Diseases of Ear, Nose and Throat

This book is a complete guide to the diagnosis and management of ENT diseases for undergraduate medical students and trainees in otolaryngology.

Divided into nine sections, the text begins with an overview of the anatomy and physiology of each part of the otolaryngologic system and explains bacteria, antibiotics, fungi and viruses, and HIV.

The following sections cover numerous diseases and disorders in each otolaryngologic region – ear, nose and sinuses, oral cavity and salivary glands, pharynx and oesophagus, larynx, trachea and bronchus; and neck. The final chapters discuss surgical procedures, imaging, radio- and chemotherapy, anaesthesia, and laser surgery.

The second edition has been fully revised to provide students with the latest information, and features many new topics, including a clinical highlights section to assist preparation for examinations, and a comprehensive appendix of 101 clinical secrets, problem-oriented clinical cases, and miscellaneous key points.

The book is accompanied by a complimentary online resource featuring the full text as an ebook, MCQs with image-based questions, live surgery videos, and animation.

Key points

• Fully revised, second edition providing comprehensive guide to ENT diseases
• Includes clinical highlights section and comprehensive appendix to assist with exam preparation
• Accompanied by free online resource featuring ebook, MCQs, and surgical videos
• Previous edition (9789350259436) published in 2012

Author information

Mohan Bansal MS PhD FICS FACS
In-charge, Department of Otorhinolaryngology, Head and Neck Surgery, CU Shah Medical College Surendranagar, Gujarat, India

CONTENTS

SECTION 1

BASIC SCIENCES

1. Anatomy and Physiology of Ear 1

2. Anatomy and Physiology of Nose and Paranasal Sinuses 30

3. Anatomy and Physiology of Oral Cavity, Pharynx and Esophagus 50

■Oral Cavity 51; ■Salivary Glands53 ; ■Pharynx56; ■Esophagus63; ■Physiology of Swallowing64; ■Pharyngial (Branchial) Apparatus65

4. Anatomy and Physiology of Larynx and Tracheobronchial Tree 68

5. Anatomy of Neck 79

■Surface Anatomy 80; ■Triangles of Neck 81; ■Cervical Fascia 81; ■Lymph Nodes 83; ■Neck Dissection 84; ■Thyroid 86; ■Parathyroid 88

6. Bacteria and Antibiotics 89

7. Fungi and Viruses 101

8. Human Immunodeficiency Virus Infection 106

9. History and Examination 113

■Otorhinolaryngology 114; ■History Taking 114; ■Physical Examination 115; ■General Set-up 116;

■Swellings and Ulcers 117; ■Sinus and Fistula 121; ■Examination of Cranial Nerves 122; ■Headache 122;

■Facial Pain 127; ■Temporomandibular Disorders 128

SECTION 2

EAR

10. Otologic Symptoms and Examination 131

■Ear Symptoms131; ■Ear Examination131; ■Otalgia134; ■Otorrhea136; ■Ear Polyp139; ■Tinnitus139; ■Hyperacusis144

11. Hearing Evaluation 145

12. Conductive Hearing Loss and Otosclerosis 160

■Classification of Hearing Loss160; ■Conductive Hearing Loss160; ■Otosclerosis162; ■Stapedectomy165

13. Sensorineural Hearing Loss 168

14. Hearing Impairment in Infants and Young Children 178

15. Hearing Aids and Cochlear Implants 187

16. Diseases of External Ear and Tympanic Membrane 198

17. Disorders of Eustachian Tube 210

18. Acute Otitis Media and Otitis Media with Effusion 217

19. Chronic Suppurative Otitis Media and Cholesteatoma 224

20. Complications of Suppurative Otitis Media 235

21. Evaluation of Dizzy Patient 247

22. Peripheral Vestibular Disorders 259

23. Central Vestibular Disorders 271

24. Facial Nerve Disorders 278

25. Tumors of the Ear and Cerebellopontine Angle 293

■Benign Tumors of External Ear293; ■Malignant Tumors of External Ear295; ■Tumors of Middle Ear and Mastoid296; ■Acoustic Neuroma299

