clinical features
Treatment
LARYNGOESOPHAGEAL CLEFT
Predisposing Factors
Nature of Foreign Bodies
Clinical Features
Differential Diagnoses
Diagnosis
Management
Modes of Injuries
Pathology
Clinical Features
Diagnosis
Associated Injuries
Complications
Treatment
SECTION 7: NECK
52:
Cervical Symptoms and Examination
HISTORY
PHYSICAL EXAMINATION
Examination of Lymph Nodes of Neck
Clinical Features of Common Neck Lesions
DIAGNOSTIC TESTS
Unknown Neck Mass (Unknown Primary Lesions)
HISTORY
EXAMINATION
General Appearance
Local Examination
Toxic Manifestations
INVESTIGATIONS
53:
Neck Nodes, Masses and Thyroid
NECK NODES AND MASSES
Management of Unknown Neck Mass (Unknown Primary Lesions)
Thyroid Neoplasms
Lymphoma
Salivary Neoplasms
Carotid Body Tumors and Glomus Tumors
Schwannomas or Neurilemmomas
Lipomas
Branchial Cysts
Branchial Sinus or Fistula
Thyroglossal Cyst
Cervical Lymphangioma (Cystic Hygroma)
Dermoid Cyst
Acute Cervical Lymphadenitis
Tuberculous Cervical Lymphadenitis (Scrofula)
Nontuberculous Mycobacteria Cervical Lymphadenitis
Sternomastoid Tumor
Cervical Rib
THYROID NEOPLASMS
Predisposing (Risk) Factors
Thyroid Nodule
Adenoma
Papillary Adenocarcinoma
Follicular Adenocarcinoma
Medullary Thyroid Carcinoma
Lymphoma and Anaplastic Carcinoma
Investigations
Staging
Treatment
54:
Deep Neck Infections
PERTINENT ANATOMY
Peritonsillar Space
Parapharyngeal Space or Pharyngomaxillary Space or Lateral Pharyngeal Space
Retropharyngeal Space
Danger Space
Prevertebral Space
Submandibular Space (Fig. 2)
Space of Body of Mandible
Masticator Space
SOURCES OF INFECTIONS
MICROBIOLOGY
CLINICAL FEATURES
INVESTIGATIONS
TREATMENT
Antibiotic Therapy
Surgical Drainage
PERITONSILLAR INFECTIONS
Source of Infection
Clinical Features
Treatment
Complications
PARAPHARYNGEAL SPACE ABSCESS OR PHARYNGOMAXILLARY ABSCESS OR LATERAL PHARYNGEAL SPACE ABSCESS
Sources of Infections
Clinical Features
Complications
Treatment
ACUTE RETROPHARYNGEAL ABSCESS
Sources of Infection
Clinical Features
Diagnosis
Treatment
CHRONIC RETROPHARYNGEAL ABSCESS OR PREVERTEBRAL SPACE ABSCESS
Sources of Infection
Clinical Features
Diagnosis
Treatment
LUDWIG'S ANGINA
Bacteriology
Sources of Infection
Clinical Features
Treatment
Complications
ABSCESS OF SPACE OF BODY OF MANDIBLE
MASTICATOR SPACE ABSCESS
Sources of Infections
Clinical Features
Treatment
Complications
TRISMUS
Causes
Sequela
SECTION 8: OPERATIVE PROCEDURES AND INSTRUMENTS
55:
Middle Ear and Mastoid Surgeries
MYRINGOTOMY AND TYMPANOSTOMY TUBES (GROMMET)
Indications for Myringotomy
Indications for Grommet
Preoperative Evaluation
Anesthesia
Types of Tympanostomy Tubes (Figs 2A to D)
Technique
Postoperative Care
Complications
Indications for Removal of Retained Tympanostomy Tube
MASTOIDECTOMY
Surgical Approaches
Anesthesia
Position of Patient
CORTICAL MASTOIDECTOMY
Indications
