An Illustrated Textbook: Ear, Nose & Throat and Head & Neck Surgery Rakesh Prasad Shrivastav
INDEX
ABCDEFGHIJKLMNOPQRSTUVWXYZ
Note: Page number followed by f and t indicates figure and table respectively.
A
Aberrant right subclavian artery, 271
Abscess
brain, 57
cerebellar, 57
cold, 194, 195f, 199
masseteric, 197
mastoid, 37t, 54
orbital, 126t
parapharyngeal space, 195–196
parotid, 197
peritonsillar, 196
postauricular, 55
retropharyngeal, 194–195
septal, 99t, 132
subdural, 50, 56
temporal, 57
Absolute bone conduction (ABC) test, 29
Achalasia, of esophagus, 271
Acinic cell tumor, 186
Acoustic trauma, 70
Acquired atresia, EAC, 43–44
Acquired cholesteatoma, 50–51
Acquired immune deficiency syndrome (AIDS), oral manifestations of, 181
Acute acoustic trauma, 70–71
Acute laryngeal edema, in children, 299
Acute laryngotracheobronchitis, 297–298
clinical features of, 297–298
investigation of, 298
pathology, 297
treatment of, 298
Acute mastoiditis, 22
Acute otitis externa, 22
Acute otitis media (AOM), 22, 45–46, 282–283. See also Otitis media with effusion (OME)
bacteriology of, 45, 282
classification of, 45f
clinical features, 45, 282–283
course of disease, 283
investigation of, 283
predisposing factors of, 282
source and routes of infection, 46
treatment of, 283
Acute rhinitis/common cold/coryza, 227
clinical features
signs, 118
symptoms, 118
complications, 118t
management, 118
Acute sinusitis
clinical features
signs, 119
symptoms, 118
investigations, 119
treatment, 119–120
Acute subglottic laryngitis, 299
Acute tonsillitis, 292–296
Adam’s apple, 207
Adenocarcinoma, of nose and sinuses, 144
Adenoid curette, 324, 324f
Adenoid cystic carcinoma, 186
of nose and sinuses, 144
Adenoid hyperplasia, 287–288
clinical features, 287–288
diagnosis, 288
grading of, 288, 288f
symptoms and diseases of, 287f
treatment of, 288
Adenoids
adenoidectomy of, 288, 288f, 288t
defined, 287
diseases of, 287–290
adenoid hyperplasia, 287–288
sleep apnea, 289–290
snoring, 289
facies, 288
Adenolymphoma. See Warthin’s tumor
Adhesive otitis media, 46
Aditus, posterior wall, 9
Adjuvant chemotherapy, in ENT and head and neck cancers, 313
Adjuvant radiotherapy, in ENT and head and neck cancers, 311
Agranulocytosis, 229
oral manifestations of, 181
Airway obstruction, management of, 252–258
tracheostomy, 254–258
complications of, 255t
incisions for, 254, 255f
indications for, 254, 254t
operative steps for, 254–255, 255f
position during, 254
postoperative care of, 257–258, 257t–258t
technique for, 254
tracheostomy tubes, 255–257
upper airway obstruction, 252–254
acute life-threatening respiratory obstruction, 252–253
gradual onset respiratory obstruction, 253–254
Alcohol, and carcinoma of oral cavity, 178
Allergic rhinitis
etiology/pathophysiology, 113
perennial, 113–115
seasonal (Hay fever), 113
Allergy tests
microscopy of nasal smears, 108
serological tests, 108–109
skin prick test, 108
Alveolar ridge, 161
carcinoma of, 179
Aminoglycosides, 77
Ampullae, 12
Amylase, 164
Anaplastic carcinoma, of thyroid, 188–189
Anemia, oral manifestations of, 181
Angiofibroma, of nasopharynx, 225
clinical features, 225
etiology, 225
investigations, 225, 225f
treatment, 225
Angiography, 108
in oral cavity and head and neck diseases, 172, 172f
Angioma of septum. See Capillary hemangioma
Angioneurotic edema, 249
Angular stomatitis, 168
Anosmia, 99–100
causes for, 100t
Anterior ethmoidal syndrome, 154
Anterior nasal packing, 151–152, 152f
Anterior recess, 8
Anterior rhinoscopy, 103f, 103t
lateral wall, 103–104
nasal cavity, 104
nasal mucosa, 103
nasal septum, 103
secretions, 103
Antrochoanal polyps, 134–135, 135f
clinical features, 135
differential diagnosis, 135–136
investigations, 136
treatment, 136
Antrum wash out (AWO), 119–120
AOM. See Acute otitis media (AOM)
Aortic aneurysm, 271
Aphthous ulcers, 166, 168, 175
Aphonia, 246, 248
Argon laser, in ENT surgery, 316
Arterial ligation, to control epistaxis, 152–153
Artificial larynx, 242
Asch’s septum forceps, 322, 322f
Aspergillus fumigatus, 123
Aspergillus niger, 26, 40, 41
Atenolol, 77
Atresia EAC, 40, 273f
choanal, 275
Atrophic rhinitis, 137–138
Atypical facial pain, 156
Audiogram, 48, 52
Audiological investigations
audiometric tests for malingers, 33
brainstem-evoked response audiometry (BERA), 34
masking, 33, 33f
otoacoustic emission (OAE), 35, 35f
play audiometry, 33–34
pure tone audiometry, 32–33
special audiometric tests, 33
speech audiometry, 32–33
tympanogram, 34, 34f
Auricle, 7, 7f
blood supply, 7
clinical examination of, 25
congenital anomalies of, 275
diseases
congenital anomalies, 38
infections, 38–39
neoplasms, 39
skin diseases, 39
trauma, 38
lymphatic drainage, 7
venous drainage, 7
Autoimmune diseases, 72
AWO. See Antrum wash out (AWO)
B
Bacterial infections, of oral cavity, 174
syphilis, 174
tuberculosis, 174
Bacterial labyrinthitis, 69–70
Bacterial laryngitis, 235
Bacterial otitis externa
diffuse otitis externa, 40
fungal otitis externa (Otomycosis), 40–41
localized otitis externa (Furunculosis), 40
viral otitis externa, 41
Bacterial pharyngitis, 227
Bacterial sialadenitis, 182
Bacterial thyroiditis, 190
Bacteriology (for nose and sinus), 108
BAHA. See Bone anchored hearing aid (BAHA)
Ballenger swivel knife, 321, 321f
Barium swallow, 220, 220f
Barotrauma, 22, 71
barotraumatic otitis media, 63–64
blast injury, 64
Basal cell carcinoma, 39, 41, 111–112, 112f
Basal lamella, 90
Behcet’s syndrome, 175–176
Behind the ear (BTE), 81
Bell’s palsy
clinical features, 84
treatment, 84–85
Benign paroxysmal positional vertigo (BPPV), 14, 24, 30, 75
BERA. See Brainstem-evoked response audiometry (BERA)
Bernoulli phenomenon, 210
Betel leaf, and carcinoma of oral cavity, 178
Bezold’s abscess, 25, 55
β-Hemolytic Streptococcus, 294
Bifid uvula, 279
Bilateral nasal discharge, 99
Biopsy, 109
Bismuthiodoform-paraffin-paste (BIPP), 151–152
Bithermal caloric test, 35
Black hairy tongue, 175, 175f
Bleeding polypus. See Capillary hemangioma
Body worn (BW), 81
Bone anchored hearing aid (BAHA), 82
BonebridgeTM implant system, 82
Bony cochlea, 12, 12f
Bony labyrinth, 12f
bony cochlea, 12, 12f
bony vestibule, 11–12
Bony spiral lamina, 12
Bony vestibule, 11–12
Bow sign, 219
Boyle-Davis mouth gag, 323, 323f
BPPV. See Benign paroxysmal positional vertigo (BPPV)
Brachytherapy, in ENT and head and neck cancers, 312
Brain abscess, 57
Brainstem-evoked response audiometry (BERA), 34, 303
Branchial cyst, 169, 278, 278f
Branchial fistula, 167, 278, 278f
Bronchoscope, 322, 323f
Bronchus, 262
laser surgery in, 317
BTE. See Behind the ear (BTE)
Buccal mucosa, 161
carcinoma of, 179, 179f
examination of, 168
lymphatic drainage from, 162
Bull’s eye lamp with head mirror, 3
Burrs in mastoid surgery, 319, 320f
BW. See Body worn (BW)
C
Caldwell-Luc operation, 121–122, 122f
Candida albicans, 26, 40, 41, 175
Caloric test, 35
Capillary hemangioma, 143
Carboplatin, 77
Carcinoma, 22
Cardiovascular drugs, in migraine, 155
Carhart’s notch, 66, 66f
Carotid angiography, 172, 172f
Carotid body tumor, 200
Carotid space, infections of, 195
Carotid triangle, swelling in, 169
CAT. See Combined approach tympanoplasty (CAT)
Cauliflower ear, 39, 39f
Cautery, 151
Cavernous hemangioma, 143
Cavernous sinus thrombophlebitis, 148
CDP. See Computerized dynamic posturography (CDP)
Central sleep apnea, 230
Cervical fascia, deep layers of, 193, 193f, 193t
Cervical lymphadenitis, 166
Cervical spine disorders, 155
CHARGE syndrome, 277
Cheek, 161
Chemical cautery, 151
Chemodectomas. See Carotid body tumor
Chemogustometry, 172
Chemotherapy, in ENT and head and neck cancers, 313–315
adjuvant, 313
chemotherapeutic drugs, 313, 313t
palliative, 313
side effects of, 314
types of, 313
CHL. See Conductive hearing loss (CHL)
Choanal atresia, 277
Cholesteatoma
clinical description, 50
invasion theory, 51
metaplasia theory, 51
negative middle ear pressure, 51
pathology, 50
spread of, 50
types of, 50
Chorda tympani nerve, 10, 163
Chronic acoustic trauma, 71
Chronic otitis media (COM), 22
mucosal type (tubotympanic type)
bacteriology, 46, 46t
clinical features, 46–47
investigations, 47–48
myringoplasty, 48–49
prevalence, 46
routes of infection, 46, 46t
treatment, 48
squamous type (atticoantral type)
bacteriology, 51, 51t
clinical features, 52
complications, 52
investigations, 52–53
pathology, 50–51
treatment, 53
Chronic rhinosinusitis, 157. See also Functional endoscopic sinus surgery (FESS)
Chronic sinusitis
clinical features
signs, 120
symptoms, 120
etiopathogenesis, 120
investigations, 120–121
treatment
medical, 121
surgical, 121
CI. See Cochlear implants (CI)
CIC. See Completely in-the-canal (CIC)
Ciliated epithelium, 11
Cisplatin, 77
Citelli’s abscess, 25, 55
Cleft lip, 279
Cleft palate, 279
Closed sinusitis, 120
Cochlear duct (scala media), 12f, 13
Cochlear hearing mechanism
frequency localization, 19
mechanical energy of sound to bioelectrical energy, 19
Cochlear implants (CI), 82–83, 83f
Cochlear sensory epithelium, 13
Coffin corner, 169
CO2 laser, in ENT surgery, 316
Cold abscess, 194, 195f, 199
Columellar septum, 90
COM. See Chronic otitis media (COM)
Combined approach tympanoplasty (CAT), 60
Completely in-the-canal (CIC), 81–82
Computerized dynamic posturography (CDP), 36
Conditioned oriented response audiometry (CORA), 34
Conductive hearing loss (CHL), 23
Congenital anomalies, 38
of auricle, 275
of external auditory canal, 276
of inner ear, 276
of middle ear, 276
Congenital atresia
of EAC, 40
of external auditory canal, 276
