45 NOTES TO PG

Dr. Ankit Yadavendra, M.B.B.S., Dr.V.M.G.M.C., Solapur

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
area temporal lobe
Auditory Brainstem Response Audiometry(ABRA)
I-IICNVIII(distal&proximal segment)
III-cochlear nucleus
IV-sup olive
V-Lat Leminiscus(Largest wave)
VI-VIIinf colliculus
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 stula
ds-TM
ASOM-presuppurative-cartwheel, suppurative-lighthouse
barotrauma-congested&retracted, air bubble, hgic effusion
healed myringitis bullosa-sagograin
hemotympanum, glue ear, glomus tm, hemangioma middle ear-blue
keratin deposit, osmium tetroxide-snakelike
myringitis bullosa(influenza virus)-hgic bleb
otosclerosis-norm(90%)-translucent&pearly gray, active ds-flamingo tint(pink spot)
retracted-dull lustreless
serous otitis media-dull, opaque, grey/bluish, potbelly
spontaneous heal-dimeric(sq epithbrous layer)
TB otitis media-camphor ice, multiple perforation
tympanosclerosis-chalky white plaque

audiometry
audiometric 0=25db
conductive deafn(mild)40db
sensory(cochlea) deafn(severe)60db
neural(retrocochlear) deafn(very severe)80db
Carhart notch=2000Hz
noise induced trauma4000Hz
auditory fatigue90dB4000Hz
WHO-noise exposure<85db8h5d
Indian fact Act-noise exposure<90db
discomfort120db
pain130db
presbyacusis-HFHL
Meneire ds-LFHL
high freq audiometry-ototoxic drug-8000- 20000Hz
WHO
0-25db-not signif-no difculty
26-40-mild-faint speech
41-55-mod-norm speech
56-70-mod severe-loud speech
71-91-severe-shout/amplied speech
>91-profound-cant understand amplied speech
natural resonance freq
ossicular chain=500-2000Hz
middle ear=800Hz
TM=800-1600Hz
EAC=3000Hz
greatest sensitivity of sound transmission= 500-3000Hz
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%

v poor<70%
tympanometry
A-norm
AS-otoSclerosis
AD-ossicular Disruption
B-Perforation
C-EustaChian tube dysfn
Flat-Fluid/glue ear
impedance audiometry=tympanometry+ stapedial reflex
rehabilitation of deaf
hearing aid-RAM
Receiver
Amplier
Microphone
CIC-Completely In Canal
BTE-Behind The Ear
ITE-In The Ear
BAHA-Bone Anchored Hearing Aid(TES)
Titanium implant, Ext abutment, Sound processor
EAC stenosis, atresia, pus, anotia
cochlear implant(MSTR)-severe deaf
Microphone(pick up acoustic signal) Speech process(sound electric energy)
Transmitter Receiver(stimulator)
elecTrode-scala Tympani
multip channel>single channel implant
MC indication-Mondini dysplasia(cochlea= 1turn)
C/i-MiChael dysplasia(absent cochlea)
lowest age=1y
ideal to avoid maldevelopm-6mth
Alexander dysplasia-basal turn of memb cochlea abs(high freq affect)
Bing Siebmann dysplasia-complete absent memb labyrinth
Sheibes dysplasia-absent memb cochlea, vestibule, bony part norm
lever action
malleus:stapes=1.3:1
TM reliable marker
uMbo>handle>cone of light

spread of inf fr ear

ssure of Santorini-Soft part
ssure of Huschke-bony part
mastoid tip develop-2y
pinna develop adult size-6y
cong anomaly ear
Anotia-cong Absence pinna
bAt-no Antihelix
cleft pinna-cong ssure pinna
collaural stula-b/n EAC&neck, 1st pharyngeal cleft
coloboma lobuli-cong ssure earlobe
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
stula SCCnystagmus
lateral-horizontal(towards normal ear)
superior-rotatory(towards normal ear)
posterior-vertical
abscesssite
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
mastoidectomy

canal wall down-AACSOM+complication

RM
MRM
atticotomy
canal wall up-AACSOMcomplication
cort mastoidectomy(Schwartz operation)
combin approach tympanoplasty
mulberry like
nasal polyP-rhinosPoridiosis
vocal corD-rhinosporiDiosis
nasal mucosa-inf turb hypertrophy
potato nose-rhinophyma
Strawberry nose-Sarcoidosis
tapiR nose-Rhinosclerosis
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 bre
synkinesis-cross innervation CNVII pt close eye twitch angle mouth
desc order freq-sinus
developm, ca, sinusitis-MEFS
mucocele, osteoma-FEMS
fungal ball-MSEF
orbital complication-EFMS
angiobroma nose
Mx-earLy-WiLson transpalatal approach

lAte-SArdAnA transpalatal sublab approach

laser
CO2(10600nm)-larynx, ear
KTP-nose, Pharynx
supraglott-insp dyspnea+feeding difculty
glottis-biphasic dyspnea+hoarseness
subglottis-biphasic dyspnea
trachbronch-exp dyspnea
phonaesthesia(weak voice)
m palsy-glottis shape on ILscopy
thyroarytenoid-ellipse
interarytenoid-triangle
both-keyhole
papillomatosis
juvenile-multiple, spont resolve, recur
SeNile-Single, Never resolve, Never recur
mposition of VCfnn inj
add-median-phonation-RLN
add-paramed-whisper-RLN
cadaver-intermed-circular-RLN,ILN
-gentle abd-breathe-ILN
abd-complete abduct-full breath-ILN
n palsyVC positionsymptMx
u/l RLN-|\-hoarseness-w/w
b/l RLN-||-dyspnea-tracheostomy
u/l SLN-/|-hoarseness-w/w
b/l SLN-/\-aphonia,aspiration-tracheostomy epiglottoplasty
20-30y fem-otosclerosis
30-40y fem-Meniere ds
40-60y-acoustic neuroma
endoscope
90-larynx
60,30(best)-nose
0-ear
A P-Stamberger approach