Instruments (Figs 5A to I and 6A to O)
Steps of Operation
Postoperative Care
Complications
RADICAL MASTOIDECTOMY
Indications
Steps of Operation (See Steps of Cortical Mastoidectomy)
Postoperative Care
Complications
MODIFIED RADICAL MASTOIDECTOMY
Indications
Operation
Bondy Procedure
TYMPANOPLASTY
Types of Tympanoplasty (Wullstein) (Figs 12A to E)
Myringoplasty
Ossiculoplasty
56:
Operations of Nose and Paranasal Sinuses
PREOPERATIVE ASSESSMENT
DIAGNOSTIC NASAL ENDOSCOPY (SINUSCOPY) (FIG. 1)
Indications
Instruments
Techniques
ENDOSCOPIC SINUS SURGERY
Indications
Contraindications
Anesthesia
Preparations
Position of Patient
Techniques
Postoperative Care
Complications
ANTRAL PUNCTURE OR PROOF PUNCTURE
Indications
Contraindications
Anesthesia and Position
Instruments
Technique
Complications
INFERIOR MEATAL ANTROSTOMY
CALDWELL-LUC OPERATION
Indications
Contraindication
Anesthesia
Position
Instruments
Techniques (Figs 6A and B)
Postoperative Care
Complications
Indications
Contraindications
Anesthesia
Techniques
Instruments
SUBMUCOUS RESECTION OF NASAL SEPTUM
SEPTOPLASTY (FIGS 8 TO FIGS 10)
POSTOPERATIVE CARE
COMPLICATIONS
57:
Adenotonsillectomy
PREOPERATIVE ASSESSMENT
INDICATIONS FOR TONSILLECTOMY
Absolute
Relative
Part of Other Operations
INDICATIONS FOR ADENOIDECTOMY
CONTRAINDICATIONS
SURGICAL TECHNIQUES
Newer Technologies
PREOPERATIVE MEASURES
ANESTHESIA
POSITION
SURGICAL INSTRUMENTS
OPERATIVE STEPS
Adenoidectomy
Tonsillectomy (Dissection and Snare Method)
POSTOPERATIVE CARE
Inpatient Versus Outpatient Procedures
COMPLICATIONS
Immediate
Delayed
Rare Complications
58:
Endoscopies
INDICATIONS
CONTRAINDICATIONS
ANESTHESIA
POSITION
PROCEDURES
POSTOPERATIVE CARE
COMPLICATIONS
FLEXIBLE NASOPHARYNGOLARYNGOSCOPY
INDICATIONS FOR BRONCHOSCOPY
RIGID BRONCHOSCOPY
Advantages
Anesthesia
Oxygenation and Ventilation
Position
Techniques
Postoperative Care
Complications
FLEXIBLE FIBEROPTIC BRONCHOSCOPY
Types of Fiberoptic Bronchoscope
Advantages
INDICATIONS
CONTRAINDICATIONS OF ESOPHAGOSCOPY
RIGID ESOPHAGOSCOPY
Advantages
Disadvantages
Anesthesia
Position
Techniques (Fig. 8)
Postoperative Care
Complications
FLEXIBLE ESOPHAGOSCOPY
Advantages
Disadvantages
Common Indications
Endoscope and Instruments (Fig. 9)
Techniques
59:
Instruments
INTRODUCTION
OPD INSTRUMENTS
MASTOID AND EAR MICROSURGERY
ANTRUM PUNCTURE
INFERIOR MEATAL ANTROSTOMY
NASAL FRACTURE REDUCTION FORCEPS (FIGS 12A AND B)
NASAL SEPTAL AND SINUS SURGERY
MOUTH GAGS AND RETRACTORS (FIGS 17A TO D AND 18A TO C)
ADENOTONSILLECTOMY (FIGS 19A TO P AND 21A TO K)
INCISION AND DRAINAGE OF QUINSY
ENDOSCOPES
Laryngoscopes
Bronchoscope
Esophagoscope
Endoscope and Instruments (Figs 24A to L)
TRACHEOSTOMY
Types of Tracheostomy Tubes (Figs 25 and 26)
Fuller's Bivalved Tracheostomy Tube
Chevalier Jackson's Tracheostomy Tube
Nonmetallic Tracheostomy Tubes (Fig. 26)