Congenital cholesteatoma, 50
Congenital diseases
of ear, 275–276
of esophagus, 280
of hypopharynx, 279
of larynx, 279–280
congenital subglottic stenosis, 280
laryngomalacia, 279–280
recurrent laryngeal papillomatosis, 279
of nasopharynx, 279
of nose, 276–277
choanal atresia, 277
congenital nasal deformities, 277
congenital nasal masses, 277
of oral cavity, head and neck, 277–279
branchial cyst/fistula, 278, 278f
cleft lip, 279
cleft palate, 279
dermoid cyst, 278
hemangioma, 278, 278f
lymphangioma, 278, 278f
thyroglossal cyst/fistula, 277–278, 277f
of pharynx, 279
of trachea, 280
Congenital laryngeal web, 238, 280f
Congenital nasal deformities, 277
Congenital nasal masses, 277
Congenital subglottic stenosis, 280
Contact dermatitis, EAC, 41
Contact ulcer, 238
Continuous positive airway pressure (CPAP), 231
Conversation voice test, 27
CORA. See Conditioned oriented response audiometry (CORA)
Cortical mastoidectomy, 59–60, 60f
Corynebacterium diphtheriae, 295
Cottle’s classification (Septal deviations), 130
Cottle’s test, 131, 131f
Cough reflex, 210
Cricoid cartilage, 206. See also Larynx
Cricothyroid muscle, 208, 208f
Cricothyroidotomy, 253t
Crista, 13
CSF rhinorrhea
facial trauma and, 148
functional endoscopic sinus surgery and, 158
Curative radiotherapy, in ENT and head and neck cancers, 311
Cystic hygroma, in child, 278f
Cytotoxic agents, 77
D
Deaf child, 302–304
detection of deafness, 303
distraction test, 303
objective tests for, 303
play audiometry for, 303
startle reflex test for, 303
management of, 303
sensorineural hearing loss, 302
Decibel, 17
Deep neck spaces, 193
carotid space, 195
cervical fascia, deep layers of, 193, 193f, 193t
classification of, 193–194, 194t
infections, 193
masticator space, 197
parapharyngeal space, 195–196
parotid space, 197
peritonsillar space, 196
retropharyngeal space, 194–195
spread of infection from, 194, 194f
submandibular space, 196–197
Dental disorders, and facial pain, 154
Dental ulcer, 166, 168
De Quervain’s thyroiditis, 190
Dermoid cyst, 278
Deviated nasal septum (DNS), 130–131, 130f
Diabetes, oral manifestations of, 181
Diamond and cutting burrs, of mastoid drill, 319–320, 320f
Difficulty in opening mouth. See Trismus
Difficulty in swallowing. See Dysphagia
Diffuse otitis externa, 40
Digital subtraction angiography, in oral cavity and head and neck diseases, 172
Diode laser, in ENT surgery, 316
Diphtheria, 295–296
clinical features of, 295–296
investigation of, 296
treatment of, 296
Discharging sinus, 167
Distraction test, for deafness, 303
Dix-Hallpike maneuver, 30, 30f, 75f
DNS. See Deviated nasal septum (DNS)
Drug-induced rhinitis, 116
Drug reactions, oral manifestations of, 181
Dysphagia, 165, 269–271
acute, 269
cardinal symptoms in, 269f
chronic, 270–271
extrinsic lesions, 271
intrinsic lesion, 270–271
neuromuscular disorders and, 271
psychosomatic causes of, 271
clinical features of, 270t
investigations of, 269
overview, 269
Dysphonia
habitual, 249–250, 249t
psychogenic, 249t, 250
Dysphonia plicae ventricularis, 250
E
EAC. See External auditory canal (EAC)
Eagle’s syndrome, 212
Ear
anatomy, 7–14, 7f
clinical examination of, 25–30
complications of otitis media, 54–57
congenital diseases of, 275–276
diseases of external ear, 38–44
diseases of the inner ear, 69–76
emergencies in, 307
facial nerve paralysis, 84–85
hearing aid, cochlear implant and tinnitus masker, 81–83
investigations for ear diseases, 32–38, 32t
laser surgery in, 316
mastoidectomy operation, 58–60
neoplasms of the middle ear, 67–68
otosclerosis, 65–66
ototoxicity, 77
physiology of hearing and equilibrium, 17–20
symptoms of ear diseases, 22–24, 22t
trauma to, 62–64
vertigo, 78–80
Earache, 22, 166
Ear discharge, 23, 24t
Ear dressing forceps, 3, 4
Ear mould, 81
Ear speculum, 3, 318, 318f
Ear surgical instruments, 318–320
diamond and cutting burrs of mastoid drill, 319–320, 320f
ear speculum, 318, 318f
hand-piece of mastoid drill, 319, 319f
Jobson-Horne probe, 318, 318f
mastoid curette, 319, 319f
mastoid gouge, 319, 319f
mastoid hammer, 319, 319f
myringotomy knife, 318, 318f
periosteum elevator, 319, 319f
self-retaining mastoid retractor, 318–319, 319f
Siegel’s pneumatic speculum, 320, 320f
Simpson’s aural syringe, 318, 318f
tuning fork (512 Hz), 318, 318f
Ear syringe, 3, 4
E. coli, 40
Edema of uvula, 229
Electric cautery, 151
Electric warmer, 3
Electrogustometry, 172–173
Electronystagmography (ENG), 35
Emergencies, in ENT, 307–308
Emotion-induced rhinitis, 116–117
Endolymph, 12, 13
movement of, 20, 20f
Endolymphatic sac, 13
Endoscopic examination (nasal cavity and nasopharynx)
flexible endoscopy, 105
rigid endoscopy, 105
ENG. See Electronystagmography (ENG)
ENT
cancers. See ENT cancers
emergencies in, 307–308
examination of. See ENT, examination of
imaging in, 309–310
surgical instruments for, 318–324
ENT cancers. See also Head and neck cancers
chemotherapeutic agents in, 314t
chemotherapy in, 313–315
radiotherapy in, 311–312
ENT, examination of
ear, specific instruments and equipment
dressing forceps, 3, 4
Jobson-Horne probe, 3, 4
microscope, 3, 4
otoscope, 3
pneumatic ear specula, 3–4
specula, 3
syringe, 3, 4
tuning fork, 3, 4
wax hook, 3, 4
general instruments and equipment for
Bull’s eye lamp with head mirror, 3
ENT treatment unit with ENT, 3
headlight, 3
mirror warmer, 3
sprit lamp, 3
suction machine, 3
nose, specific instruments and equipment
nasal dressing forceps, 3, 4
nasal specula, 3, 4
otoscope, 3, 4
posterior rhinoscopy mirrors, 3, 4
rigid endoscope, 3, 4
throat, specific instruments and equipment
flexible endoscope, 3, 4
laryngeal mirrors, 3, 4
tongue depressors, 3, 4
ENT treatment unit, 3, 4f
Epiglottitis, acute, 235–236, 298–299
clinical features of, 298
investigation of, 298, 298f
thumb sign, 298, 298f
treatment of, 299
turban, 236
Epipharynx. See Nasopharynx
Epistaxis, 99, 150–153
causes of, 150, 150t
management of, 151
anterior nasal packing, 151–152, 152f
arterial ligations, 152–153
blood loss, assessment of, 151
cause of bleeding, evaluation of, 151
cautery, 151
general measures, 153
initial measures in, 151
posterior nasal packing, 152, 152f
septoplasty with bilateral flap elevation, 152
pyrexia and, 150
site of bleeding, 150–151, 150f
Epistaxis balloons, 152
Epitympanum (Attic), 9
Epley’s maneuver, 75
Equilibrium, physiology of, 19t
body balance in ear disease, 20
saccule role, 20
semicircular canals role, 20
utricle role, 20
Ergotamine, 155
Erysipelas, 111
Erythema migrans linguae, 175
Erythroplakia, 178
Esophageal manometry, 221
Esophageal perforation, 267–268
clinical features, 267
management of, 268
Esophageal sphincter, 261–262
Esophageal stricture, 270
Esophagus, 261–262
achalasia of, 271
anatomy of, 261
blood supply in, 261
congenital diseases of, 280
constrictions in, 261
foreign bodies in, 266–267
clinical features of, 266
complications of, 267
esophagoscopy, 267
investigations for, 266–267, 266f–267f
treatment of, 267
types of, 266, 266t
lymphatic drainage, 261
nerve supply in, 261
physiology of, 261–262
physiology of
sphincters, 261–262
swallowing phase, 262
wall of, 261
ET. See Eustachian tube (ET)
Ethmoidal polyps, 134–135
investigations, 136
treatment, 136
Ethmoid sinuses, 92–93
drainage procedures for, 122
Ethmoid sinusitis, and eye pain, 155
Eustachian tube (ET)
acute otitis media and, 282
anatomy of, 282
dysfunction, 284, 284f
extent, 10
function, 10, 10f, 29–30
in infants and young children, 10
parts, 10
Exostosis, 41
External and middle ear hearing mechanism
bone conduction, 18, 18f
collection of sound, 17
middle ear transformer mechanism, 18
sound pressure differential, 19
transmission of sound, 17–18
External auditory canal (EAC), 3, 7
blood supply, 8
clinical examination of, 25
congenital anomalies of, 276
diseases, 39–44, 39t
lymphatic supply, 8
nerve supply, 8
skin, 8
External beam radiotherapy, in ENT and head and neck cancers, 311–312
External ear
auricle, 7, 7f
external auditory canal, 8
External ethmoidectomy, 122
External nose and nasal vestibule, disease of
congenital anomalies, 112
infections
acute, 110–111
chronic, 111
injuries to external nose, 112
nasal deformities, 112
neoplasms of, 111–112
stenosis of nasal vestibule, 112
Extradural abscess, 56
Extrinsic lesions, 271
Eye disorders, and facial pain, 155
F
Facial asymmetry, 167
Facial cellulitis, 125
Facial fractures, 147, 147f
Facial nerve, 14, 30
branches of
within facial canal, 16
geniculate ganglion, 16
in neck, 16
from parotid plexus, 16
fibers within, 15t
intracranial part, 15
intratympanic part
mastoid portion, 15
petrous portion, 15
pyramidal portion, 15
tympanic portion, 15
neck and parotid gland part, 15–16
topography of, 15f
Facial nerve paralysis, 24, 56, 186
Bell’s palsy
clinical features, 84
treatment, 84–85
causes, 84t
Facial pain, 154–156, 154t
atypical, 156
local causes of
cervical spine disorders, 155
dental disorders, 154
eye disorders, 155
facial trauma and fractures, 154
otalgia, 154–155
salivary gland disorders, 155
septal deviation, 154
sinusitis, 154
TM joint disorders, 154
primary neuralgia and, 155–156
glossopharyngeal neuralgia, 156
trigeminal neuralgia, 155–156
secondary neuralgia and, 156
head and neck pathology, 156
intracranial pathology, 156
skull base pathology, 156
tension headache, 156
of vascular origin
giant cell arteries, 155
migraine, 155
Facial trauma, 146–149
complications of, 148, 148t
cavernous sinus thrombophlebitis, 148
CSF rhinorrhea, 148
inhalation injuries, 148
meningitis, 148