SECTION 3

NOSE AND PARANASAL SINUSES

26. Nasal Symptoms and Examination 305

■History Taking306; ■Examination306; ■Smell311; ■Measurement of Mucociliary Flow312; ■Nasal Obstruction312; ■Nasal Valves Disorders314; ■Proptosis (Exophthalmos)315

27. Diseases of External Nose and Epistaxis 316

28. Rhinosinusitis 325

■Viral Rhinosinusitis326; ■Acute Bacterial Rhinosinusitis326; ■Chronic Rhinosinusitis329; ■Pediatric Rhinosinusitis331; ■Complications of Rhinosinusitis332; ■Nasal Polyps335

29. Nasal Manifestation of Systemic Diseases 338

■Wegener’s Granulomatosis 338; ■Peripheral T-cell Neoplasm 339; ■Atrophic Rhinitis (Ozena) 340; ■Rhinitis Sicca 341; ■Rhinitis Caseosa 341; ■Sarcoidosis 341; ■Churg-Strauss Syndrome 342; ■Rhinoscleroma 342; ■Tuberculosis 342; ■Lupus Vulgaris 342; ■Nontuberculous Mycobacteria 342; ■Leprosy 343; ■Syphilis 343; ■Histoplasmosis 343; ■Rhinosporidiosis 343; ■Fungal Sinusitis 344

30. Allergic and Nonallergic Rhinitis 347

■Allergy and Immunology348; ■Allergic Rhinitis350; ■Nonallergic Rhinitis (Vasomotor Rhinitis)358

31. Nasal Septum 361

■Fracture of Nasal Septum361; ■Deviated Nasal Septum362; ■Septal Hematoma364; ■Septal Abscess364; ■Septal Perforation 365; ■Hypertrophied Turbinates365; ■Nasal Synechia366; ■Choanal Atresia367

32. Maxillofacial Trauma 368

■Etiology368; ■Classification368; ■General Principles369; ■Evaluation370; ■Oroantral Fistula379; ■Cerebrospinal Fluid Rhinorrhea379; ■Foreign Body Nose381; ■Rhinolith381; ■Nasal Myiasis (Maggots Nose)381

33. Tumors of Nose, Paranasal Sinuses and Jaws 383

SECTION 4

ORAL CAVITY AND SALIVARY GLANDS

34. Oral Symptoms and Examination 397

■Oral Cavity: Symptoms and Examination397, 398; ■Evaluation of Oral Cancer Patient401; ■Salivary Glands: Clinical Features402; ■Diagnostic Imaging402; ■Fine-needle Aspiration Cytology404; ■Drooling404

35. Oral Mucosal Lesions 406

36. Disorders of Salivary Glands 420

37. Neoplasms of the Oral Cavity 434

SECTION 5

PHARYNX AND ESOPHAGUS

38. Pharyngeal Symptoms and Examination 447

■Evaluation of Pharynx447; ■Evaluation of Esophagus450; ■Dysphagia452

39. Pharyngitis and Adenotonsillar Disease 455

■Pharyngitis455; ■Infectious Mononucleosis456; ■Streptococcal Tonsillitis-pharyngitis456; ■Faucial Diphtheria458; ■Tonsillar Concretions or Tonsilloliths459; ■Intratonsillar Abscess459; ■Tonsillar Cyst459; ■

Keratosis Pharyngitis459; ■Diseases of Lingual Tonsils459; ■Chronic Adenotonsillar Hypertrophy460; • Obstructive Sleep Apnea in Children 461

40. Snoring and Obstructive Sleep Apnea 463

41. Tumors of Nasopharynx 470

42. Tumors of Oropharynx 478

■Malignant Tumors478;■Benign Swellings482; ■Parapharyngeal Tumors483; ■Stylalgia (Eagle’s yndrome)483