Size of Tracheostomy Tube
AIRWAY DEVICES (FIGS 27A TO H)
Nasopharyngeal Airway (Trumpet) (Fig. 27A)
Oropharyngeal Airway (Figs 27B to D)
Laryngeal Mask Airway (Fig. 27E)
Endotracheal Tubes (Figs 27G and H)
SECTION 9: RELATED DISCIPLINES
60:
Diagnostic Imaging
CONVENTIONAL RADIOLOGY
Temporal Bone (Figs 1 and 2)
Nose and Paranasal Sinuses
Neck, Larynx and Pharynx
Barium Swallow
ORTHOPANTOMOGRAM
ULTRASOUND
COMPUTERIZED TOMOGRAPHY
MAGNETIC RESONANCE IMAGING
Principle
Machines
Imaging Protocols
RADIONUCLIDE IMAGING
INTERVENTIONAL RADIOLOGY
APPLICATIONS OF CT, MRI AND US
CT
MRI
US
CT ANATOMY OF EAR, NOSE, THROAT, HEAD AND NECK
61:
Radiotherapy and Chemotherapy
BASIC PHYSICS
Electromagnetic Radiations
Ionizing Radiations
Radiation Units
Sources of Radiation
Depth-Dose
RADIOBIOLOGY
Oxygen Enhancement Ratio
THERAPEUTIC WINDOW
MODES OF RADIOTHERAPY
COMBINED MODALITY TREATMENT
Preoperative Radiation
Postoperative Radiation
Intraoperative Radiotherapy
Radiotherapy and Chemotherapy
PLANNING OF RADIOTHERAPY
Factors Affecting Response to Radiotherapy
Fractionation of Radiotherapy
Intensity Modulated Radiation Therapy
COMPLICATIONS OF RADIOTHERAPY
Early Complications
Late Complications
Patient Care during Radiotherapy
Principles
Criteria for Response
Prognostic Factors
Biologic factors
Work-up Before Chemotherapy
Toxicity of Anticancer Drugs
PALLIATIVE CHEMOTHERAPY
COMBINED MODALITY THERAPY
Induction or Anterior Chemotherapy (Neoadjuvant Chemotherapy)
Chemoradiation
Adjuvant or Posterior Chemotherapy
ORGAN PRESERVATION
INTRA-ARTERIAL CHEMOTHERAPY
PREVENTION OF CANCER
Lifestyle Modifications
Chemoprevention
62:
Anesthesia
INTRODUCTION
Preoperative Medications
GENERAL ANESTHESIA
Inhaled Anesthetics
Intravenous Anesthetics
Neuromuscular Blockade (Skeletal Muscle Relaxants)
Hemostasis and Blood Pressure Control
Monitoring During Anesthesia
Recovery
Day Care (Ambulatory) Surgery
Laser Surgery
Endoscopy
Head and Neck Oncology
Thyroid Surgery
Complications
Malignant Hyperthermia (MH)
IMMEDIATE AIRWAY MANAGEMENT
Endotracheal Intubation
Other Procedures for Immediate Airway Management
Assessment for Difficult Intubation (Figs 3A and B)
Complications of Endotracheal Intubation
LOCAL ANESTHESIA
Local Anesthetics
Types
63:
Laser Surgery and Cryosurgery
RELATED PHYSICS
Properties of Radiant Laser Energy
CONTROL OF LASER
Transverse Electromagnetic Mode
TISSUE EFFECT
LASER IN Otolaryngology
Argon Laser
Potassium-Titanyl-Phosphate-532 Laser (KTR-532)
Neodymium: Yttrium-Aluminium-Garnet Laser (Nd:YAG)
Carbon Dioxide Laser
Complications and Safety
PHOTODYNAMIC THERAPY
Principle
Indications
Side Effects
Indications
Material and Method
Principle
Tissue Effect
Technique
Indications
Advantages
Disadvantages
Mode of Action
Material and Method
Indications
Appendix
INDEX
TOC
Index
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