CONTENTS

Section 1 : Basic Sciences

1. Anatomy and Physiology of Ear Temporal Bone 2

1 Anatomy of External Ear 2 Auricle 2; EkternalAuditory Canal 4; TympanicMembrane 5; Middle EarAnatomy 6; PartsofMiddle Ear(Tympanum) 6. Boundaries of Middle Ear Z Ossicles 8; lntratympanic Muscles 9 lntratympanic Nerves 9; Middle Ear Mucosa 9; CompartmentsandFoldsofMiddleEar 9; MastoidAntrum 11; TypesofMastoid 1 I; Korner'sSeptum 1 I; BloodSupply 13; Lymphatic Drarnage of Ear 13

Anatomy of Internal Ear 13 Bony Labyrinth 13; Membranous Labyrinth 15; Inner Ear Fluids 14. Organ of Corti 16; Vestibular Receptors 16; Blood Supply of Labyrinth 19; Internal Auditory Canal 19

Development of Ear 19 Central Connections (Neural Pathways) 20 Audrtory Neural Pathways 20; Central Vestibular Connections 21; Physiology of Hearing 22; Conduction ofsound 22 Transduction of Mechanical Energy to Electrical Impulses 23; Medial Geniculate Body and Temporal Lobe Auditory Cortex 25

Physiology ofvestibular System 25 Semicircular Canals Functions 25; Utricle and Saccule Functions 26

1 Maintenance of Body Equilibrium 26

2. Anatomy and Physiology of Nose and Paranasal Sinuses 1 Anatomy of Nose 30

External Nose 30; lnternal Nose 30; Anatomy ofParanasalSinuses 37

Physiology of Nose 39 Respiration 39; Air-ConditioningoflnspiredAir 4$ Protection ofAirway 40; Vocal Resonance 41; NasalReflexes 41; Olfaction 4 1

1 Physiology of Paranasal Sinuses 41 Functions 4 1; Ventilation ofsinuses 42

3. Anatomy and Physiology of Oral Cavity, Pharynx and Esophagus 1 Oral Cavity 44

Salivary Glands 46 1 Pharynx 49

Waldeyer's Ring 5 t Nasopharynx 51 Adenoids 52

Oropharynx 52 Palatine (Faucial) Tonsils 53

Laryngopharynx 56 Esophagus 56

1 Physiology of Swallowing 58 Embryology 58

4. Anatomy and Physiology of Larynx and Tracheobronchial Tree Anatomy of Larynx 61 Cartilages 61; Joints 62; Membranes and Ligaments 62; Cavity of the Larynx 63; Mucous Membrane of the

xii 3 Larynx 64; Lymphatic Drainage 64; Spaces of the Larynx 64; Functional Divisions of Vocal Folds 65; Phase Difference 65; Muscles of Larynx 65; Nerve Supply of Larynx 66; Development 67

Functions of Larynx 68 Protection of Lower Airways 68; Phonation and Speech 68; Respiration 68; Fixation of Chest 68

Anatomy ofTracheobronchial Tree 68 Trachea and Bronchi 68; Tracheal Cartilages 68; Mucosa 69; Bronchopulmonary Segments 69

5. Anatomy of Neck Surface Anatomy 72; Triangles of Neck 73; Cervical Fascia 74; Lymph Nodes of Head and Neck 75; Neck Dissection 78; ThyroidGIand 78; ParathyroidGlands 79; Development 79

6. Bacteria and Antibiotics Bacteria 81 Staphylococci 81; Streptococci 83; Corynebacterium Diphtheriae 83; NeisseriaSpecies 84; MorexellaCatarrhalis 84; Haemophilus lnfluenzae 84; Bordetella Pertussis 84; Pseudomonas Aeruginosa 84; Enterobacteriaceae 84; Anaerobes 84; MicroaerophilicBacteria 84; Mycobacteria 84; Mycoplasma Pneumoniae 85; Chlamydiae 85; Spirochaetes 85

Antibiotics 85 lnhibitors of Bacterial Cell Wall Synthesis (Beta-Lactam Antibiotics) 86; Inhibitors of Nucleic Acid Synthesis 88;

lnhibitors of Bacterial Protein Synthesis (Ribosomal) 88; An titubercular Drugs 89; Nonspecific Antiseptics 90

