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5. A middle aged woman complaining of pain in the right ear & vertigo,
ear examination revealed post auricular scar of previous operation done
for the treatment of Cholesteatoma, the middle ear ossicles are removed
during the operation.
a. What is the cause of vertigo & pain?
Removal of the ossicles results in formation of radical cavity "the middle
ear cavity communicate with the mastoid" so exposure of the lateral canal
in the radical cavity make it sensitive to weather changes causing "vertigo
& pain ".
11. A middle aged male came to ENT clinic complaining of pain and
dysphagia. On examination, there was a membrane covering the right
tonsil.
a. What is the differential diagnosis of a membrane in the throat?
DD of a membrane in the throat = DD of ulcers in the throat. As any ulcer
in the throat will be covered by a membrane.
N.B: Acute follicular tonsillitis is presented bilaterally.
2. Weber test is more sensitive than Rinne test; as the Weber can
differentiate the hearing loss between the 2 ears when the difference is
5 db in between, while the difference between both ears in Rinne is 20
db.
3. Tensor palati is the main opener of the ET.
4. Why does the posterior perforation of the drum affect hearing more
than the anterior perforation?
The round window is exposed through the posterior perforation during
transmission of sound.
Some sound waves transmitted through the exposed round window to the inner
ear, While the other waves transmitted by the usual pathway to the oval window.
So both waves oppose each other and finally the movement of the inner ear fluid
becomes minimal.
2. A 42 years old male complaining of hypertrophy of the left ala of nose &
the area around it. It is of short duration a month ago & it is slowly
progressive. From the CT scan there was opacity in the left maxillary
sinus.
a. What is the most probable diagnosis?
Benign mass in the alveolar region causing 2ry mucosal oedema in the
maxillary sinus produces hypertrophy around the ala of nose this appears
from the CT scan.
N.B: Pan Coast tumor: the 1st sign produced by is left vocal cord paralysis.
duration by examination of the ear there was otitis media with effusion
while examination of the nasopharynx shows mass occupying fossa of
Rosen-Muller.
a. What is the most probable cause of this case?
Nasopharyngeal tumor occluding the ET.
All Team "One Vision One Mission"
N.B: Otitis media with effusion is a disease of children when comes in adult may be
due to obstruction of the ET by nasopharyngeal tumor.
6. A 8 years old girl came to ENT clinic with her mother complaining of
high temperature 38.5 C, sore throat, dysphagia & later otalgia. All these
symptoms occur 2 days ago and the recurrence rate: 3 times / year.
a. What is your diagnosis?
Acute follicular tonsillitis.
b. When you take a decision for tonsillectomy?
If the recurrence rate of tonsillitis is more than 5-6 times / year Do
operation, otherwise Don't do it.
c. What are the criteria should be present to diagnose an attack?
High fever > 38 C.
Inability to swallow.
Enlargement of upper deep cervical lymph node.
All Team "One Vision One Mission"
7. A 35 years old male complaining of left painless neck mass 4 months ago
is annoying him because of disfigurement.
a. What is your diagnosis?
Lymph node enlargement in case of occult primary.
b. How can you ensure this case?
History
Examination
Write them in details.
Investigations
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