ENT Mnemonics 1

‫ﻢ ﷲ اﻟﺮﲪﻦ اﻟﺮﺣﲓ‬ ENT Mnemonics Ear *** Eustachian Tube

Cartilage is:

C-SHAPED Collapsed under normal conditions, opens during swallowing, yawning, chewing gums or Valsalva Maneuver. *** Regarding Congenital Cholesteatoma (E

Pidermoid),

Aetiology: -

Persistent Embryonic Squamous Epithelial cells. Sites:

(( Related to

Petrous A Cerebello –

Petrous bone ))

Pex >> Trigeminal Facial Pain

Pontine angle >> Facial tics then Paralysis

Tym

Panum (Middle ear) >> CHL

*** In cholesteatoma, if suspected

COMPlications , ask for COMPuted Tomography (CT ) *** Gra

Denigo’s triad of Petrositis:

Can be encoded by

-

-

3

D

Discharging Ear.

Diplopia & squint due to cranial nerve VI affection, while passing in Dorello Canal.

-

Deep Facial pain, due to affection of Trigeminal “Gasserian” ganglion at the petrous apex. *** Grie

SINger’s sign is characteristic for Lateral SINus thrombosis

(Edema & Tenderness over the posterior border of Mastoid process, resulting from Septic Thrombosis of the Mastoid Emissary vein 2ry to Lateral sinus Thrombophlebitis.)

***

Otosclerosis The golden Letter for Otosclerosis is

F -It’s a -More common in

Familial “Hereditary” disease.

Females in Fertility period “Related to Pregnancy”.

- Characterized by Replacement of normal compact bone by Spongy

Fragile” Bone, then Sclerotic Bone.

Hypervascular “

- Most commonly occurs around the

Footplate of Stapes, leading to its

Fixation. (Stapedial Type).

- In active stage of the disease, Otoscopy may show a

Flamingo-Red

tympanic membrane (Schwartz sign). Treatment: - Surgical: Stapedectomy: (The treatment of choice) - Removal of Stapes & replacement by Te

Flon piston or Wire & Fat.

(This operation may be complicated by Perilymph by Temporalis

Fistula, which’s treated

Fascia graft).

- Medical:

Fluoride.

Sodium

***

MENieRE’s Disease: Using its name, we can encode:

Membranous Labyrinth with ENdolymph, characterized by REcurrent attacks of the triad: Vertigo, - Definition: distension of the

Deafness & tinnitus. -Incidence: More common in - Usually U

Males around the age of 50.

Nilateral (Bilateral in 25 %) ***

In congenital causes of SNHL,

MONdini’s disease: Partial aplasia of the Cochlea, so it’s MONoturn (Single Turn). *** Benign Paroxysmal Positional Vertigo: The Golden Letter is

S - Vertigo of

Sudden onset.

-

Short Duration (30 Seconds).

- When the patient takes a - Cause: debris in posterior

-

Specific Position.

Semicircular canal.

Self-limiting within Six months & improved with Epley Maneuver,

(A specific sequence of head positions that would result in movement of the debris out of the posterior canal, through the common crus and into the vestibule.)

- Resistant cases are

Surgically treated by Singular Nerve Neurectomy. ***

Vestibular investigations (for Vertigo cases), can be encoded by the Word:

CAROTiD (But we’ll use E instead of i :)

CAloric test ROTating chair test Electronystagmography Dynamic posturography

*** Nystagmus can be observed by:

D, E, F, G -

Direct looking at the eye.

-

Electronystagmography. -

Frenzle Glasses. ***

In Tympanometry, to remember what each curve means, let’s think & remember that: Tympanometry = Measurement of Middle ear pressure, through measuring the TM Compliance (Mobility). ***

A = The Best (always class A is the Best). So,

A = Normal

A = Normal ME Pressure A Alone means also Normal TM Compliance ***

As =A+s A = Normal ME Pressure s = stunted = stiffness (Reduced Compliance) s

e.g. Oto clerosis. ***

Ad=A+D A = Normal ME Pressure D = D ynamic = Hypermobility (Increased compliance) e.g. Ossicular chain

D isruption or D islocation. ***

B curve: B for Buildup of FLuid in Middle ear (Otitis Media with Effusion). FLuid >> FLat curve. ***

C curve = Normal Compliance, but –ve ME Pressure.

- In Eustachian Tube Dysfunction. ***

Oscillating Tympanogram =

Pulsatile Pressure = Pulsatile mass = Glomus Tumor ***

Mc Ewen’s triangle is the surgical Landmark for Mastoid Antrum *** Nose *** When the normal ciliary action is inhibited, the cilia stop & become

STILL This can occur due to

STILL Smoking Temperature changes (Excessive heat or cold) ILLness (Infection)

***

Cyclic Asphyxia is characteristic for Bilateral

Choanal Atresia ***

Traumatic diseases of the Nose are 4

F:

Fracture Nasal Bones. Foreign Body in the Nose. Oroantral

CS

Fistula.

F Rhinorrhea. ***

CSF Rhinorrhea increases by CSF Coughing Straining Forward leaning (Tea Pot Sign)

***

CSF Biochemical analysis shows the following Characteristics: Clear & Colorless Sugar more than 30% Reduces

Fehling’s solution

F

Contains B2 Trans errin (Diagnostic) (B2 only in CSF) *** Investigations of

CSF Rhinorrhea can be encoded by CSF

- CT Scan with intrathecal Omnipaque. - Intrathecal Fluoresciene, then detect it in the Nasal Cavity by Nasal endoscope.

- CSF Biochemical Analysis (Mentioned before) ***

Treatment of

CSF Rhinorrhea can be encoded by CSF Conservative :

-Most traumatic cases heal spontaneously. - Bed rest in semi-setting position with head-up. - Avoid CSF (Coughing, Straining &Forward leaning) - Avoid Blowing of Nose. - Avoid Nasal Medications (Drops or Packs) - Prophylactic antibiotics to prevent Meningitis.

Surgical: If conservative failed - Covering the defect by a graft (Temporails

Fascia) or Flap (Muco-

periosteal septal flap. *** Traumatic surgical causes of Oro-antral fistula can be coded by:

DR. X Dental Extraction. Radical Antrum Operation. Xcision of dental or dentigerous Cyst.

E

***

To remember the sequence stages of Rhinoscleroma, remember that Rhino = Nose = ‫أﻧف‬

ANF = ‫أﻧف‬ -Active

Atrophic stage.

Nodular stage (Hypertrophic). -

Fibrotic stage ***

LuPus Vulgaris affects the Anterior CartiLagenous part of the Nasal septum, causing the characteristic APPLe Jelly nodules. *** 3ry

Syphilis affects the Posterior Bony part of the Nasal Septum, causing Saddle Nose. *** Complications of

-

Septal Abscess:

Supratip depression: due to Necrosis of septal cartilage & septal perforation.

- Cavernous

Sinus Thrombosis: due to spread of infection via emissary veins (Dangerous area of the face). *** In management of Epistaxis: First aid:

- The patient is seated with the head flexed forwards & Apply: -Direct

Compression: pinching the nose between 2 fingers. -

-

Cold Compresses.

Constrictors. (Introduce cotton piece soaked with Vasoconstrictor into the nose for 10 minutes). *** Investigations to detect the cause of Epistaxis: -

Coagulation Profile.

Complete blood count.

Computed Tomography (CT).

± Biopsy (If tumor is suspected). *** Best Wishes dr R.M