7. Fungi and Viruses Fungi 93 Antifungal Therapy 93 Viruses 94 Antivirals 95 Pandemic Influenza A H l N 1 (Swine Nu] %

IC o 8. Human Immunodeficiency Virus Infection U) HIV/AIDS 101; CervicalAdenopathy 104; Neoplasms 704; NoseandSinuses 105; Nasopharynx 705; Ear 105; 3 m Oral Cavity 105; Occupational Exposure 106 a, U) 9. History and Examination b' Otorhinolaryngology 707; History Taking 108; Physical Examination 108; Generalset-Up 109; Swellings and Ulcers 109;

Examination of Cranial Nerves I 15; Headache 115; Facial Pain 120; Temporomandibular (Craniomandibular) Disorders 12 1

Section 2 : Ear

10. Otologic Symptoms and Examination Ear Symptoms 125 Ear Examination 125 Otalgia (Earache) 128 Otorrhea 130 Assessment 13 1 Ear Polyp 132 Tinnitus 132 Hyperacusis 135

1 1. Hearing Evaluation i-' . ,t..

Audiology and Acoustics 138; Types of Hearing Loss 139; Need of Hearing Evaluation 139; Methods of Hearing Evaluation 139; TuningFork Tests 140; Pure ToneAudiometry 142; SpeechAudiometry 143; Impedance Audiometry 144; Electrocochleography 145; Brainstem EvokedResponseAudiometry 146; OtoacousticEmissions 746; Auditory Steady State Response (ASSR) 147

12. Conductive Hearing Loss and Otosclerosis Classification of Hearing Loss 149; Conductive Hearing Loss 149; Otosclerosis 150; Stapedectomy 153

13. Sensorineural Hearing Loss Sensorineural Hearing Loss 157; Labyrinthitis 158; Syphilis 158; Cisplatin 760; Aminoglycoside Antibiotics 160; Noise Trauma 160; Sudden Sensorineural Hearing Loss 16 1; Presbycusis 162; Genetic Sensorineural Hearing Loss 163; Non-Organic Hearing Loss 163; Degree of Hearing Loss 164; The Only Hearing Ear 165

I 14. Hearing Impairment in lnfants and Young Children Etiology 167;. Clinical Features 168; High-Risk Registry 168; Universal Newborn Hearing Screening (UNHS) 168; Evaluation of Universal Newborn Hearing Screening Refer Infants 169; Other Hearing Tests 170; Treatment 171; Rehabilitative Measures 171

15. Hearing Aids and Cochlear Implants Training 173; Hearing Aids 174; Assistive Devrces 177; Implantable Hearing Aids 177; Cochlear Implants 178; Audrtory Brainstem Implant 182

16. Diseases of External Ear and Tympanic Membrane 183 Disorders of Auricle 183

1 Congenital Disorders 183; Traumatic Disorders 185; Erysipelas 186; Perrchondritis and Chondritis 186; Chondrodermatrtrs Nodu- laris Chronica Hebcis 186; Relapsing Polychondritis 186

Disorders of External Auditory Canal 187 Congenital Disorders of External Auditory Canal 187; Trauma of External Auditory Canal 187; Forergn Bodres of Ear 187; Ear Maggots 187;. Otitis Externa 187; Otomycosis 189; Furunculosis 189; Keratosis Obturans 189; Ear Wax 190; Ear Syringing 190; Herpes Zoster Oticus-Ramsay Hunt Syndrome (Varicellazoster Virus) 191; Bullous Otitrs Externa and Myringitis 191

I Disorders ofTympanic Membrane 191 Granular Myringrtis 19 1; Malignant or Necrotizrng Otrtrs Externa 191; Retracted Tympanic Membrane 191; Tympanosclerosrs 192; Perforatron of Tympanic Membrane 192; Traumatic Rupture of Tympanic Membrane 192

17. Disorders of Eustachian Tube Anatomy 194; Physiology 1%; Examination of Eustachian Tube 1%; Tests for Eustachian Tube Function 197 Obstruction of Eustachian Tube 198; Patulous Eustachian Tube 199

18, Acute Otitis Media and Otitis Media with Effusion Acute Otitis Media 201 Etiopathology 201; ClrnicalFeatures 201; Diagnoas 202; Treatment 202; RecurrentAcute Otitis Media 203; Acute Necrotising 0 t h Media 204