43. Malignant Tumors of Hypopharynx 485

44. Disorders of Esophagus 490

SECTION 6

LARYNX, TRACHEA AND BRONCHUS

45. Laryngeal Symptoms and Examination 503

■Symptoms503; ■Examination503; ■Endoscopy504; ■Stroboscopy508; ■Narrow Band Imaging 509; ■Laryngeal Electromyography509; ■Hoarseness of Voice509; ■Stridor511

46. Infections of Larynx 515

47. Benign Tumors of Larynx 523

48. Neurological Disorders of Larynx 530

■Neurological Disorders of Larynx530; ■Phonosurgery535; ■Aspiration535

49. Voice and Speech Disorders 537

50. Malignant Tumors of Larynx 544

51. Management of Impaired Airway 553

■Tracheostomy553; ■Cricothyrotomy557; ■Congenital Lesions of Larynx558; ■Foreign Bodies of Air Passages560; ■Laryngotracheal Trauma562

SECTION 7

NECK

52. Cervical Symptoms and Examination 565

■Neck565History 565; •Physical Examination 565; •Diagnostic Tests 568; •Unknown Neck Mass 568■Thyroid 568History 568; •Examination 569; •Investigations 572

53. Neck Masses, Thyroid and Parathyroid 573

■Neck Masses573; ■Disorders of Thyroid Gland580; ■Thyroid Neoplasms584; ■Malignant Tumors of Thyroid587; ■Thyroid Surgery591; ■Parathyroid Tumors592

54. Deep Neck Infections 594

SECTION 8

OPERATIVE PROCEDURES AND INSTRUMENTS

55. Middle Ear and Mastoid Surgeries 605

■Myringotomy and Tympanostomy Tubes605; ■Mastoidectomy607; ■Simple Cortical Mastoidectomy

608; ■Radical Mastoidectomy610; ■Modified Radical Mastoidectomy611; ■Tympanoplasty612

56. Operations of Nose, Paranasal Sinuses and Skull Base 616

■Diagnostic Nasal Endoscopy 617; ■Endoscopic Sinus Surgery617; ■Antral Puncture620; ■Inferior Meatal Antrostomy621; ■Caldwell-Luc Operation621; ■Submucous Resection of Septum623; ■Septoplasty623; ■Rhinoplasty626; ■Pituitary Surgery628; ■Endoscopic Skull Base Surgery 629

57. Adenotonsillectomy 631

58. Endoscopies 637

■Direct Laryngoscopy/Microlaryngoscopy637; ■Bronchoscopy Rigid and Flexible639, 640; ■Esophagoscopy Rigid and Flexible642, 643

59. Instruments 645

■Outpatient Department Instruments646; ■Mastoid and Ear Microsurgery648; Antrum Puncture651; ■Inferior Meatal Antrostomy651; ■Nasal Bone Fracture651; ■Nasal Septal and Sinus Surgery651; ■Mouth Gags and Retractors655; ■Adenotonsillectomy655; ■Quinsy658; ■Endoscopes659; ■Tracheostomy661; ■Airway Devices663

SECTION 9

RELATED DISCIPLINES

60. Diagnostic Imaging 665

■Conventional Radiology665; ■Orthopantomogram668; ■Ultrasound669; ■Computerized Tomography669; ■Magnetic Resonance Imaging671; ■Radionuclide Imaging672; ■Interventional Radiology672; ■Applications of CT, MRI and Ultrasound672; ■CT Anatomy of Ear, Nose, Throat, Head and Neck674; CT and MRI Criteria for Secondary Neck Nodes 679

61. Radiotherapy and Chemotherapy 680

■Tumor Biology681; ■Radiotherapy682; ■Chemotherapy688; ■Prevention of Cancer691

62. Anesthesia 692

■General Anesthesia693; ■Immediate Airway Management696; ■Local Anesthesia698

63. Laser Surgery and Other Technologies 700

■Laser700; ■Photodynamic Therapy704; ■Radiofrequency Surgery704; ■Cryosurgery704; ■Hyperbaric Oxygen Therapy 705; ■Robotic Surgery in Otorhinolaryngology706

Appendix 707

■Top 101 Clinical Secrets707■Problem-oriented Clinical Cases710■Miscellaneous Key Points712

Index 715