ENT Mnemonics 1

ﲓﺣﺮﻟا ﻦﲪﺮﻟا ﷲ ﻢ

ENT Mnemonics

Ear

***

Eustachian Tube

C

artilage is:

C

-SHAPED

C

ollapsed under normal conditions, opens during swallowing, yawning, chewing gums or Valsalva Maneuver.

***

Regarding Congenital Cholesteatoma(E

P

idermoid), Aetiology:

-

P

ersistent EmbryonicSquamous Epithelial cells. Sites: (( Related to

P

etrous bone ))

P

etrous A

P

ex>> Trigeminal Facial

P

ain

Cerebello –

P

ontine angle>> Facial tics then

P

aralysis Tym

P

anum (Middle ear) >> CHL

***

In cholesteatoma,

if suspected

COMP

lications, ask for

COMP

uted Tomography (CT )

***

Gra

D

enigo’s triad of Petrositis: Can be encoded by

3

D

-

D

ischarging Ear.

-

D

iplopia & squint due to cranial nerve VI affection, while passing in

D

orello Canal.

-

D

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

***

Grie

SIN

ger’s signis characteristic forLateral

SIN

us 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

F

amilial“Hereditary” disease.

-More common in

F

emalesin

F

ertility period“Related to Pregnancy”. - Characterized by Replacement of normal compact bone by Spongy

Hypervascular “

F

ragile” Bone, then Sclerotic Bone.

- Most commonly occurs around the

F

ootplate of Stapes, leading to its

F

ixation. (Stapedial Type).

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

F

lamingo-Red tympanic membrane(Schwartz sign).

Treatment: - Surgical:

Stapedectomy: (The treatment of choice)

- Removal of Stapes & replacement by Te

F

lon piston or Wire &

F

at. (This operation may be complicated by Perilymph

F

istula, which’s treated

by Temporalis

F

ascia graft). - Medical:

Sodium

F

luoride. ***

M

EN

ie

RE

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

- Definition: distension of the

M

embranous Labyrinth with

EN

dolymph,characterized by

RE

current attacks of the triad: Vertigo, Deafness & tinnitus.

-Incidence: More common in

M

alesaround the age of 50. - Usually U

N

i

lateral (Bilateral in 25 %)

***

In congenital causes of SNHL,

MON

dini’s

disease:Partial aplasia of the Cochlea, so it’s

MON

o

-turn (Single Turn).

***

Benign Paroxysmal Positional Vertigo: The Golden Letter is

S

-

S

hort Duration (30

S

econds).

- When the patient takes a

S

pecific Position. - Cause: debris in posterior

S

emicircular canal.

-

S

elf-limitingwithin

S

ix 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

S

urgically treated by

S

ingular Nerve Neurectomy. ***

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

CA

ROT

i

D

(But we’ll use

E

instead of

i

:)

CA

loric test

ROT

ating chair test

E

lectronystagmography

***

Nystagmus can be observed by:

D

,

E

,

F

,

G

-

D

irect looking at the eye. -

E

lectronystagmography.

-

F

renzle

G

lasses. ***

In Tympanometry, to remember what each curve means, let’s think & remember that:

Tympanometry=Measurementof Middle earpressure, 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 ***

A

s

=

A

+

s

A

=

Normal

ME Pressure

s

=

s

tunted =

s

tiffness (Reduced Compliance) e.g. Oto

s

clerosis.

***

A

d

=

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

B

uildup of

FL

uidin Middle ear (Otitis Media with Effusion).

FL

uid >>

FL

at curve. ***

C

curve =Normal

C

ompliance, but –ve ME Pressure.

- In Eustachian Tube Dysfunction. ***

Oscillating

Tympanogram

=

Pulsatile

Pressure =

Pulsatile

mass =Glomus Tumor

***

M

c Ewen’s triangle is the surgical Landmark for

M

astoid Antrum ***

Nose ***

When the normal ciliary action is inhibited, the cilia stop & become

STILL

This can occur due to

S

T

ILL

S

moking

T

emperature changes (Excessive heat or cold)

ILL

ness (Infection)

***

C

yclic

A

sphyx

ia

is characteristic for Bilateral

C

hoanal

A

tres

ia

***

Traumatic diseases of the Nose are4

F

:

F

ractureNasal Bones.

F

oreign Body in the Nose. Oroantral

F

istula. CS

F

Rhinorrhea. ***

C

S

F

Rhinorrhea increases by

C

S

F

C

oughing

S

training

***

C

S

F

Biochemical analysis shows the following Characteristics:

C

lear &

C

olorless

S

ugar more than 30%

Reduces

F

ehling’s solution

Contains

B2 Trans

F

errin

(Diagnostic) (B2 only in CSF) ***

Investigations of

C

S

F

Rhinorrhea can be encoded by

C

S

F

- C

T

S

can

with intrathecal Omnipaque.

-

Intrathecal

F

luoresciene, then detect it in the Nasal Cavity by Nasal endoscope.

- C

S

F

Biochemical Analysis

(Mentioned before) ***

Treatment of

C

S

F

Rhinorrhea can be encoded by

C

S

F

C

onservative

:

-Most traumatic cases heal spontaneously. - Bed rest in semi-setting position with head-up. - Avoid

C

S

F

(

Coughing,

Straining &

Forward leaning

)

- Avoid Blowing of Nose.

- Avoid Nasal Medications (Drops or Packs) - Prophylactic antibiotics to prevent Meningitis.

S

urgical

:

If conservative failed

- Covering the defect by a graft (Temporails

F

ascia) or

F

lap (Muco-periosteal septal flap.

***

Traumatic surgical causes of Oro-antral fistula can be coded by:

D

R.

X

D

ental Extraction.

R

adical Antrum Operation.

E

X

cision of dental or dentigerous Cyst.

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

A

N

F

= فﻧأ -

A

trophic stage.

-Active

N

odularstage (Hypertrophic). -

F

ibrotic stage

***

L

u

P

us Vulgarisaffects the Anterior CartiLagenous part of the Nasal septum, causing the characteristic A

PPL

e Jelly nodules.

***

3ry

S

yphilis affectsthe Posterior Bony part of the Nasal Septum, causing

S

addle Nose.

***

Complications of

S

eptal Abscess:

-

S

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

- Cavernous

S

inus 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

Co

mpression: pinching the nose between 2 fingers.

-

Co

ld Compresses.

-

Co

nstrictors. (Introduce cotton piece soaked with Vasoconstrictor into the nose for 10 minutes).

***

Investigations to detect the cause of Epistaxis: -

Co

agulation Profile.

-

Co

mplete blood count. -

Co

mputed Tomography (CT).

± Biopsy (If tumor is suspected). ***

Best Wishes