Otitis Media with Effusion 204 Etrology 204; Clrnical Features 2 W Dragnosis 204; Treatment 205; Sequelae and Complications 205; Aero Otitrs Media (Otrt, - Barotrauma) 205

19. Chronic Suppurative Otitis Media and Cholesteatoma Mastoid Pneumatization 207; Atelectasis and Adhesive Otitis Media 208; Chronic Suppurative Otrtrs Medra 208; Atticoantral CSOM or Chronic OM with Cholesteatoma 210; Tubotympanic CSOM or Chronrc OM without Cholesteatoma 214

20. Complications of Suppurative Otitis Media

1 Factors lnfluencrng Development of Complications 217; Pathways ofspread 217; Acute Mastorditis 218; Masked (Latent) Mastorditis 21 9; Extratemporal Complications (Abscesses) 21 9 Petrositis or Petrous Apicitis 22Q Facral Nerve Paralysis 221; Labynnthrtrs 221; Extradural(Epidura1)Abscess 221; SubduralAbscessor Empyema 221; Meningrtis 222; OtogenrcBrarn Abscess 223; LateralSinus Thrombophlebitis 224; Otitic Hydrocephalus 225

21. Evaluation of Dizzy Patient f Evaluation-General Outline 228; Description of Dizziness 228; Onset, Duratron and Progression 230; Provoking Factors 230;

AssociatedSymptoms 23 1; Personal, Family and Past History 23 1; Spontaneous Nystagmus 23 1; Dynamic Ocular Exammation 232. Frstula Test 232; Valsalva Maneuver 233; Dix-Hallpike Maneuver 233; Optokinetrc Test 234; Rotation Tests 2M; CaloricTest 234; Tandem Walking 235 Romberg's Test 235 Cerebellar Tests 235 Hyperventilatron 23% OrthostaticHypoten- aon 239 Special Vestibular investigations 235 Differences between Central and Peripheral Vertrgo 235

22. Peripheral Vestibular Disorders . Benign Paroxysmal Posrtional Vertigo 237;. Acute Vestibular Neuritrs 239; Meniere's Disease (idiopathic Endolymphatic Hydrops) 241; Delayed Endolymphatic Hydrops 244; Recurrent Vestrbulopathy 244; Middle Ear Effusron 244; Labyrinthrne Fistula 244; Serous Labynnthitis 24% Suppuratrve (Purulent) Labyrinthrtis 245; PerilymphaticFistula 245

23. Central Vestibular Disorders Mlgrarne 248; Vertebrobasilar lnsufticiency 250; Subclavian Steal Syndrome 259 Wallenberg's Syndrome 25Q Cerebellar Infarction 251; Cerebellar Hemorrhage 251; Multiple Sclerosis 251; Motion Sickness 252; Phobic Postural Vertigo 253; Hypervent~lation 253; Agoraphobia 253; Cervical Vertigo or Whiplash Vertigo 253

24. Facial Nerve Disorders Pertinent Anatomy 255; Surgical Landmarks 257; Clinical Evaluation of Facial Palsy 258; Pathophysiology of Nerve Injury 258; Sunderland Classification 258; Differences between Upper and Lower Motor Neuron Palsy 259; Investigations 25% Causes of Facial Nerve Paralysis 267; Sequelae/Complication of Facial Nerve Palsy 261; Bell's Palsy 262; Recurrent Facral

xiv - Palsy 263; Melkersson's Syndrome 26.3; Ramsay Hunt Syndrome or Herpes Zoster Oticus (Varicella-Zoster Virus) 263; Temporal Bone Fracture 263; Lyme Disease (Bannwarth's Syndrome) 265; Sarcoidosis 265; Mobius Syndrome 265; Iatrogenic or Surgical Trauma 265; Hyperkinetic Disorders of Facial Nerve 266; Surgical Treatment of Facial Nerve Palsy 266

25. Tumors of the Ear and Cerebellopontine Angle 268 Benign Tumors of External Ear 268; Malignant Tumors of External Ear 269; Tumors of Middle Ear and Mastoid 2 M ; Internal Auditory Canal and Cerebellopontine Angle 273