respiratory obstruction, 148
severe hemorrhage, 148
and facial pain, 154
mandible, fracture of, 147–148, 148f
middle 1/3rd of face, fracture of, 147, 147f
nasal bone, fracture of, 146–147, 146f
orbit, fracture of, 147, 147f
zygomaticomaxillary complex fracture, 147
False vocal cords, 207
FESS. See Functional endoscopic sinus surgery (FESS)
Fibrous dysplasia, of maxilla, 142–143, 143f
Fine needle aspiration cytology (FNAC), 173
in parapharyngeal space tumors, 196
of pharynx and larynx, 220
Fissured tongue, 175, 175f
Fissures of Santorini, 8
Fistula
branchial, 167, 278f
mastoid, 55
oroantral, 92, 104
thyroglossal, 277–278
tracheoesophageal, 256t
Fistula test, 29
Fistulography, 172, 172f
Fitzgerald-Hallpike test, 35
Flat nonciliated epithelium, 11
Flaves, 123
Flexible endoscope, 3, 4, 105
Flexible nasopharyngolaryngoscope, 215–217, 217f
Floor of mouth, 162
carcinoma of, 179, 179f
examination of, 169
lymphatic drainage of, 162
FNAC. See Fine needle aspiration cytology (FNAC)
Foley’s catheter, with anterior nasal packing, 152, 152f
Follicular carcinoma, of thyroid, 188
Food-induced rhinitis, 116
Foreign bodies
in airway, 264–266
larynx, 264–265
tracheobronchial tree, 265–266
in digestive tract, 266–268
esophagus, 266–267
pharynx, 266
in EAC, 43, 43t
Foreign body, 140
Fossa of Rosenmüller, 203, 217
Foul-smelling breath. See Halitosis
Frenulum, 162
Frequency (Sound), 17
Frontal sinus, 92
drainage procedures for, 122
obliteration of, 122
Frontal sinus osteoma, 142, 142f
Frontoethmoidectomy, 122
Functional aphonia, 250
Functional endoscopic sinus surgery (FESS), 121, 157–158, 157f
chronic rhinosinusitis and, 157, 158
complications of, 158
goals of, 157
indications for, 158
techniques of, 157
Messerklinger’s technique, 157–158
Wigand’s technique, 158
Functional voice disorders, 250
Fungal granulomas, 140
Fungal infections, of oral cavity, 174
Fungal rhinosinusitis, 123
invasive, 123
noninvasive, 123
Furunculosis, 110–111
G
Gag reflex, assessment of, 215
Gastroesophageal reflex disease, 212, 228
Gastrografin, 220
Gaze nystagmus, 30
Geographical tongue, 175, 175f
Giant cell arteries, 155
Gingivitis, 181
Glaucoma, and eye pain, 155
Globus pharyngis, 213, 228, 271
Glomus jugulare, 67
Glomus tumors, middle ear
clinical features, 67
management, 67
types
glomus jugulare, 67
glomus tympanicus, 67
Glomus tympanicus, 67
Glossopharyngeal nerve, 163, 163f
Glossopharyngeal neuralgia, 156
Goblet cells, 11
Goiter, 191, 191f
Gradenigo’s syndrome, 56
Granular myringitis, 45
Granulation tissue, 51
Granulomatous thyroiditis, 190
Grave’s disease, 191–192
Gums, 161
examination of, 168
H
Habitual dysphonia, 249–250, 249t
noninfective laryngitis, 249–250
Haematoma auricle, 38
septal, 129, 308
Haemophilus influenzae, 108, 235, 236, 292, 298
Halitosis, 166, 168
Hand-piece, of mastoid drill, 319, 319f
Hashimoto’s disease, 190–191
Head and neck
examination of, 169–170
lymph nodes, 169–170, 170f
mid-line neck swellings, 169
other neck swellings, 169
investigations for diseases of, 171–173
symptoms of diseases of
discharging sinus, 167
facial asymmetry, 167
neck swellings, 166
pain and tenderness, 166
Head and neck cancers. See also ENT cancers
chemotherapeutic agents in, 314t
chemotherapy in, 313–315
radiotherapy in, 311–312
Headache, 98, 156
Headlights, 3
Head mirrors, 3
Head turning test, 34
Hearing aids
fitting of, 82
limitation and problems of, 82
types of, 20f
behind the ear (BTE), 81
body worn (BW), 81
bone anchored hearing aid (BAHA), 82
BonebridgeTM implant system, 82
completely in-the-canal (CIC), 81–82
in the ear (ITE), 81
Hearing loss. See also Deaf child
age of onset, 23
degree of, 23
duration of, 23
family history, 23
onset, 23
progression, 23
severity, 23
types
conductive, 23
mixed, 23
sensorineural, 23
Hearing, physiology of
mechanism of
cochlear, 19
external and middle ear, 17–19
retrocochlear analysis, 19
sound, 17, 18f
Hearing tests
absolute bone conduction (ABC) test, 29
Rinne test, 27–28, 28f
Schwabach’s test, 29
Weber test, 28, 28f
Helicotrema, 12
Hemangiomas, 278, 278f
of nasal cavity, 143
Hematomas, 38
Hemorrhage
facial trauma and, 148
functional endoscopic sinus surgery and, 158
Hemotympanum, 62, 63
Herpangina, 174
Herpes labialis, 168, 174
Herpes simplex, 111
Herpes zoster, 45, 70, 111
of maxillary division of trigeminal nerve, 174, 174f
Hiatus semilunaris, 91
Hoarseness, 247
defined, 249
habitual dysphonia, 249–250
nonorganic causes of, 249, 249t
organic causes of, 249, 249t
psychogenic dysphonia, 250
systemic causes for, 249
Hormonal rhinitis, 116
Horner’s syndrome, 195
Hydraulic ratio, 18
Hypernasal voice, 166
Hypertension, 99
Hyperthyroidism, 191
and hoarseness, 249
primary thyrotoxicosis, 191–192
secondary thyrotoxicosis, 192
Hypoglossal nerve, 162
Hypopharynx, 204–205, 204f
congenital diseases of, 279
postcricoid region, 204
posterior pharyngeal wall, 204
pyriform fossae, 204
Hyposmia, 99–100
causes for, 100t
Hypothyroidism, 191
clinical features, 191
and hoarseness, 249
primary, 191
secondary, 191
treatment, 191
Hypotympanum, 9
Hysterical voice disorders, 250
I
Imaging, in ENT and head and neck diseases, 309–310
computed tomography, 309, 309t
magnetic resonance imaging, 309–310, 310t
nuclear medicine, 310
radioisotopes and radiotracers for, 310
ultrasonogram, 309
Impetigo, 111
Incisura terminalis, 7
Incus ossicle, 10
Indirect laryngoscopy, 216–217, 216f, 233
Induced nystagmus, 30
Infectious mononucleosis, 295
Inflammatory diseases
herpes zoster oticus (Ramsay Hunt syndrome), 70
labyrinthitis
bacterial, 69–70
viral, 70
Inflammatory diseases, of oral cavity, 174–175
bacterial infections, 174
fungal infections, 174
viral infections, 174
Inflammatory lymph nodes, in children, 300
Inhalation injuries, facial trauma and, 148
Inner ear
blood supply, 14
bony labyrinth, 11–12
congenital anomalies of, 276
membranous labyrinth, 12–14
vestibulocochlear nerve, 14
Inspection and palpation (external nose, orbit and face), 101
Intensity (Sound), 17
In the ear (ITE), 81
Intraluminal esophageal pH monitoring, 221
Intranasal antrostomy, 121
Intranasal avulsion, 136
Intranasal ethmoidectomy, 122
Intrinsic lesion, 270–271
esophageal stricture, 270
neoplasia, 270
pharyngeal pouch, 270–271
Intubation granuloma, 238, 238f
Invasive fungal rhinosinusitis, 123
Inverted papilloma, 142
Iodine-based radioisotopes, 310
Iodine supplementation, in physiological goiter, 191
Isotope scanning/scintigraphy, 172
Isshiki’s thyroplasty, 250–251
Itching/irritation, ear disease symptom, 24
ITE. See In the ear (ITE)
J
Jobson-Horne probe, 3, 4, 318, 318f
K
Kartagener’s syndrome, 123
Keratosis obturans, 43
Keratosis pharyngis, 229
Kiesselbach’s plexus, 93, 151
Killian’s double-ended elevator, 321, 321f
Killian’s nasal speculum, 4, 321, 321f
Klebsiella rhinoscleromatis, 139
KTP 532 laser, in ENT surgery, 316
L
Labyrinthine fistula, 55–56
Labyrinthitis, 55–56
Lacerations, 38
Lamina papyracea, 92–93
Langerhans cell histiocytosis, middle ear
clinical features, 67
management, 67
Laryngeal crepitus, 169
Laryngeal mirrors, 3, 4, 324, 324f
Laryngeal papillomatosis, recurrent, 298
Laryngeal stenosis, chronic, 247–248
clinical features of, 248
management of, 248
Laryngeal stroboscopy, 220–221
Laryngitis
acute subglottic, 299
noninfective, 249–250
acute, 249–250
chronic, 250
Laryngocele, 200
Laryngomalacia, 279–280
clinical presentation, 279
diagnosis, 279–280
etiology, 279
management of, 280
pathogenesis, 279
Laryngopharyngeal reflux (LPR), 212, 213, 221, 228
Laryngopharynx. See Hypopharynx
Laryngotracheal injuries, 247–248
laryngeal stenosis, chronic, 247–248
clinical features of, 248
management of, 248
laryngotracheal trauma, acute, 247
clinical features of, 247
management of, 247
types of, 247t
Laryngotracheal trauma, acute, 247
clinical features of, 247
management of, 247
types of, 247t
Laryngotracheobronchitis, 235
Larynx
anatomy of, 206–209
cartilages and membranes, 206–207, 206f
glottis, 207, 207f
subglottis, 207, 207f
supraglottis, 207, 207f
blood supply of, 209
clinical examination of, 216–217
flexible nasopharyngolaryngoscopy, 217, 217f
indirect laryngoscopy, 216–217, 216f
congenital diseases of, 279–280
congenital subglottic stenosis, 280
laryngomalacia, 279–280
recurrent laryngeal papillomatosis, 279
emergencies in, 308
foreign bodies in, 264–265
clinical features, 264, 264f
laryngoscopy, 264–265
rigid, 264–265, 264t
treatment, 264
infections of, 235–237, 235t
acute epiglottitis, 235–236
acute laryngitis, 235, 235f
acute laryngotracheobronchitis, 235
acute subglottic laryngitis, 235
chronic nonspecific laryngitis, 236
granulomatous laryngitis, 236
investigations for diseases of, 219–221
laser surgery in, 317
lymphatic drainage, 209
muscles of, 207–208, 207t
extrinsic, 207t, 208
intrinsic, 207t, 208, 208f, 208t
neoplasms of, 239–242
papillomas, 239
squamous cell carcinoma, 239–242
nerve supply, 208
motor, 208–209
sensory, 208
non-neoplastic lesions of, 237–238
contact ulcer, 238
intubation granuloma, 238, 238f
retention cyst, 238
vocal cord nodules, 237, 237f
vocal cord polyps, 237, 237f
physiology of, 210–211
closure of larynx, 210
cough reflex, 210
lower airway, protection of, 210
phonation, 210–211, 211f
respiration, 211
thoracic fixation, 211
symptoms related to diseases of, 212, 212t
aspiration, 214
cough, 214
hoarseness, 213
pain, 213–214
stridor, 213
Laser, 316–317
advantage of, 317
in ENT surgery, 316–317
principle of, 316
safety measures in, 317
types of, 316
Laser assisted uvulopalatoplasty (LAUP), 231