P A-Wigand approach
1st pass-Inf meatus
2nd pass-Sup meatus
3rd pass-Middle meatus
nasal mass
<2y-intracran mass-meningocele
2-10y-recur polyp-cyst, brosis
10-14y-AC polyp
14y mal-angiobroma
20-40y-ethmoidal polyp
40-60y-inverted/Schneiderian/transitional cell papilloma(always u/l,
10-15%malign-SCC)
>60y-SCC
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-ofce headache, just above med canthus
nasal douche=Na BBC(1:1:2), Bicarbonate, Biborate, Cl
focal lth objective lens
ear-200/250mm
nose/PNS-300mm
larynx-400mm
Lempert endaural incision-above tragus, incisura terminalis
Rosen incision(post wall EAC)-stapedectomy
Wild incision-classic postaural
Last struct to develop in pinna-Lobule
grommet(ventilation tube)
insert after 3mth med Rx failure
Prussac space
ant pouch von Trolusch ant epitympanum
post pouch von Trolusch post epitympanum

ottic capsule
14centre of ossicat
1st appear-16w, last appear-20w
cholesteatoma
cong-IUL
prim-retraction pocket
sec-perforation
tert-iatrogenic
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 mouth
Rx-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
electrolyteendolymphperilymph
Na-3-140
K-144-10
prot-126-(200-400)

glu-(10-40)-(85)
produced by-stria vascularis-capillary of spinal lig
incis ant to SCM-parapharyng abscess
incis post to SCM-retropharyng absces
UPSIT(University of Pennysylvania Smell Inventory)-olfactory power
frontal sinus Sx
frontal sinus trephination
Killian meth
Lothrop meth
Lynch procedure(frontoethmoidectomy)
Riedel meth
classic-ds
Antoni-vestib schwannoma
Austin Kartush classic
A-M,S+,I
B-M,foot plate S+
C-M,S+
D-M,S suprastruct
E-S xation
F-ossicul head Fixation
O-intact Ossicul chain
Austin MOOre-Ossicular lOss
Chandler-orbital complication, E sinusitis
COhN-CONg laryng web
COttoN Myer, McCaffey-CONg laryng stenosis
Devlaki-cong cholesteatoma
European Laryngological Society-Endoscopic Cordectomy(ELSCEC)(SSTTCAVS)
I-Subepithelial
II-Subligamental
III-Transmuscular
IV-Total
IVa-C/l fold
IVb-Arytenoid
IVc-Ventricular fold
IVd-Subglottis

Fisch, GLasscock Jackson-GLomus tm

Ford-sulcus vocalis
Guerin-trauma to face
I-Vert#-CheValley-fr bel-nasal septum, E, orbit spare
II-horiz#(45)-Jarjaway-fr front-E, orbit spare
III-nothing spare
Lederman, Ohgren-ca max
leForte-facial#
I-line through floor M-low max#/floating palate
II-line across nasolabial fold-pyramidal#
III-line through orbit-craniofacial dysjn
Levanson-malign otitis externa
NelSOn-CSOM
Nodar-tiNNitus
descriptioN, preseNce, contiNuous/pulsatile, siNgle/multiple, aNnoyance
SAde-pars tenSA
I-slight retracted TM
II-retracted TM touch incus/stapes
III-TM touch promontary
IV-TM adherent to promontary
Shea-Meneire ds
Issihika-thyroplasty(MLSL)
I-Medialise vocal cord-u/l VC palsy
II-Lateralis VC(thy cartilage split ant)
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

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
stapes-Partial Ossicular Replacem Prosthesis(PORP)
4-malleus,incus,stapes absent, graft on round window-TORP
5-fenestration procedure
instrument
Dunda grant apparatus-cold caloric test
electrolarynx
Blom Singer tracheoesoph prosthesis
handfree electrolarynx
head mirror
concave mirror, focal lth=25cm, diam=89mm, hole=19mm
Menitt device
Siegel speculum
silastic button
2cm nasal perforat
silastic keel
Walsham forceps-#nasal bone
Abbreviations
a-artery, AA-amino acid, abtc-antibiotic, AI-autoimmune
bef-before, bel-below, b/l-bilateral, bld-blood, b/n-between, bn-benign, br-branch,
Bx-biopsy
ca-carcinoma, carb-carbohydrate, c/i-contraindication, c/l-contralateral,
conc-concentration, cong-congenital, Cx-cervix
d-day, def-deficient, ds-disease, d/t-due to, Dx-diagnosis
E-estrogen
fem-female, fr-from
gld-gland, glu-glucose
h-hormone
idiop-idiopathic, i/l-ipsilateral, inf-infection, inj-injury
lig-ligament, LL-lower limb, l/t-leading to
m-muscle, maj-major, mal-male, MC-most common, met-metastasis, min-minor,
mtx-methotrexate, Mx-management
n-nerve, norm-normal

P-progesterone, pl-plasma, prot-protein, pt-patient

Rx-treatment
SCC-squamous cell carcinoma, sr-serum, Sx-surgery, sz-seizure
tm-tumour, ts-tissue
UL-upper limb, u/l-unilateral
vag-vagina, VC-vocal cord, vel-velocity, vert-vertebra, vit-vitamin, vol-volume
w-week, wt-weight
Xr-X ray
y-year
#-fracture
-degree
-(N.B.-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. FOR ANY
FEEDBACK/QUERY PLEASE CONTACT- ankit.yadavendra@facebook.com or
dr.ankityadavendra@gmail.com )