Section 3 : Nose and Paranasal Sinuses

26. Nasal Symptoms and Examination HistoryTaking 279 Examination 280 External Nose 280; Vestibule 280; Anterior Rhinoscopy (Examination of Nasal Cavity) 28 1; Posterior Rhinoscopy 284; Patency of Nasal Cavities 284; Sense of Smell 284; Paranasal Sinuses 284 Special lnvestigations of Nasal Complaints 285 Smell 285; Measurement of Mucociliary Now 286; Nasal Obstruction 286; Nasal Valves Disorders 287; Radiological Imaging 288; Diagnostic Antrum Puncture 288; Allergic Tests 288

27. Diseases of External Nose and Epistaxis Diseases of External Nose 289 Infections 289; Deformities of External Nose 290; Tumors of External Nose 291

Epistaxis 293 PertinentAnatomy 293; Causes 293; Evaluation 293; Sites of Epistaxis 295; lnvestigations 294; Treatment 294

28. Infectious Rhinosinusitis Classification 298; Viral Rhinosinusitis 1Common Cold) 299; Pandemic Influenza A Hl Nl (Swine Nu) 299; Acute Bacterial Rhinosinusitis 299; Chronic Rhinosinusitis 302; Pediatric Rhinosinusitis 304; Complications of Rhinosinusitis 305; Mucocele/Pyocele 305; Orbital Complications 306; Osteomyelitis/Osteitis 306; Cavernous Sinus Thrombosis 307; lntracranialComplications 307; Hypertrophied Turbinates 307; Nasal Polyps 307; Fungal Sinusitis 309; Atrophic Rhinitis (Ozena) 309

29. Nasal Manifestation of Systemic Diseases Wegener's Granulomatosis 3 12; Perrpheral T-cell Neoplasm (Nonhealing Midline Granuloma, Polymorphic Reticulosis) 3 13; Atrophic Rhinitis (Ozena) 3 13; Rhinitis Sicca 3 14; Rhinitis Caseosa 3 14; Sarcoidosis 3 14; Churg-Strauss Syndrome 3 15; Rhinoscleroma 3 15; Tuberculosis 3 15; Lupus Vulgaris 3 15; Nontuberculous Mycobacteria 3 16; Leprosy 3 16; Syphilis 3 16; Histoplasmosis 3 16; Rhinosporidiosis 3 16; Fungal Sinusitis 317

30. Allergic and Nonallergic Rhinitis Allergy and Immunology 321 Types of immunologic (Hypersensitivity) Mechanism 322

Allergic Rhinitis 323 Etiology 323; Classification 324; lnvestigations 326; Treatment 327

Nonallergic Rhinitis (Vasomotor Rhinitis) 330 Pathophysiology 330; Classification 330; ClinicalFeatures 331; lnvestigations 332; Treatment 332

31. Nasal Septum Fracture of Nasal Septum 333; Deviated NasalSeptum 334; Septal Hematoma 336; Septal Abscess 336; Perforation ofNasalSeptum 336; Hypertrophied Turbinates 337; NasalSynechia 337; Choanal Atresia 337

32. Maxillofacial Trauma Etiology 339; Classification 340; General Principles 340; Evaluation 341; Soft Tissue Injuries 342; Frontal Sinus 342; Supraorbital Ridge 342; Frontal Bone 342; Nasal Bones and Septum 342; Naso-Orbital Ethmoid (NOE) 344; Zygoma (Tripod Fracture) 344; Zygomatic Arch 345; Orbit (Blowout Fracture) 345; Naso-Maxillary Complex 345; Mandible 346; Oroantral Fistula 347; Cerebrospinal Fluid Rhinorrhea 348; Foreign Body Nose 349; Rhinolith 349; Nasal Myiasis (Maggots Nose) 350

33. Tumors of Nose, Paranasal Sinuses and Jaws Tumors of Nose and Paranasal Sinuses 352 Neoplasms in Children 352; Diagnosis 352; Angiofibroma 353; lntranasal Meningoencephalocele 353; Gliomas 353; Nasal Dermoid 353; Monostotic Fibrous Dysplosia 353; Squamous Papilloma 353; Osteomas 353; Pleomorphic