Lateral sinus thrombosis, 56
Le Fort fractures, 147, 147f
Le Fort I, 147
Le Fort II, 147
Le Fort III, 147
Leprosy, 139–140
Lethal midline granuloma, 140
Leukemias, oral manifestations of, 181
Leukoplakia, 177–178
Lichen planus, 176
Lingual nerve, 163
Lingual thyroid, 279, 279f
Lips, 161
carcinoma of, 178–179
development of, 161
examination of, 168
lymphatic drainage of, 162
Little’s area, 150–151, 150f
Localized otitis externa (furunculosis), 40
Loop diuretics, 77
LPR. See Laryngopharyngeal reflux (LPR)
Luc’s forceps, 321, 321f
Ludwig’s angina, 165, 169, 196–197, 196f
Lupus vulgaris, 111
Lymphangioma, 278, 278f
Lymph nodes, 169
levels of neck, 170, 170f
palpation of, 169–170, 170f
Lymphoepithelioma, 144, 232
M
Mac Ewen’s triangle, 11, 11f
Macula, 14, 14f
Malignant lymphoma, of thyroid, 189
Malignant tumors, middle ear
clinical features, 67
management, 67
Malleus ossicle, 10, 10f
Mandible, fracture of, 147–148, 148f
orthopantomogram (OPG) for, 148, 148f
treatment of, 148
Mandibular-responding splints (MRS), 231
Masking, 33, 33f
Masseteric abscess, 197
Masticator space, 197
Mastoid antrum
blood supply, 11
lymphatics, 11
nerve supply, 11
surface landmark, 11, 11f
venous drainage, 11
Mastoid bone
development, 10–11
mastoid process, 10
pneumatization, 11
Mastoid curette, 319, 319f
Mastoidectomy operation
canal down mastoidectomy
modified radical mastoidectomy, 59
radical mastoidectomy, 58–59
canal up mastoidectomy
combined approach tympanoplasty (CAT), 60
cortical mastoidectomy, 59–60, 60f
complications of, 60
Mastoid gouge, 319, 319f
Mastoid hammer, 319, 319f
Mastoiditis, 22
Maxillary sinus, 92
drainage procedures for, 121–122
obliteration of, 122
Meatoplasty, 44
Meatuses, 91
Medullary carcinoma, of thyroid, 188
Melanoma, 112
of nose and sinuses, 144–145
Membranous cochlea, 13
Membranous labyrinth, 12f
cochlea, 13
endolymph, 13
semicircular ducts, 13–14
vestibule, 13
Membranous semicircular ducts
utricle and saccule, 14
vestibular sensory epithelium, 13, 13f
Membranous vestibule, 14
saccule, 13
utricle, 13
Ménière’s disease, 23, 73–74, 74f
Meningitis, facial trauma and, 148
Meningocele, 277
Merocel nasal pack, 152
Mesotympanum, 9
Metaplasia theory, 51, 51f
Metastatic lymph nodes, 199–200, 199f
in children, 301
Microscope, 3, 4
Middle ear cleft, 8f
eustachian tube (ET), 10
infections of
acute otitis media (AOM), 45–46
adhesive otitis media, 46
chronic otitis media, 46–49
otitis media with effusion (OME), 46
mastoid antrum, 11
mastoid bone, 10–11
mucosa of, 11
tympanic cavity (Middle ear cavity), 9
tympanic membrane, 8–9
walls of middle ear cavity, 9–10
Middle ear, congenital anomalies of, 276
Mid-line lethal granuloma, 133
Middle ear transformer mechanism, 18
Migraine, 155
signs and symptoms of, 155
treatment of, 155
pain-relieving medications, 155
preventive medications, 155
Mixed hearing loss, 23
Modified radical mastoidectomy, 59, 59f
Modiolus, 12
Mondini malformation, 276
Mononucleosis, infectious, 295
Mucocele, 126
Mucoepidermoid carcinoma, 185–186
Mucormycosis, 123
Mucosal candidiasis of oral cavity, 175
Mucosa, middle ear cleft, 11
Mucous glands, 11
Mucous retention cyst, 168, 177
Multinodular goiter, 191, 191f
Mumps, 182–183, 300
Muscles, of walls of middle ear cavity
stapedius, 10
tensor tympani, 10
Musculoskeletal tension disorders, 250
Mycobacterium bacilli, 236
Mycobacterium leprae, 139
Myoepithelial sialadenitis. See Sjögren’s syndrome
Myringitis bullosa, 45
Myringoplasty
aims of, 49t
complications, 49t
contraindications for, 49t
prerequisites for, 48–49
procedure, 49
success rate, 49
vs. ossiculoplasty, 49–50, 50t
vs. tympanoplasty, 49–50, 50t
Myringotomy knife, 318, 318f
N
Nasal bleeding, 99
Nasal bone, fracture of, 146–147, 146f
clinical features, 146
treatment, 146–147
X-ray in, 146, 146f
Nasal cavity, 90–91, 90f
chronic infections of, 137t
diseases of, 137t
granulomas of, 137t
Nasal deformity, 100
Nasal dermoid cyst, 277
Nasal discharge (Rhinorrhea), 99, 99t
Nasal dressing forceps, 3, 4
Nasal glioma, 277, 277f
Nasal intonation of voice, 100, 166
Nasal mucosa, 91–92
Nasal myiasis, 141
Nasal obstruction, 98–99, 100t
Nasal packing, 148
anterior, 151–152, 152f
posterior, 152, 152f
Nasal patency assessment, 102, 102f
Nasal polyps
characteristic features, 134t
differential diagnosis, 135–136, 135t
etiology, 134
and functional endoscopic sinus surgery, 158
investigations, 136
treatment, 136
types
antrochoanal polyps, 134–135
ethmoidal polyps, 134–135
Nasal regurgitation, 166
Nasal septum, 89–90, 90f
Nasal skeleton, 89, 89f
Nasal specula, 3, 4
Nasal surgical instruments, 320–322
Asch’s septum forceps, 322, 322f
Ballenger swivel knife, 321, 321f
Killian’s double-ended elevator, 321, 321f
Killian’s nasal speculum, 321, 321f
Luc’s forceps, 321, 321f
nasal telescope, 322, 322f
posterior rhinoscopy mirror, 322, 322f
septal gouge, 321, 321f
trocar and cannula, for antrum wash out, 320–321, 320f
turbinectomy scissors, 321–322, 322f
Walsham’s lateral nasal forceps, 322, 322f
Nasal syphilis, 139
Nasal telescope, 322, 322f
Nasal turbinates, 90
Nasal valve, 91
Nasal vestibule, 91
inspection of, 102
Nasopharynx, 203, 224
tumors of, 224, 224t
angiofibroma, 225
squamous cell carcinoma (SCC), 224–225
Nasopharynx, congenital diseases of, 279
Nd:YAG laser, in ENT surgery, 316
Neck, deep neck spaces of, 193. See also Deep neck spaces
Neck swelling, pediatric, 300–301
congenital conditions, 300
inflammatory conditions, 300
neoplasia, 300–301
leukemia, 301
lymphoma, 300–301
metastatic lymph node, 301
rhabdomyosarcoma, 301
ranula, 301
Neck swellings, 166, 198
classification of, 198
diagnosis of, 198, 198t
examination in, 169
lateral, 198–200, 199t
carotid body tumor, 200
HIV infection and, 200
inflammatory lymph nodes, 198–199
laryngocele, 200
lymphomas, 199
metastatic lymph nodes, 199–200, 199f
mumps (acute parotitis), 198
neurogenic tumors, 200
occult primary, 200
rhabdomyosarcoma, 199
thyroid and salivary glands, neoplasms of, 199
tuberculous lymph node, 199, 199f
mid-line, 169, 199t, 200
chondroma of laryngeal cartilages, 200
enlarged lymph nodes and, 200
Ludwig’s angina, 200
pyramidal lobe of thyroid as, 200
thyroglossal cyst/fistula, 200
thyroid swellings, 200
Necrotizing otitis externa, 41
Negus artery forceps, 323, 323f
Negus ligature pusher/tier, 323, 324f
Neoplasia of neck, pediatric, 300–301
leukemia, 301
lymphoma, 300–301
metastatic lymph node, 301
rhabdomyosarcoma, 301
Neoplasms
basal cell carcinoma, 39
benign neoplasms, 41
of external nose, 111–112
of larynx, 239–242
benign, 239
malignant, 239–242
malignant neoplasms, 41
of middle ear
glomus tumor, 67
langerhans cell histiocytosis, 67
malignant tumors, 67
osteomas, 68
of nasal cavity and paranasal sinuses, 142–145
of nasopharynx, 224–225
of oral cavity, 177–180, 177t
benign neoplasms, 177
malignant neoplasms, 178–179
premalignant conditions, 177–178
tumour-like lesions, 177, 177f
of parapharyngeal space, 196, 196f, 196t
of pharynx, 232–234
hypopharynx, 233
nasopharynx, 224–225
oropharynx, 232–233
of salivary gland, 185–186, 185t
benign, 185
malignant, 186
of variable malignancy, 185–186
squamous cell carcinoma, 39
of thyroid gland, 187–189
benign, 187–188
malignant, 188–189
vestibular schwannoma, 71–72
Nerves, walls of middle ear cavity
chorda tympani, 10
tympanic plexus, 10
Nervus intermedius, 15
Neurogenic tumors, 200
Neurological lesions of pharynx, 229
Nonallergic rhinitis
drug-induced rhinitis, 116
emotion-induced rhinitis, 116–117
food-induced rhinitis, 116
hormonal rhinitis, 116
occupational rhinitis, 116
physical and chemical factors, 116
rhinitis medicamentosa, 116
vasomotor rhinitis (Idiopathic rhinitis), 115–116
Nonchromaffin paraganglioma, 67
Nonhealing mid-line granulomas, 140
Non-Hodgkin’s lymphoma, 199
of oropharynx, 232
Noninfective rhinitis
allergic rhinitis, 113–115
nonallergic rhinitis, 115–117
Noninvasive fungal rhinosinusitis, 123
Non-purulent thyroiditis, 190
Nose
congenital diseases of, 276–277
choanal atresia, 277
congenital nasal deformities, 277
congenital nasal masses, 277
emergencies in, 308
external nose
blood supply, 89
lymphatic drainage, 89
nerve supply, 89
laser surgery in, 316–317
nasal cavity, 90–91, 90f
nasal mucosa, 91–92
nasal septum, 89–90, 90f
nasal valve, 91
swellings of, 102t
Nose and paranasal sinuses
anatomy of, 88–95
chronic infections of nasal cavity, 137–141
clinical examination, 101–106
complications of rhinosinusitis, 125–128
diseases of external nose, 110–112
diseases of the nasal septum, 129–133
investigations for, 107–109
nasal polyps, 134–136
noninfective rhinitis, 113–117
rhinosinusitis, 118–124
symptoms of, 98–100
Nose and sinuses, neoplasms of, 142–145, 142t
benign, 142–143
adenoma, 143
chondroma, 143
fibroma, 143
hemangiomas, 143
inverted papilloma, 142
neurofibroma, 143
ossifying fibroma (fibrous dysplasia), 142–143, 143f
osteoma, 142, 142f
malignant, 143–145
adenocarcinoma, 144
adenoid cystic carcinoma, 144
lymphoepithelioma, 144
malignant melanoma, 144–145
rhabdomyosarcoma, 145
squamous cell carcinoma, 143–144, 143f, 144f, 144t
Nosebleed. See Epistaxis
Notch of Rivinus, 8
Nystagmus
definition, 30
types of, 30
O
OAE. See Otoacoustic emission (OAE)
Obstructive sleep apnea (OSA), 230, 230f, 289–290
diagnosis, 289
potential complications of, 289t
treatment of, 290
Occupational rhinitis, 116
Odynophagia, 165
Oesophagoscopy, 267, 268
Oesophageal voice, 242
OME. See Otitis media with effusion (OME)
Open biopsy, in head and neck diseases, 173
