Image-Based Case Studies in ENT and Head and Neck Surgery Rahmat Omar, Prepageran Narayanan
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1Image-Based Case Studies in ENT AND HEAD & NECK SURGERY2
3Image-Based Case Studies in ENT AND HEAD & NECK SURGERY
Rahmat OmarMBBS (Malaya) MS ORL (UM) Consultant Otolaryngologist and Head and Neck Surgeon Department of Otorhinolaryngology Faculty of Medicine University of Malaya, Kuala Lumpur, Malaysia Prepageran NarayananMBBS (Malaya) MS ORL (UM) FRCS (Ed) FRCS (Glas) Professor Senior Consultant Otolaryngologist and Head and Neck Surgeon Department of Otorhinolaryngology Faculty of Medicine University of Malaya Kuala Lumpur, Malaysia ForewordGhauth Jasmon
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© 2013, Jaypee Brothers Medical Publishers
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This book has been published in good faith that the contents provided by the authors contained herein are original, and is intended for educational purposes only. While every effort is made to ensure accuracy of information, the publisher and the authors specifically disclaim any damage, liability, or loss incurred, directly or indirectly, from the use or application of any of the contents of this work. If not specifically stated, all figures and tables are courtesy of the authors. Where appropriate, the readers should consult with a specialist or contact the manufacturer of the drug or device.
Image-Based Case Studies in ENT and Head & Neck Surgery
First Edition: 2013
Printed at
5Dedicated to
My beloved parents: for your everlasting inspirations and motivations.
My family: Dr Salmah Ismail, Nur Rabbaniyyah, Muhammad Iqbal, Ahmad Farhan, and Mursyid Syaqeer.
My students, past and present.
Rahmat Omar
The Divine Mother and My Family
Prepageran Narayanan
It gives me a great pleasure to write a few words on the Image-Based Case Studies in ENT and Head & Neck Surgery.
I understand that this is the second book of this nature published by the authors; the successor of the first book which was an outstanding success. This proves that there is a demand for clear precise pictorial reference books as it enables the readers to appreciate the varied clinical presentations and its subsequent management in day-to-day clinical practice. This questions and answers book will complement the previous book which was an atlas. It is said a picture paints a thousand words and this is indeed true in clinical settings. This book covers the varied clinical images in different segments of otorhinolaryngology (ENT), ranging from otology, rhinology, head and neck and laryngology. It is a testament to the dedication and enthusiasm of the authors. I wish to congratulate the authors Associate Professor Dr Rahmat Omar and Professor Dr Prepageran on the publication of this book.
University of Malaya is committed to become a center of excellence in academic pursuit not only in Malaysia but also in the region and internationally. We encourage knowledge expansion and dissemination, and books written by young upcoming academicians are very much an integral part of the University of Malaya's effort to promote academics and culture of publishing among its academic staffs. I hope this will encourage more authors to put their wisdom and knowledge gathered over the years into books of similar nature to keep the readers updated and refreshed with core as well as current best practice information.
Finally, I would like to compliment the authors again and believe this book will be well accepted among a wide spectrum of readers ranging from medical students, primary care physicians to ENT masters students.
Ghauth Jasmon
Vice Chancellor
University of Malaya
50603 Kuala Lumpur8
It is our pleasure to write a questions and answers book in ENT and Head and Neck Surgery which seems appropriate for the purpose of exercise and quick revision especially to our undergraduate and postgraduate students. The fundamental will still be the core of this book with applied and functional knowledge added for integration. These are based on real scenarios and clinical findings which were encountered during daily outpatient practice and in the operating table during surgery. The cases were carefully selected to represent the main issue of particular question.
Almost all the images were taken and edited by the first author. The book is divided into four sections; Otology, Rhinology, Head and Neck, and Laryngology. Special techniques like endoscopy and videostroboscopy were used to enable excellent high quality color photographs to be taken especially from the ear, nasal cavity, and larynx.
This book is complementary to the Ear Nose Throat Colour Atlas and Synopsis which was published earlier by University of Malaya Press. It would be an ideal resource for exam preparation and revision; hopefully readers would find it useful and practical. For qualified specialists and ENT surgeons, this book would be an indispensable quick reference.
We would like to thank the patients appearing in this book, as without their willingness and cooperation this work would not have been completed. Special thanks to the medical officers in training and colleagues from the Department of Otorhinolaryngology, University of Malaya, who had directly or indirectly contributed in any way in the production of this book.
Rahmat Omar
Prepageran Narayanan
13Abbreviations AA:
basal cell carcinoma
brainstem evoked response audiometry
calcium hydroxyapatite
combined approach tympanoplasty
CO2 laser:
carbon dioxide laser
cerebellopontine angle
cerebrospinal fluid
chronic suppurative otitis media (atticoantral)
chronic suppurative otitis media (tubotympanic)
CT scan:
computed tomography-scan
deviated nasal septum
Eustachian tube
full blood count
fine needle aspiration cytology
fossa of Rosenmüller
general anesthesia
histopathological examination
high resolution computed tomography
internal auditory meatus
laryngopharyngeal reflux
middle ear effusion
magnetic resonance imaging
modified radical mastoidectomy
myringotomy and grommet
osteomeatal complex
postnasal space
pure tone audiogram
sensorineural hearing loss
tympanic membrane
vestibular schwannoma