Adenoma 353; Chondroma 353; Schwannoma and Neurofibroma 353; Ossifying Fibroma and Cementoma 354; Odontogenic Tumors 354; Inverted Papilloma 354; Meningiomas 354; Hemangiomas 354; Hemangiopericytoma 354; Plasmacytoma 354; Malignant Neoplasms 354; Malignancy of Maxillary Sinus 358; Malignancy of Ethmoid Sinus 358; Malignancy of Frontal Sinus 359; Malignancy ofsphenoid Sinus 359; Adenocarcinoma 359; Adenoid Cystic Carcinoma 359; Malignant Melanoma 359; Olfactory Neuroblastoma 359; Sarcomas 359; Rhabdomyosarcoma 360

b Tumors and Related Jaw Lesions 360 Management of Jaw Swellings 360; Fissural Cysts 36 1; Periapical Cysts 36 1; Follicular (Den tigerous) Cysts 36 1;

1, Odontogenic Keratocyst 36 1; Basal Cell Nevus Syndrome 362; Retention Cyst 362; Ameloblastoma 362; Ossibing Fibroma 362; Fibrous Dysplasia 362; Cherubism 362; Adenomatoid Odon togenic Tumor 363

5 Section 4 : Oral Cavity and Salivary Glands

34. Oral Symptoms and Examination Oral Cavity 365; Evaluation of Cancer Lesions 369; Salivary Glands 369; Diagnostic Imaging 370; Fine-Needle Aspiration Cytology 372

35. Oral Mucosal Lesions RedNVhite Lesions 374 Oral Submucous Fibrosis 374; Leukoedema 375; Oral Leukoplakia 376; Oral Hairy Leukoplakia 377; Oral Lichen Planus 378; Chronic Discoid Lupus Erythematosus 378; Candidiasis (Moniliasis) 378; Fordyce's Spots 379; Nicotine Stomatitis 379

1 Vesiculobullous/Ulcerative Lesions 379 Pemphigus Vulgaris 379; Mucous Membrane Pemphigoid or Cicatricial Pemphigoid 379; Herpes Simplex Virus: Herpetic

Ging~vostomatitis or Orolabial Herpes 380; Hand, Foot and Mouth Disease 381; Herpangina 381; Acute Necrotizrng

Ulcerative Gingivitis 38 1; Recurrent Aphthous Stomatitis 381; Behcet's Syndrome 383; Erythema Multiforme 383; (Eosinophilic) Granuloma 384; Traumatic Ulcers 384; Radiation Mucositis 384; Blood Disorders 384; Drug-Induced

Oral Lesions 384

Pigmented Lesions 384 Melanotic Macules 385; Melanoma 385; Amalgam Tattoo 385

Lesions of Tongue 385 Geographical Tongue or Migratory Glossitis 385; Hairy Tongue 385; Fissured Tongue 385; Tongue Tie (Ankyloglossia) 386

36. Disorders of Salivary Glands inflammatory Disorders 387 Acute Suppurative Sialadenitis 388; Parotid Abscess 389; Neonatal Suppurative Parotitis 390; Recurrent Parotitis of Childhood 390; Chronic Sialadenitis 391; Tuberculous Mycobacterial Disease 391; Nontuberculous Mycobacterial Dlsease 391; Actinomycosis 392; CatScratch Disease 392; Toxoplasmosis 393; HIV 393

1 Obstructive Disorders 393 Sialolithiasis 393

Neoplasms of Salivary Glands 394 Histogenesis of Neoplasms 394; Pleomorphic Adenoma 395; Warthin's Tumor or Adenolymphoma (Papillary

Cystadenoma Lymphomatosuml 3%; Oncocytoma 3%; Hemangiomas 3%; Lymphangiomas 3%; Mucoepidermoid

Carcinoma 3%; Adenoid Cystic Carcinoma (Cylindroma) 397; Acinic Cell Carcinoma 398; Squamous Cell Carcinoma 398;

Malignant Mixed Tumor 398; Adenocarcinoma 398; Lymphoepithelial Carcinoma or Undifferentiated Carcinoma 398

Xerostomia 398 Sjogren's Syndrome 398; Diffuse Infiltrative Lymphocytosis Syndrome 399; Frey's Syndrome (Gustatory Sweating) 399