Optokinetic test, 35
Oral candidiasis, 168
Oral cavity
applied anatomy of, 161
alveolar ridge, 161
cheek, 161
floor of mouth, 162
gums, 161
lips, 161
oral vestibule, 161
palate, 161–162
retromolar trigone, 161
tongue, 162
diseases of tongue, 175
embryology of, 161
lips, development of, 161
tongue, development of, 161
examination of, 168–169
angle of mouth, 168
buccal mucosa, 168
coffin corner, 169
floor of mouth, 169
lips, 168
mucosa, 168
palate, 169
parotid gland duct, opening of, 168
teeth and gum, 168
tongue, 168–169
immune disorders of, 175–176
aphthous ulcer, 175
Behcet’s syndrome, 175–176
lichen planus, 176
pemphigus vulgaris, 176
inflammatory diseases of, 174–175
herpangina, 174
herpes simplex, 174
herpes zoster, 174, 174f
syphilis, 174
thrush, 175
tuberculosis, 174
investigations for diseases of, 171–173
angiography, 172, 172f
chemogustometry, 172
color Doppler ultrasound, 172
CT and MRI scan, 171
digital subtraction angiography, 172
electrogustometry, 172–173
endoscopy, 172
fine needle aspiration cytology (FNAC), 173
fistulography, 172, 172f
isotope scanning/scintigraphy, 172
open biopsy, 173
orthopantomogram, 171, 171f
pathological tests, 173
PETscan, 172
plain X-ray, 171
sialendoscopy, 172
sialography, 172, 172f
supravital staining and biopsy, 173, 173f
taste sensation, tests for, 172–173
thyroid hormone assay, 172
ultrasonogram (USG), 171–172
lymphatic drainage of, 162
buccal mucosa, 162
floor of mouth, 162
hard palate, 162
lips, 162
tongue, 162
neoplasms of, 177–180, 177t
carcinomas of oral cavity, 178–179, 179f
erythroplakia, 178
leukoplakia, 177–178
mucous retention cyst, 177
oral submucous fibrosis, 178
papilloma, 177
pleomorphic adenoma, 177, 177f
ranula, 177, 177f
physiology of, 163–164
saliva, formation and function of, 163–164
swallowing mechanism, 164
taste sensation, perception of, 163, 163f
symptoms of diseases of, 165, 165t
change in tone of voice, 166
difficulty in opening mouth, 166
difficulty in swallowing, 165
earache, 166
foul breath, 166
pain, 165
painful swallowing (odynophagia), 165
salivary disturbances, 165–166
taste disturbances, 166
ulcers, 166
Oral cavity carcinomas, 178
of alveolar ridge, 179
of anterior 2/3rd of tongue, 179, 179f
of buccal mucosa, 179, 179f
etiological factors for, 178, 178t
of floor of mouth, 179, 179f
of hard palate, 179, 179f
of lip, 178–179
of retromolar trigone, 179
Oral cavity, head and neck
congenital diseases of, 277–279
branchial cyst/fistula, 278, 278f
cleft lip, 279
cleft palate, 279
dermoid cyst, 278
hemangioma, 278, 278f
lymphangioma, 278, 278f
thyroglossal cyst/fistula, 277–278, 277f
clinical features of, 277
treatment of, 278
emergencies in, 308
surgical instruments for, 318–324
Oral manifestations, of systemic diseases, 181, 181t
Oral submucous fibrosis (OSMF), 178
Oral vestibule, 161
Orbital blow-out fracture, 147, 147f
Orbital cellulitis, 127
Organ of Corti, 13, 14
Oropharynx, 204
Orthopantomogram (OPG), 171, 171f
OSA. See Obstructive sleep apnea (OSA)
Ossicles, 10f
in epitympanum (Attic), 10
incus, 10
malleus, 10
stapes, 10
Ossicular chain fixation, 276
Ossicular deformity, 276
Ossifying fibroma, of maxilla, 142–143, 143f
Osteoma, 41, 68
of frontal sinus, 142, 142f
Osteomyelitis, 125–126
Ostiomeatal complex (OMC), 91, 91f, 157
Otalgia, and facial pain, 154–155
Otitis externa, 22, 25, 39t
Otitis media, complications of, 54t
extracranial
acute mastoiditis/mastoid abscess, 54–55
facial nerve paralysis, 56
labyrinthine fistula, 55–56
labyrinthitis, 55–56
other abscesses, 55
intracranial
brain abscess, 57
extradural/subdural abscess, 56
lateral sinus thrombosis, 56
pyogenic meningitis, 56
routes of spread, 54
Otitis media with effusion (OME), 23, 46, 284–286. See also Acute otitis media (AOM)
clinical features of, 284–285
differential diagnosis, 285
etiology, 284
investigation of, 285
natural history of, 285
sequelae of, 285
synonyms of, 284
treatment of, 285–286
medical, 286
spontaneous resolution, 285
surgical, 285–286, 285f
Otoacoustic emission (OAE), 35, 35f
test for deafness, 303
Otoconia, 14, 75
Otomycosis, 40
Otosclerosis
characteristic features, 65
clinical features
signs, 65–66
symptoms, 65
definition, 65
investigations, 66
pathology, 65, 65t
treatment
hearing aid, 66
medical treatment, 66
surgical, 66
types
clinical, 65, 65t
histological, 65
Otoscope, 3, 4
Ototoxicity
clinical features, 77
common drugs
aminoglycosides, 77
atenolol, 77
cytotoxic agents, 77
loop diuretics, 77
phenytoin, 77
quinine, 77
treatment, 77
Oval window, 9, 10, 12
Ozaenae, 137
P
Pachydermia, 238
Pain
midfacial pain and headache, 98
in neck region, 166
in oral cavity, 165
in pharynx, 212
Painful swallowing. See Odynophagia
Pain-relieving drugs, in migraine, 155
Palate, 161–162
carcinoma of, 179, 179f
Palliative chemotherapy, in ENT and head and neck cancers, 313
Palpation (paranasal sinuses), 101–102, 102f
Panendoscopy, 220
Papillary carcinoma, of thyroid, 188
Papilloma, of oral cavity, 177
Papillomata (Wart), 111, 111f
Paracusis willisi, 65–66
Paranasal sinuses, 92f
anterior group, 92t
frontal sinus, 92
maxillary sinus (antrum), 92
venous drainage, 93
blood supply, 93, 93f
emergencies in, 308
lymphatic drainage, 94
nerve supply, 94
posterior group
ethmoid sinuses, 92–93
sphenoid sinus, 93
venous drainage, 93
Parapharyngeal space, 195
anatomy of, 195, 195f
compartment and contents of, 196t
infections and abscess of, 195–196
neoplasms of, 196, 196f, 196t
Parasympathetic fibers, 94
Parotid abscess, 182, 182f
Parotid glands
adenoid cystic carcinoma of, 186, 186f
non-Hodgkin’s lymphoma of, 186
parotitis, 181, 192
saliva from, 163
viral infection of, 182–183
Pars flaccida, 8
Pars tensa, 8
Patterson-Brown Kelly syndrome, 233
Pemphigus vulgaris, 176
Pendred syndrome, 276
Perennial allergic rhinitis
clinical features, 113–114
investigations, 114
prognosis, 114
treatment, 114–115
Perichondritis, auricle, 38–39, 39f
Perilymph, 11
Perilymphatic fistula, 71
Periosteum elevator, 319, 319f
Peritonsillar abscess, 213, 222
Persistent lymphadenopathy syndrome (PLS), 200
Persistent stapedial artery, 276
Pharyngeal pouch, 270–271
Pharyngeal space. See Parapharyngeal space
Pharyngo-maxillary space. See Parapharyngeal space
Pharynx
anatomy of, 203–205, 203f
blood supply and venous drainage, 204
hypopharynx, 204–205, 204f
lymphatic drainage, 204
lymphoepithelial system, 204–205, 204f
nasopharynx, 203
nerve supply, 204
oropharynx, 204
pharyngeal musculature, 203, 203f
clinical examination of, 215–216
hypopharynx, 215–216
nasopharynx, 215
oropharynx, 215
congenital diseases of, 279
emergencies in, 308
foreign bodies in, 266
complications, 267
infections of, 227, 227t
bacterial pharyngitis, 227
chronic pharyngitis, 227–228
nonspecific chronic pharyngitis, 228
tuberculous pharyngitis, 228
viral pharyngitis, 227
investigations for diseases of, 219–221
angiography, 220
barium swallow, 220, 220f
biopsy, 220
contrast esophagogram, 220
CT scans, 219
fine needle aspiration cytology, 220
flexible and rigid endoscopy, 220–221
MRI, 219
PET scans, 219–220
plain X-rays, 219
supravital staining and biopsy, 220
ultrasonogram (USG), 219
laser surgery in, 317
neoplasms of, 232–234
lymphoepithelioma, 232
minor salivary gland tumors, 233
non-Hodgkin’s lymphoma, 232
squamous cell carcinoma (SCC), 232, 233
non-infective diseases of, 228
edema of uvula, 229
globus pharyngeus, 228
keratosis pharyngeus, 229
laryngopharyngeal reflux (LPR), 228
neurological lesions, 229
physiology of, 210
sleep apnea, 230–231
snoring, 230
symptoms related to diseases of, 212, 212t
airway obstruction, 213
feeling of lump in throat, 213
hoarseness, 213
irritation, 213
itching/dryness, 213
odynophagia/dysphagia, 212
pain, 212
swelling/ulcers, 212
white patch, 212–213
systemic diseases, manifestations of, 229, 229t
Phenytoin, 16
Phonation, 210–211, 211f
mechanism of, 210, 211f
theories of, 210
Phonosurgery, 250–251
Isshiki’s thyroplasty, 250–251
types of surgery under, 250t
Physical trauma, 62t
fractures of temporal bone, 62
longitudinal, 63
transverse, 63
laceration of skin of EAC, 62
traumatic perforation of TM, 62
Physiological goiter, 191
Pillar retractor, 323, 323f
Pituitary diseases, oral manifestations of, 181
Plain radiographs, in oral cavity and head and neck diseases, 171
Play audiometry, for deafness, 303
Pleomorphic adenoma
of hard palate, 177, 177f
of salivary glands, 185, 185f
Plummer’s disease, 192
Plummer-Vinson syndrome, 233
Plunging ranula, 177, 301
Pneumatic ear specula, 3–4
Pneumatization, 11, 11f
Positron emission tomography (PET), 310
Postcricoid region, 203
Posterior cricoarytenoid muscle, 208
Posterior nasal packing, 152, 152f
Posterior rhinoscopy, 105, 105f, 105t
Posterior rhinoscopy mirrors, 3, 4, 322, 322f
Posturography tests, 35–36
Pott’s puffy tumor, 126
Preauricular sinus, 25, 275, 275f
Prednisolone, 84
Presbyacusis, 72–73
Prevertebral fascia, 193, 193f
Primary neuralgia, 155–156
glossopharyngeal neuralgia, 156
trigeminal neuralgia, 155–156
Proof puncture, 109
Pseudocyst, 39
Pseudomonas aeruginosa, 38, 41
Psychogenic dysphonia, 249t, 250
Ptyalism, 165–166
Puberphonia, 250
Pure tone audiometry, 32–33, 32f
Pyocele, 126
Pyogenic meningitis, 56
Pyramid, posterior wall, 9
Pyriform fossa, 265, 269t
Q
Quinine, 77
Quinsy forceps, 323, 323f
R
Radiation mucositis, 165
Radical mastoidectomy, 58–59, 58f
Radioallergosorbent test (RAST), 108–109
Radiological investigations
for ear
CT and MRI Scans, 37
plain X-rays of internal auditory canals (IAC), 37, 37f
