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21-ENT
auditory pathway→ 1st-spiral ganglion(bipolar)
→ → 2nd-dorsal,ventral cochlear nucleus cross to opposite side(in trapezoid body)→ → 3rd-sup olivary nucleus lat laminiscus
→ → 4th-inf colliculus inf brachium→ → → 5th-med geniculate body audit radiat sublentiform part internal capsule audit
displacusis-same tone heard as notes of diff pitch in either ear-inj to n to stapedius, cong syphilis(Hennebert sign) EAC exostosis-recur prolong cold H2O exposure hyperacusis-discomfort/pain on exposure to norm sound otitic barotrauma-underH2O diving, descend in aircraft, compression in press chamber paracusis willisi-sound heard better in presence of background noise-otosclerosis Tullio phenom-attack of vertigo/dizziness by loud sound-labyrinthine fistula
Rinne test 20-30db AB gap-–ve 256Hz, +ve 512Hz 30-45db AB gap-–ve 512Hz, +1024Hz 45-60db AB gap-–ve 1024Hz
speech audiometry deafn-rt shift roll over phenom-SNHL cant sustain plateau Speech Reception Threshold(SRT)=sound intensity at which 50% word rpt speech discrimination threshold=% word rpt at 30db above SRT good>90% poor=70-90%
⅓ ⅓ Darwin/auricular tubercle-thick helix(jn up -mid ) low set ear-cong low displaced pinna macrotia-cong large pinna MElotia-cong displaceMEnt pinna microtia-cong small pinna Mozart-Mixing of antihelix&helix polyotia-additional pinna preauric sinus-1st arch anomaly preauric tag-small appendage ant to pinna scroll ear-rim(helix) roll forward,inward Wildermuth-no helix
fistula SCC—nystagmus lateral-horizontal(towards normal ear) superior-rotatory(towards normal ear) posterior-vertical
abscess—site Bezold-SCM sheath Citelle-digastric triangle DuboiS-thymuS(SyphiliS) Gillete-retropharyngeal(b/n pharynx& prevertebral fascia) Luc-temporal bone(roof of EAC) parapharyngeal-parapharyngeal space peritonsillar(quinsy)-tonsillar capsule& sup constrictor PoLitzeri-Labyrinthitis postauricular-behind pinna WilD-subperiosteal mastoiD
Pure Tone Audiometry Rt ear-Red Lt ear-bLue O-AC(unmask) rt X-AC lt [-BC(mask) rt ]-BC lt <-BC(mask) rt >-BC lt
signif-TM quadrant cone of light, grommet insertion, ASOM perforation-AI incision of myringotomy-PI MC site of cholesteatoma, direction of waterjet during syringing-PS
sequele Bell palsy crocodile tear/gustatory lacrimation-faulty regeneration parasympath fibre
American society sympt sinusitis a/c<2w, c/c>12w, a/c on c/c=2-12w minor-halitosis, c/c fever, pain in body, headache, fatigue, cough major-Anosmia, Blockage, Congestion, Discharge(purulent), fEver, Facial pain M sinusitis-cheek, dental, swelling lower eyelid LE sinusitis-root(radix), dorsum, upper eyelid S sinusitis-retroorbital, occipital F sinusitis-office headache, just above med canthus
Eustach tube press diff>15mmHg #Temp bone CNVII palsy-Transv total nasal sept destruction-Weg granulomatosis enlarged vestibular aqueduct>2mm during inspiration main airflow current-middle part cavity in middle meatus parabolic curve
#temporal bone Longitudinal(80%)-CNVIIpalsy(20%) tympanic seg, less&delay, CSF otorrhoea+, Lat skull trauma(parietal blow), conductive deafn, blding fr ear+, #line parallel to Long axis petrous pyramid transverse(20%)-CNVIIpalsy(50%) labyrinthine seg, immediate, frontooccipital trauma, vertigo severe, #line across petrous
c/c hypertrophic candidiasis/candidial leukoplakia white patch oral cavity, not wipe off ant buccal mucosa, post to angle of mouthRx-excision
tonsillectomy torrential bld-paratonsillar v
globus pharyngeus something stuck in throat/sensation of lump tightn in throat relieved by food/talking
allergic pharyngitis granularity in post pharynx d/t-hyperplasia of submucosal lymphoid ts
↓ III-Shortening&relaxing to pitch↑ IV-Lengthening&tensing to pitch
↑ ↓ pitch-fem- , mal-
Tos-pars flaccida(T not t) I-pars flaccida dimple II-retraction pocket is adherent to handle of malleus III-erosion of outer attic wall IV-severe erosion of outer attic wall
Wullstein-tympanoplasty
Aim4a
iims.i
n
temporalis fascia, perichondrium, periosteum, alloderm transcanal>postaural,endaural 1(myringopexy)-graft on malleus 2(myringoincudopexy)-malleus absent, graft over incus 3(columella/myringostapediopexy, bird like)-malleus,incus absent, graft on
THESE NOTES ARE ONLY FOR THE PURPOSE OF GUIDANCE AND HELP TO PG ASPIRANTS, NOT FOR COMMERCIAL OR OTHER PURPOSE. REFERENCE HAS BEEN TAKEN FROM VARIOUS STANDARD TEXTBOOKS.