37. Neoplasms of Oral Cavity Benign Tumors of Oral Cavity 401 Papilloma 401; PleomorphicAdenoma 402; Hemangioma 402; Lymphangioma 402; GranularCeNTumor 402;

Ameloblastoma 402; Torus 403; PyogenicGranuloma 403; Irritation Fibroma 403; Mucocele 403;

Ranula 403; DermoidCysts 403

Carcinoma of Oral Cavity 403 Carcinoma Lips 406; Carcinoma Gingiva/Alveolar Ridge 407; Carcinoma Oral Tongue 407; Carcinoma Floor of Mouth 409;

Carcinoma Buccal Mucosa 4 10; Carcinoma Hard Palate 4 1 1; Carcinoma Retromolar Trigone 4 1 1;

Minor Salivary Gland Tumors 4 12; Melanoma 4 12; Kaposi's Sarcoma 4 12

Section 5 : Pharynx and Esophagus

38. Pharyngeal Symptoms and Examination Evaluation of Pharynx 41 5 Nasopharynx 4 15; Oropharynx 4 16; Laryngopharynx 4 17

Evaluation of Esophagus 41 7 Barium Esophagography 4 18; Esophageal Manometry 420; Ambulatory24-Hours EsophagealpH Record~ng 420; Esophagoscopy 420

Dysphagia 420 Evaluation 42 1

39. Pharyngitis and Adenotonsillar Disease Pharyngitis 423; lnfectious Mononucleosis 424; Streptococcal Tonsillitis-Pharyngitis 424; Faucial Diphtheria 425; Tonsillar Concretions/Tonsilloliths 426; lntratonsillar Abscess 427; Tonsillar Cyst 427; Keratosis Pharyngitis 427; Diseases of Lingual Tonsils 427; Chronic Adenotonsillar Hypertrophy 427; Adenoid Facies and Craniofacial Growth Abnormalities 428; Obstructive Sleep Apnea 428

40. Sleep Apnea and Sleep-Disordered Breathing Pathophysiology of Obstructive Sleep Apnea 43 1; Diagnosis and Evaluation of OSA 43 1; Severity of OSA 432; Complications of OSA 433; Nonsurgical Treatment 433; Surgical Treatment of OSA 434; Surgical Treatment of Snoring without OSA 435

41. Tumors of Nasopharynx Juvenile NasopharyngealAngiofibroma 437; NasopharyngealCarcinoma 438; Teratomas 441; Thornwaldt's Disease (Pharyngeal Bursitis) 44 1; Proptosis (Exophthalmos) 44 1

42. Tumors of Oropharynx Malignant Tumors 443 Histopathology 443; Risk Factors 444; Evaluation 444; Staging 444; Treatment 444; Carcinoma Base of Tongue 445; Carcinoma Tonsil 446; Lymphoma 446; Carcinoma Soft Palate 446; Carcinoma Posterior Pharyngeal Wall 447

Benign Swellings 447 Parapharyngeal Tumors 448; Stylalgia (Eagle's Syndrome) 448

43. Malignant Tumors of Hypopharynx RiskFactors 449; Pathology 450; ClinicalFeatures 45Q Diagnosis 450; Staging 450; Management 450; Carcinoma Pyriform Sinus 45 1; Carcinoma Postcricoid 452; Carcinoma Posterior Pharyngeal Wall 453

Disorders of Esophagus Perforation of Esophagus 455; Corrosive Burns 456; Mallory Weiss Syndrome 457; Foreign Bodies 457; Pill-Induced Esophagitis 458; GastroesophagealReflux Disease 458; Barrett's Esophagus 460; Benign Strictures 460; Hiatus Hernia 460; Schatzki's Ring 46 1; Plummer-Vinson (Patterson Brown-Kelly) Syndrome 461; Infectious Esophagitis 46 1; Cricopharyngeal Spasm 462; Diffuse Esophageal Spasm 462; Nutcracker Esophagus 462; Cardiac Achalasia 462; Scleroderma or Progressive SystemicSclerosis 4 3 ; ZenkerDiverticulum 463; Globus Hystericus Pharyngeus 463; Benign Neoplasms 463; Carcinoma Esophagus 464

Section 6 : Larynx, Trachea and Bronchus

45. Laryngeal Symptoms and Examination Symptoms 467; Clinical Examination 467; Endoscopy 469; Laryngoscopic Parameters and Patient's Task 471; Stroboscopy 472; Direct Laryngoscopy (Microlaryngoscopy) and Bronchoscopy 472