plain X-rays of mastoids, 36
X-ray of mastoids-lateral oblique views, 36, 36f
X-ray of mastoid-Towne’s view, 36–37, 37f
for nose and sinus
angiography, 108
CT scans, 108, 108f
magnetic resonance imaging (MRI), 108
plain X-rays, 107–108, 107f, 108f, 108t
Radiotherapy, in ENT and head and neck cancers, 311–312
adjuvant, 311
brachytherapy, 312
conventional fractionation of, 312
curative, 311
external beam, 311–312
postoperative, 311
preoperative, 311
side effects of, 312, 312t
sources of, 312
types of, 311–312
units of measurement, 312
unsealed radionuclide therapy, 312
Ramsay Hunt Syndrome, 70
Ranula, 177, 177f, 301
RAST. See Radioallergosorbent test (RAST)
Reactive airway, 214
Recurrent aphthous stomatitis (RAS), 175
Recurrent laryngeal nerve, 208–209, 209f
paralysis, 188–189
Recurrent laryngeal papillomatosis, 298
Recurrent respiratory papillomatosis, 239
Referred otalgia, 22, 22f, 22t, 155, 166, 168
Reflex action, 164
Reinke’s edema, 237
Respiratory obstruction, facial trauma and, 148
Retention cyst, 238
Retrocochlear analysis, 19
Retromolar trigone, 161
carcinoma of, 179
Retropharyngeal abscess, 194–195
causes of, 194, 194t
clinical features, 194, 194f
cold abscess, 194, 195f
treatment, 194–195
Retropharyngeal space, 194
Reverse smoking, and carcinoma of hard palate, 178
Rhabdomyosarcoma, in children, 301
Rheumatoid arthritis, and hoarseness, 249
Rhinitis
acute, 282, 284
allergic, 282, 290
vasomotor, 289
Rhinitis medicamentosa, 116
Rhinitis sicca, 138
Rhinolalia, 100, 166
aperta, 166
clausa, 166
Rhinolith, 140
Rhinomanometry, 109
Rhinophyma, 111, 111f
Rhinoscleroma (scleroma), 139
Rhinosinusitis
acute rhinitis/common cold/coryza, 118
acute sinusitis, 118–120
chronic sinusitis, 120–121
complications of
distant, 128
intracranial, 127–128
laryngeal, 128
local spread, 125–126
nasal, 126–127
orbital, 127
pharyngeal, 128
pulmonary, 128
drainage procedures for sinuses, 121–122
fungal rhinosinusitis, 123
management of associated nasal conditions, 123
obliteration procedures for sinuses, 122
Rhinoplasty, 88, 111
Rhinosporidiosis, 138–139, 138f
Rhinosporidium seeberi, 138
Riedel’s thyroiditis, 191
Rigid endoscope, 3, 4, 105
Rigid laryngoscope, 323, 323f
Rima glottis, 207
Rinne test, 27–28, 28f
results and interpretations of, 28–29, 29t
Rotation chair test, 35
Rotatory vertigo, 78
Round window, bone conduction, 18, 18f
S
Saccule, 13
role in equilibrium, 20
Salicylate, 77
Saliva, 163, 210
control of control of, 164
functions of, 164, 164t
production of, 163–164
Salivary disturbances, 165–166
Salivary duct calculus, 155
Salivary gland disorders, and facial pain, 155
Salivary glands
infections of, 182–183
bacterial, 182, 182f
Sjögren’s syndrome, 183
tuberculosis, 183
viral, 182–183
neoplasms of, 185–186, 185t
acinic cell tumor, 186
adenocarcinomas, 186
adenoid cystic carcinoma, 186
hemangiomas, 185
lymphangiomas, 185
malignant pleomorphic adenoma, 186
mucoepidermoid carcinoma, 185–186
non-Hodgkin’s lymphoma, 186
pleomorphic adenoma, 185, 185f
squamous cell carcinoma, 186
Warthin’s tumor, 185
saliva from, 164
submandibular, 182
SCC. See Squamous cell carcinoma (SCC)
Schwabach’s test, 29
SDS. See Speech discrimination score (SDS)
Seasonal allergic rhinitis (Hay fever), 113
Seborrheic dermatitis, EAC, 41
Secondary neuralgia, 156
Self-retaining mastoid retractor, 318–319, 319f
Semicircular ducts, 14
Sensorineural hearing loss (SNHL), 23
children at risk of, 302
common causes of, 76
Sensory (olfactory) nerve fibers, 94
Septal deviation, and facial pain, 154
Septal gouge, 321, 321f
Septal hematoma/abscess, 129–130, 129f
Septal neoplasms, 133
Septal perforation, 132–133, 133t
Septal trauma, 129
Septoplasty, 132
vs. SMR, 132
Septoplasty with bilateral flap elevation, 152
Sialendoscopy, 172
Sialography, 172, 172f
Sialolithiasis, 183–184
clinical features, 183
investigation in, 183–184, 184f
treatment of, 184
Siegel’s pneumatic speculum, 320, 320f
Simpson’s aural syringe, 318, 318f
Sinusitis, and facial pain, 154
Sjögren’s syndrome, 183
Skin diseases, auricle, 39
Skin infections, auricle, 39
Skin prick test, 108
Skull base, 225
neoplasms of, 225, 226t
surgery, 226, 226t
surgical anatomy of, 225
Sleep apnea, 230, 289–290
central, 230, 289
mixed type, 230, 289
obstructive, 230, 289–290
treatment, 231
Sluder’s neuralgia, 131
Sluder’s syndrome, 154
Smell disorders, 99–100
Smell, sense of, 163
Smell test, 109
SMR. See Submucous resection (SMR)
Sneezing, 99
SNHL. See Sensorineural hearing loss (SNHL)
Snoring, 230, 230f, 289
Social deafness, 73
Soft palate implants, 231
Solitary thyroid nodule, 187–188, 187t, 188f
cold, 187–188
differential diagnosis of, 187t
FNAC in, 187
hot, 188
ultrasonography in, 187
Somnoplasty, 231
Sound, 18f
frequency, 17
intensity, 17
timber, 17
Sound pressure differential, 19
Speech audiometry, 32–33
Speech discrimination score (SDS), 33
Speech reception threshold (SRT), 33
Sphenoid sinus, 93
drainage procedures for, 122
Sphenopalatine artery, clipping of, 152
Spirit lamps, 3
Spontaneous nystagmus, 30
Squamous cell carcinoma (SCC), 39, 41, 112
of ethmoid sinuses, 143, 144f
of hypopharynx, 233
of larynx, 239–242
classification of, 239
glottic SSC, 239–240, 240f
investigations for, 240, 241f
prognosis of, 241
subglottic SCC, 240
supraglottic SCC, 240, 240f
and total laryngectomy, 241, 241f
treatment for, 240–241
voice restoration after total laryngectomy, 241–242
of maxillary sinus, 143, 143f, 144f, 144t
of nasal cavity, 143
of nasopharynx, 224–225, 225f
of oral cavity, 178–179, 179f
of oropharynx, 232
Squamous papilloma, 177
SRT. See Speech reception threshold (SRT)
Stapedius, 10
Stapedotomy, 66, 66f, 66t
Stapes ossicle, 10f
Staphylococcus aureus, 40, 110, 128
Startle reflex test, for deafness, 303
Stenger’s and Chimani-Moos tests, 33
Stenson’s duct, 161
Stomodeum, 161
Strap muscles of neck, 208
Streptococcal acute pharyngitis, 227
Streptococcus pneumoniae, 108, 292
Streptococcus pyogenes, 108
Stridor, 213, 247. See also Upper airway obstruction
defined, 252
differential diagnosis of, 252, 252t, 297, 297t
Subacute thyroiditis, 190
Subglottic stenosis, 251t, 252
Submandibular glands, saliva from, 163–164
Submandibular lymph node, 169
Submandibular salivary gland, enlarged, bimanual palpation of, 169, 169f
Submandibular sialadenitis, 165
Submandibular space, 196
Ludwig’s angina, 196–197, 196f
Submucous fibrosis, 178
Submucous resection (SMR), 132
Subtotal thyroidectomy, 191, 192
Suction machines, 3
Sudden sensorineural deafness (Idiopathic), 75–76
Supraglottic vocal tract, 211
Supravital staining and biopsy, 173, 173f
Surgical emphysema, 247
Surgical instruments, for ENT and head and neck, 318–324
ear instruments, 318–320
diamond and cutting burrs of mastoid drill, 319–320, 320f
ear speculum, 318, 318f
hand-piece of mastoid drill, 319, 319f
Jobson-Horne probe, 318, 318f
mastoid curette, 319, 319f
mastoid gouge, 319, 319f
mastoid hammer, 319, 319f
myringotomy knife, 318, 318f
periosteum elevator, 319, 319f
self-retaining mastoid retractor, 318–319, 319f
Siegel’s pneumatic speculum, 320, 320f
Simpson’s aural syringe, 318, 318f
tuning fork (512 Hz), 318, 318f
nasal instruments, 320–322
Asch’s septum forceps, 322, 322f
Ballenger swivel knife, 321, 321f
Killian’s double-ended elevator, 321, 321f
Killian’s nasal speculum, 321, 321f
Luc’s forceps, 321, 321f
nasal telescope, 322, 322f
posterior rhinoscopy mirror, 322, 322f
septal gouge, 321, 321f
trocar and cannula, for antrum wash out, 320–321, 320f
turbinectomy scissors, 321–322, 322f
Walsham’s lateral nasal forceps, 322, 322f
throat instruments, 322–324
adenoid curette, 324, 324f
Boyle-Davis mouth gag, 323, 323f
bronchoscope, 322, 323f
esophagoscope, 322, 322f
laryngeal mirror, 324, 324f
Negus artery forceps, 323, 323f
Negus ligature pusher/tier, 323, 324f
pillar retractor, 323, 323f
quinsy forceps, 323, 323f
rigid laryngoscope, 323, 323f
tongue blade, 323, 323f
tonsillar dissector, 323, 323f
tonsil snare, 323–324, 324f
Surgical trauma, 71
Swallowing, 164, 210
esophageal phase, 164
neural pathways, 164
oral phase, 164
painful, 165
pharyngeal phase, 164, 164t
Swelling, in neck, 166
Sympathetic fibers, 94
Synechiae in nasal cavity, functional endoscopic sinus surgery and, 158
Syphilis, 111
oral manifestations of, 174
Systemic diseases, oral manifestations of, 181, 181t
T
Taste buds, 163
Taste disturbances, 166
Taste sensation, perception of, 163, 163f
distribution of taste sensations on tongue, 163f
sense of smell and, 163
sensory taste supply, 163, 163f
taste buds, 163
Technetium-based radioisotopes, 310
Tectorial membrane, 13
Teeth, examination of, 168
Tegmen tympani, 9
Temporal artery arteritis. See Giant cell arteries
Tension headache, 156
Tensor tympani, 10
Thornwaldt’s disease, 287
Throat surgical instruments, 322–324
adenoid curette, 324, 324f
Boyle-Davis mouth gag, 323, 323f
bronchoscope, 322, 323f
esophagoscope, 322, 322f
laryngeal mirror, 324, 324f
Negus artery forceps, 323, 323f
Negus ligature pusher/tier, 323, 324f
pillar retractor, 323, 323f
quinsy forceps, 323, 323f
rigid laryngoscope, 323, 323f
tongue blade, 323, 323f
tonsillar dissector, 323, 323f
tonsil snare, 323–324, 324f
Thrombocytopenic purpura, oral manifestations of, 181
Thrush, 168, 175
Thumb sign, 236, 236f
Thyroglossal cyst/fistula, 277–278, 277f
clinical features of, 277
treatment of, 278
Thyroglossal duct, 187
Thyroglossal fistula, 167
Thyroid cartilage, 206. See also Larynx
Thyroid diseases, oral manifestations of, 181