1 Hoarseness of Voice 472 Stridor 473 Assessment of Patient with Stridor 473; Treatment 475

5 46. Infections of Larynx 477

Acute Laryngotracheobronchitis Croup or Laryngotracheitis 478; Bacterial Tracheitis 479; Pediatric Epiglottitis 479;

Adult Supraglottitis 480; Whooping Cough 480; Diphtheria 480; Chronic Nonspecific Laryngitis 481; Atrophic Laryngitis (Laryngitis

Sicca) 481; Tuberculosis 481; Lupus 482; Syphilis 482; Leprosy (Hansen's Disease) 482; Scleroma 482;

Edema of Larynx 483 I

47. Benign Tumors of Larynx Vocal Nodules (Singer's or Screamer's Nodules) 485; Vocal Polyp 485; Reinke's Edema (Bilateral Diffuse Polyposis) 486; Contact Ulcer or Granuloma 486; Intubation Granuloma 486; Leukoplakia or Keratosis 487; Amyloid Tumors 487; Ductal Cysts 487; SaccularCysts 487; Laryngocele 487; RecurrentRespiratory Papillomatosis 488; Chondroma 488; Hemangioma 488

48. Neurologic Disorders of Larynx Neurological Disorders of Larynx 490; Classification of Laryngeal Paralysis 491; Positions of Vocal Cords 491; Causes of Laryngeal Paralysis 491; Unilateral Recurrent Laryngeal Nerve (RLN) Paralysis 491; Bilateral Recurrent Laryngeal Nerve (Abductor) Paralysis 492; Unilateral Superior Laryngeal Nerve Paralysis 492; Bilateral Superior Laryngeal Nerve Paralysis 492; Unilateral Combined (Complete) Paralysis of Recurrent and Superior Laryngeal Nerve 492; Bilateral Combined (Complete) Paralysis of Recurren t and Superior Laryngeal Nerve 493; Congenital Vocal Cord Paralysis 493; Phonosurgery 493

49. Voice and Speech Disorders Voice and Speech 495; Classification of Voice and Speech Disorders 4%; Dysphonia Plica Ventricularis (Ventricular Dysphonia) 497; Functional Aphonia (Hysterical Aphonia) 497; Puberphonia (Mutabon Falsetto Voice) 497; Phonasthenia 497; Hyponasality (Rhinolalia Clausa) 497; Hypernasality (Rhinolalia Aperta) 497; Spasmodic Dysphonia 498; Vocal Tremor 498; Stuttering 498; Myoclonus 499; Tourette'sSyndrome 499; Botulinum Toxin Therapy 499

50. Malignant Tumors of Larynx 501 Risk Factors 501; Evaluation 502; Staging 503; Management 504; Glottic Cancer 505; Supraglottic Cancer 506; Subglottic Cancer 507; Verrucous Carcinoma 507; Organ Preservation Therapy 507; Photodynamic Therapy 507; Post-Laryngectomy Vocal Rehabilitation 507

51. Management of Impaired Airway Tracheostomy/Tracheotomy 51 0 Cricothyrotomy (Laryngotomy or Coniotomyl 513; Percutaneous Dilational Tracheostomy 513

1 Congenital Lesions of Larynx 514 Laryngomalacia 5 14; Congenital Vocal Cord Paralysis 5 14; Congenital Subglottic Stenosis 514; Laryngeal Web/A tresia 5 15; Subglottic Hemangiomas 5 15; Laryngoesophageal Cleft 5 15

1 Foreign Bodies of Air Passages 51 5 1 Laryngotracheal Trauma 51 7

Section 7 : Neck 52. Cervical Symptoms and Examination

Neck 519 History 519; Physical Examination 579; Diagnostic Tests 522

Thyroid Gland 523 History 523; Examination 523; Investigations 525

53. Neck Nodes, Masses and Thyroid Neck Nodes and Masses 527; Thyroid Neoplasms 532

54. Deep Neck lnfections PerrinentAnatomy 538; Sourcesoflnfections 510; Microbiology 540; Clinical Features 540; Investigations 540; Treatment 54 1; Peritonsillar lnfections 54 1; ParapharyngealSpaceAbscess or Pharyngomaxillary Abscess or Lateral Pharyngeal Space Abscess 542; Acute Retropharyngeal Abscess 543; Chronic Retropharyngeal Abscess or Prevertebral Space Abscess 543; Ludwig's Angina 543; Abscess of Space of Body of Mandible 544; Masticator Space Abscess 544; Trismus 545

Section 8 : Operative Procedures and Instruments

55. Middle Ear and Mastoid Surgeries Myringotomy and Tympanostomy Tubes (Grommet) 547; Mastoidectomy 549; Cortical Mastoidectomy 550; Radical Mastoidectomy 552; ModifiedRadical Mustoidectomy 553; Tympanoplasty 553

56. Operations of Nose and Paranasal Sinuses 557 Sinus Operations 557 Preoperative Assessment 557; Diagnostic Nasal Endoscopy (Sinuscopy) 558; Endoscopic Sinus Surgery 559; An tral Puncture or Proof Puncture 56 1; Inferior Meatal Antrostomy 542; Caldwell-Luc Operation 561 Surgery of Nasal Septum 563 Submucous Resection of Nasal Septum 564; Septoplasty 544; Postoperative Care 565; Complications 565

1 57. Adenotonsillectomy xvi i i - Preoperative Assessment 56z lndicatrons for Tonsillectomy 56Z lndicatrons for Adenoidectomy 568; Contraindications 5&8; Surgical Techniques 568, Preoperative Measures 568; Anesthesia 569; Position 569; Surgrcal lnstruments 569; Operative Steps 568 Postoperative Care 570; Complications 571

58. Endoscopies

I Direct Laryngoscopy/Microlaryngoscopy 573 lndicatrons 574; Contraindicatrons 574; Anesthesia 574; Position 574; Procedures 574; Postoperative Care 575; Complrcatrons 575; Flexible Nasopharyngolaryngoscopy 575

b Bronchoscopy 575 lndicatrons for Bronchoscopy 575; R~gid Bronchoscopy 575; Nexrble Frberoptic Bronchoscopy 576

b Esophagoscopy 577 Indications 577;. ContraindrcationsofEsophagoscopy 57Z Rjgid Esophagoscopy 578; Flexible Esophagoscopy 579

59. lnstruments OPD lnstruments S@ Mastoid and Ear Microsurgery 583; Antrum Puncture 555; Inferior Meatal Antrostomy 585; Nasal Fracture Reduction Forceps E85; Nasal Septa1 and Sinus Surgery 585; Mouth Gags and Retractors 588; Adenotonsillectomy St& Incision and Drainage of Quinsy 590; Endoscopes 590; Tracheostomy 591; Airway Devrces 593

C I- Section 9 : Related Disciplines (B

60. Diagnostic Imaging Conventional Radiology 595; Orthopantomogram 598. Ultrasound 598; Computerized Tomography 598; Magnetic Resonance lmag~ng 5 w Radionuclrde Imaging 600; Interventronal Rad~ology 600; Applicatrons of C7; MRl and US 601;

... CTAnatomy of Ear, Nose, Throat, Head and Neck 602

61. Radiotherapy and Chemotherapy Radiotherapy 609 Basic Physics 609; Radiobiology 6 10; Therapeutrc Wrndow 6 10; Modes of Radrotherapy 6 10; Combined Modality Treatmen t 6 1 C Plann~ng of Radiotherapy 6 1 1; Complications of Radiotherapy 632

Chemotherapy 613 Palliative Chemotherapy 6 1% Combined Modality Therapy 6 15; Organ Preservation 616; lntra-Arterral Chemotherapy 6 1i$ Prevention of Cancer 6 16

,62. Anesthesia General Anesthesia 618 lmmediate Airway Management 621; Local Anesthesia 622

63. Laser Surgery and Cryosurgery

I Laser 625 RelatedPhys~cs 625; ControlofLaser 626 Tissue Effect Laserln Otolaryngology 6- PhotodynamicTherapy 628

b Radiofrequency Surgery 628 Cryosurgery 628 Hyperbaric Oxygen Therapy 629

Appendix Top TO 1 Clinical Secrets 631; Problem-Oriented Cases 634; Miscellaneous Key Points 636

Index