Thyroid enlargement, 271
Thyroid gland, 187, 190
anatomy of, 187
blood supply of, 187
embryology of, 187
endocrine disorders of
hyperthyroidism, 191–192
hypothyroidism, 191
infections/inflammation of, 190–191
bacterial thyroiditis, 190
Hashimoto’s disease, 190–191
Riedel’s thyroiditis, 191
viral thyroiditis, 190
lymphatic drainage of, 187
neoplasms of, 187–189
anaplastic carcinoma, 188–189
follicular carcinoma, 188
malignant lymphoma, 189
medullary carcinoma, 188
papillary carcinoma, 188
solitary thyroid nodule, 187–188, 187t, 188f
nontoxic goiter, 190–191
Thyroid hormone assay, 172
Thyroid lobectomy, 188
Thyroid swelling, 169
Timber, 17
Tinnitus, 24
Tinnitus maskers, 83
TM. See Tympanic membrane (TM)
TM joint disorders, and facial pain, 154
TM perforation, 27
Tobacco, and carcinoma of oral cavity, 178
Tongue
anatomy of, 162
carcinoma of, 179, 179f
development of, 161
diseases of, 175
black hairy tongue, 175, 175f
fissured tongue, 175, 175f
geographical tongue, 175, 175f
dorsum of, 162
examination of, 168–169
functions of, 162
leukoplakia of, 177–178, 178f
lymphatic drainage of, 162
undersurface of, 162
Tongue blade, 323, 323f
Tongue depressors, 4
Tonsillar dissector, 323, 323f
Tonsillitis
acute, 222, 292–296
causative organisms, 292
clinical features of, 292
complications of, 292–294, 292t
diphtheria and, 295–296
infectious mononucleosis and, 295
investigation of, 292
with pus point, 292f
treatment of, 292
chronic, 294
tonsillectomy of, 294–295, 294f
complications of, 295, 295t
contraindications for, 294, 294t
indications for, 294, 294t
postoperative care, 294–295
surgical procedure, 294
techniques of, 294
Tonsils, 204–205, 204f
bed of, 291
diseases of, 222–223, 222t
acute tonsillitis, 222
tonsillar cyst and tonsollith, 222
ulcers of tonsil, 222, 222t
unilateral tonsillar enlargement, 222
grading of, 291
infections of, 291–296
acute tonsillitis, 292–296
lingual, 205
overview, 291
palatine, 205
palatine, surgical anatomy of, 291
lateral surface, 291
medial surface, 291
size of, 291
pharyngeal, 205
tubal, 205
Tonsil snare, 323–324, 324f
Tonsollith, 222
Total laryngectomy
voice restoration after, 241–242, 241f
artificial larynx, 242
esophageal voice, 242
neoglottis and use of prosthesis, 242
Total radical parotidectomy, 186
Total thyroidectomy, 188
Trachea, 262, 262f
congenital diseases of, 280
laser surgery in, 317
Tracheal stenosis, 247, 253t
Tracheobronchial tree, 262, 262f
foreign bodies in, 265–266
bronchoscopy, 265–266
clinical features, 265
investigations for, 265, 265f
treatment for, 265
Tracheoesophageal puncture (TEP), 242
Tracheostomy, 254–258
complications of, 255t
incisions for, 254, 255f
indications for, 254, 254t
operative steps for, 254–255, 255f
position during, 254
postoperative care of, 257–258, 257t–258t
technique for, 254
tracheostomy tubes, 255–257
Fuller’s metal tube, 257, 257f
metal tube, 255–257, 255f
non-metal tube (silastic), 257, 257f
Trauma
acoustic trauma
acute, 70–71
chronic, 71
barotrauma, 71
hematomas
clinical features, 38
treatment, 38
lacerations
treatment, 38
perilymphatic fistula, 71
physical trauma, 71
skin injury of EAC, 41–42
surgical trauma, 71
Triangles of neck, 170, 170f
Trigeminal neuralgia, 155–156
Tripod fracture. See Zygomaticomaxillary complex fracture
Trismus, 166
Trocar and cannula, for antrum wash out, 320–321, 320f
Trotter’s method, 151
Tuberculosis, 139
of larynx, 236
of oral and oropharyngeal mucosa, 174
of salivary gland, 183
Tuberculous laryngitis, 236
Tuberculous lymph nodes, 199, 199f
in children, 300
Tuberculous pharyngitis, 228
Tuning fork, 3, 4
Tuning fork (512 Hz), 318, 318f
Tuning fork tests, 27
Turban epiglottis, 236
Turbinectomy scissors, 321–322, 322f
Tympanic annulus, 8
Tympanic cavity (middle ear cavity), 9
Tympanic membrane (TM), 3, 8f
acute otitis media and, 282
clinical examination of
appearance/texture, 27
color, 27
landmarks of TM, 26, 26f
mobility, 27
perforation, 27
position, 27, 27t
quadrants of pars tensa, 26, 26f
histology of, 8–9
infection of
granular myringitis, 45
herpes zoster, 45
myringitis bullosa, 45
nerve supply, 9
OME and, 285
Tympanic plexus, 10
Tympanic sulcus, 8
Tympanogram, 34, 34f
Tympanomeatal flap, 49
Tympanosclerosis, 27
Tympanoplasty, 49, 58t, 59f
U
Ulcers
in oral cavity, 166
of tonsil, 222, 222t
Ultimobranchial bodies, 187
Ultrasonogram (USG), in oral cavity and head and neck diseases, 171–172
Umbo, 26
Unilateral nasal discharge, 99
Unsealed radionuclide therapy, in ENT and head and neck cancers, 312
Upper airway obstruction, 252–254. See also Stridor
acute life-threatening respiratory obstruction, 252–253
cricothyroidotomy for, 253, 253t
emergency methods for, 253f
Heimlich maneuver in, 252, 252f
gradual onset respiratory obstruction, 253–254
intubation vs. tracheostomy, 253–254, 253t
pediatric
differential diagnosis, 297
management of, 299
potential sites and causes of, 289f
Upper respiratory tract infection (URTI), 22
URTI. See Upper respiratory tract infection (URTI)
Utricle, 13
role in equilibrium, 20
Uvulopalatopharyngoplasty (U3P), 231
V
Valecullae, 203
Varicella zoster virus, 174
Vasomotor rhinitis (idiopathic rhinitis), 115–116
Ventricular folds, 207
Ventilation tube, 281, 283f
Vertigo, 23–24
causes of, 79, 79t
classification, 79t
definition, 78, 78t
diagnosis of common causes, 79t
examination, 79
history, 78–79, 78t
investigations, 79
tests for
Dix-Hallpike maneuver, 30, 30f
standing test, 30
treatment, 79–80, 80t
Vestibular investigations
caloric test, 35
electronystagmography (ENG), 35
optokinetic test, 35
posturography, 35–36
rotation chair test, 35
Vestibular neuronitis, 74–75
Vestibular schwannoma, 71–72
Vestibular sensory epithelium, 13, 13f
Vestibulitis, 110
Vestibulocochlear nerve, 14, 14f
Viral infections
of oral cavity, 174
herpangina, 174
herpes simplex, 174
herpes zoster, 174, 174f
of parotid glands, 182–183
Viral labyrinthitis, 70
Viral laryngitis, 235
Viral otitis externa, 41
Viral parotitis (mumps), 155
Viral pharyngitis, 227
Viral thyroiditis, 190
Vision loss, functional endoscopic sinus surgery and, 158
Vitamin B deficiency, 181
Vitamin C deficiency, 181
Vitamin deficiencies, oral manifestations of, 181
Vocal cord edema, 247, 247f. See also Hoarseness
Vocal cord nodules, 237
Vocal cord paralysis, 217
Vocal cord polyps, 237, 237f
Vocal cords nodules/cysts, 217
Vocalis muscle, 207
Voice disorders. See Hoarseness
Voice therapy, 235, 243
Voice tone, change in, 166
Von Recklinghausen’s neurofibromatosis, 72
W
Waardenburg syndrome, 276
Waldeyer’s ring, 204–205, 204f
Walls of middle ear cavity
anterior wall, 9
contents
muscles, 10
nerves, 10
ossicles, 10
inferior wall (floor), 9
lateral wall, 9
medial wall
bony fallopian canal of facial nerve, 9
labyrinthine windows, 9
lateral semicircular canal, 9
promontory, 9
posterior wall
aditus, 9
pyramid, 9
superior wall (roof), 9
Walsham’s lateral nasal forceps, 322, 322f
Warthin’s tumor, 185
Water’s view, 107
Wax, EAC, 42–43, 42f
Wax hook, 3, 4
Weber test, 28, 28f
results and interpretations of, 28–29, 29t
Wegener’s granuloma, 140
Wharton’s duct, 162
Whispered voice test, 27
White patch, in pharynx, 212–213
WHO. See World Health Organization (WHO)
Wisher voice test, 27
Woodruff’s plexus, 151
World Health Organization (WHO), 23
X
Xerostomia, 165
X-rays
of ear, 325–326
plain X-ray of mastoids, 325–326, 325f–326f
of head and neck, 328–330
soft tissue nasopharynx, 329–330
soft tissue neck, 328–329, 328f–330f
of mastoids, 36, 36f, 48, 52–53
in nasal bone fracture, 146, 146f
of nose and paranasal sinuses, 326–328
plain X-ray of nasal bone, 328, 328f
plain X-ray of PNS, 326–327, 326f–327f
plain X-ray of sphenoid and ethmoid, 327–328, 328f
in oral cavity diseases, 171
overview, 325
for pharynx, 219
PNS–OM view, 107, 107f, 119, 120, 121, 136
Y
Young’s syndrome, 123–124
Z
Zygomaticomaxillary complex fracture, 147
×
Chapter Notes

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1An Illustrated Textbook Ear, Nose and Throat and Head and Neck Surgery2
3An Illustrated Textbook Ear, Nose and Throat and Head and Neck Surgery
Second Edition
Rakesh Prasad Shrivastav MS FRCS Dean Tribhuvan University Institute of Medicine Professor and Former Head Department of ENT Tribhuvan University Teaching Hospital Kathmandu, Nepal Foreword Arun Agarwal
4
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An Illustrated Textbook: Ear, Nose and Throat and Head and Neck Surgery
First Edition: 2008
Second Edition: 2014
9789351523567
Printed at
5Dedicated to
My father
Lakshmi Narayan Prasad
The first ENT surgeon of Nepal
who has been the inspiration behind the first edition of this textbook
and
My late mother
Mrs Kiranmayee Prasad
who would have been proud to see this edition of the textbook6
7Contributors 9Foreword
It gives me a great pleasure to write a foreword to the second edition of An Illustrated Textbook: Ear, Nose and Throat and Head and Neck Surgery. The Editor, Professor Rakesh Prasad Shrivastav is a Senior Professor and ENT and Head and Neck Surgeon in Tribhuvan University Teaching Hospital, Kathmandu, Nepal. He did his MS in Otorhinolaryngology from All India Institute of Medical Sciences, New Delhi, India and was subsequently awarded FRCS ad eundem by the Royal College of Surgeons, England, UK. I have known him from his MS student days and during my visits to Nepal over ensuing years, I have watched with great interest the development of the ENT specialty and the establishment of new medical colleges in this country.
While this book covers all the aspects of ENT and Head and Neck, there is an underlying aim to feature those conditions, which are prevalent in Southeast Asia.
Principally, An Illustrated Textbook: Ear, Nose, Throat and Head and Neck Surgery is aimed at undergraduate students not only in India but also in all the countries in this subcontinent. Moreover, it will serve well as a starter for DLO and 1st year MS postgraduates.
The book is well-written and illustrated and the Editor is to be congratulated on including the very latest advances in the specialty.
It is hoped that undergraduates reading this book will be encouraged to consider ENT as a career.
Arun Agarwal MS
Professor Excellence
Former Dean, Maulana Azad Medical College
New Delhi, India
Former Additional Director General, Health Services
Government of India, New Delhi, India
Former Head, Department of Otorhinolaryngology
Maulana Azad Medical College
New Delhi, India10
11Preface to the Second Edition
Only a small portion of the current body of knowledge can be
taught in the prescribed period of time
Much of the knowledge that will be employed in the student's future
career is not known today, and therefore, cannot be taught
Small part of what is taught is erroneous
Not all that is taught is learned
A portion of what is learned will soon be obsolete
Of that which is taught and learned and relevant, much is quickly forgotten
— Kelly W West
This book is primarily intended for undergraduate medical students, however, DLO students and first year postgraduate ENT residents will also benefit. The biggest challenge the author faced while writing this book was how to convey the new exciting advances of this ever-expanding specialty of ENT and Head and Neck to the contemporary medical students. Accordingly, a lot of new material has been included in this edition like Skull Base Surgery, Thyroplasty, Functional Endoscopic Sinus Surgery, Cochlear Implantation, other Hearing Implants, etc. However, some omissions (like test and investigations not in current use and surgical procedures no more in vogue) had to be made keeping in view the current clinical practice and needs of the medical students. While including new advances, emphasis on diseases prevalent in this part of the world and other third world countries has been given due importance. This edition has included a separate section on “Pediatric Otolaryngology” and also included several new chapters under “Related Topics”. Moreover, the section on Diseases of the Throat has been further subdivided into “Oral Cavity and Head and Neck” and “Pharynx and Larynx”.
The book particularly emphasizes on clinical methods in ENT, which is so important for undergraduate medical students in this subcontinent, as they have to take a separate University Examination in ENT – both theory and clinical. Special emphasis has been given to pathophysiology of diseases so that the student understands how and why the diseases occur and help them to remember what he or she has read rather than just ‘mugging up’ without really understanding.
Realizing that medical students are under increasing pressure to study more these days, ‘Key Points’ (in colored boxes) have been incorporated after every chapter for easy and quick revision before the examinations.
I hope that this book will also serve as a reference book to general practitioners (GPs), pediatricians and medical officers who are working in district hospitals.
Rakesh Prasad Shrivastav12
13Preface to the First Edition
This book is primarily intended for undergraduate medical students and first year postgraduate ENT residents. The biggest challenge the author faced while writing this book was how to convey the new excitements of this ever-expanding specialty of ENT and Head and Neck to the contemporary medical students. Accordingly, a lot of new material has been included in this book like Functional Endoscopic Sinus Surgery, Cochlear Implantation, etc. However, some omissions had to be made keeping in view the needs of the medical students. While including new advances, emphasis on diseases prevalent in Nepal and this part of the world have not been ignored.
This book particularly emphasizes on clinical methods in ENT, which is so important for undergraduate medical students in Nepal, as they have to take a separate University Examination in ENT – both theory and practical (clinical). Special emphasis has been given to pathophysiology of diseases so that the student understands how and why the diseases occur and help them to remember what he or she has read rather than just ‘mugging up’ without really understanding.
Realizing that medical students are under increasing pressure to study more these days, ‘key points’ (in colored boxes) have been incorporated after every chapter for easy and quick revision before the examinations.
I hope that this book will also serve as a reference book to general practitioners (GPs), pediatricians and medical officers who are working in the different health centers, district hospitals as well as regional hospitals throughout Nepal.
Rakesh Prasad Shrivastav14
15Acknowledgments
Throughout the 30 years that I have been a teacher, I am indebted to my medical students who came forward with suggestions as to what they wanted in an ‘ideal’ ENT textbook. I would also like to thank my colleagues from the Tribhuvan University Teaching Hospital (TUTH) and various other medical colleges throughout Nepal who reluctantly offered their criticism on the first edition of this book! This was the guiding force for me to publish the second edition as a ‘multiauthor book’ with separate section editors.
Special thanks goes to my ENT colleagues in Tribhuvan University Teaching Hospital in particular the section editors: Rabindra B Pradhananga, Prof Bimal Kumar Sinha, Prof Hari Bhattarai, Prof Rajendra Prasad Sharma Guragain, Prof Dharma Kanta Baskota, Prof Bibhu Pradhan, Prof Chop Lal Bhusal and Dr Narmaya Thapa. I am also thankful to other colleagues in TUTH namely, Dr Pabina Rayamajhi, Dr Rabindra Pradhananga, Dr Urmila Gurung, Dr Kunjan Acharya, Dr Heempali Dutta and Dr Yogesh Neupane for authoring the various chapters. My thanks also goes out to my colleague, Dr Pallavi Sinha (TUTH) and audiologist/speech pathologist colleagues from TUTH: Mr Sureshwar Lal Karna, Mr Kabi Raj Khanal, Mrs Shareena Joshi, Mr Subhash Jha, Ms Sushmita Shrestha and Ms Kishan Sharma for giving suggestions from time to time and clarify matters whenever I had doubts.
I would particularly like to thank my colleagues from other medical colleges in Nepal: Prof Anil Jha from Nepal Medical College and Prof Toran KC from Kathmandu Medical College who also authored several chapters in this edition. Above all, I would also like to thank my senior, Prof Ram Chhaya Man Amatya of Kathmandu University School of Medical Sciences and also the first Head of the Department of ENT in TUTH for his never-ending support throughout my career and particularly, in writing the first as well as second edition of this book.
I am grateful to the following ENT colleagues: Dr Anupama Shah Rijal (Nepal Medical College), Dr Sangeeta Shrestha (Kathmandu Medical College), Dr Meera Bista (Kathmandu Medical College), Dr Krishna Koirala (Manipal Medical College, Pokhara), Dr Inku Shrestha Basnet (Kathmandu University School of Medical Sciences) and Dr Bikash Shrestha (Kathmandu University School of Medical Sciences) for authoring the various chapters in this edition.
I am also grateful to my colleagues Dr Nagendra Shah, Dr Kiran Rai (Birendra Army Hospital) and Dr Sarita KC (Birendra Army Hospital) for encouraging me to write the second edition of this book. I am particularly grateful to Dr Yogesh Neupane (TUTH) who helped me out with the index of this edition.
I will fail in my duty if I do not thank Mr Suraj KC, my ‘Man Friday’ for typing the entire manuscript and helping me select and edit the clinical photographs, figures and diagrams and for the many sundries that he carried out from time to time.
A special thanks goes to old family friend, Mr Neil Weir, Emeritus Consultant ENT Surgeon, Royal Surrey County Hospital, Guildford, UK for always being there to help me while editing this book.
Words are not enough for those near and dear to me: My wife Rumi, who almost everyday reminded and nagged me to finish the book and to our children Shreya, Shrinkhala and Shradhan, my brother Er Rajesh Prasad Shrivastav, sister-in-law Rashmi Shrivastav, nieces Ruhi Verma and her husband Shashank Verma and Dr Shilpi Shrivastav, my late sister Sangeeta Prasad, brother-in-law Manoj Kumar, my nephew Dr Aditya Kumar and niece Ipsita Kumar all of whom seriously questioned me several times during these trying times whether this edition was ever going to be completed! Their understanding, encouragement, patience and tolerance helped me to finally complete the second edition of this book.
Last but not the least, I am thankful to Shri Jitendar P Vij (Group Chairman), Mr Ankit Vij (Group President) and Mr Tarun Duneja (Director–Publishing) of M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India, who not only encouraged me to write the second edition of this book but also published it as well.