DO-HNS (RCSI) flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Rinne test

Tuning fork test comparing air and bone conduction; normal air greater than bone (positive); bone greater than air indicates conductive hearing loss on that side.

Weber test

Tuning fork placed on midline forehead; lateralises to the ear with conductive loss and away from the ear with sensorineural loss.

Dix-Hallpike manoeuvre

Diagnostic positioning test for benign paroxysmal positional vertigo; elicits vertigo and torsional nystagmus in posterior canal variant.

Epley manoeuvre

Repositioning sequence for posterior canal benign paroxysmal positional vertigo; moves otoconia from canal back to utricle.

Meniere disease

Episodic vertigo lasting 20 minutes to hours with fluctuating low-frequency sensorineural hearing loss, tinnitus and aural fullness.

Otosclerosis

Progressive conductive hearing loss from stapes fixation; normal tympanic membrane, absent stapes reflexes, Carhart notch at 2 kHz.

House-Brackmann scale

Six-grade clinical grading of facial nerve function from I (normal) to VI (total paralysis), used to track recovery.

Epistaxis anatomy

Most bleeds arise from Kiesselbach plexus on anterior septum; posterior bleeds arise from sphenopalatine artery branches.

Nasal septal haematoma

Blood collection between septal cartilage and perichondrium after trauma; requires urgent drainage to prevent saddle deformity and abscess.

Beta-2 transferrin

Protein found almost exclusively in cerebrospinal fluid; used to confirm cerebrospinal fluid rhinorrhoea from clear nasal discharge.

Sistrunk procedure

Excision of thyroglossal duct cyst, tract and central hyoid bone; definitive treatment for thyroglossal duct cyst.

Recurrent laryngeal nerve

Supplies all intrinsic laryngeal muscles except cricothyroid; loops around subclavian artery on right and aortic arch on left.

Neck node levels

Level I submental/submandibular, II upper jugular, III middle jugular, IV lower jugular, V posterior triangle, VI anterior compartment.

Paradise criteria

Tonsillectomy indications: 7 or more episodes in 1 year, or 5 per year for 2 years, or 3 per year for 3 years.

Croup

Laryngotracheobronchitis with barking cough and inspiratory stridor; steeple sign on X-ray; treat with dexamethasone.

Epiglottitis

Haemophilus influenzae type b infection with drooling, tripod posture and muffled voice; avoid throat examination; secure airway.

Choanal atresia

Congenital bony or membranous closure of posterior nasal aperture; bilateral causes cyanosis relieved by crying.

Organ of Corti

Sensory epithelium on basilar membrane containing inner and outer hair cells; transduces sound into electrical signals.

Endocochlear potential

Positive 80 mV potential in scala media maintained by stria vascularis; drives hair cell transduction.

Myoelastic-aerodynamic theory

Vocal fold vibration driven by subglottal pressure and mucosal wave; Bernoulli effect assists fold closure.

Tympanometry types

Type A normal, type B flat effusion, type C negative pressure; type As stiff and type Ad hypermobile.

Acoustic reflex

Stapedius muscle contraction in response to loud sound; absent in conductive loss, severe sensorineural loss and retrocochlear lesions.

Sudden sensorineural hearing loss

Loss greater than 30 dB across 3 contiguous frequencies within 72 hours; treat urgently with high-dose corticosteroids.

HINTS examination

Head impulse test, nystagmus and test of skew; distinguishes central from peripheral vertigo in acute vestibular syndrome.

Juvenile nasopharyngeal angiofibroma

Benign vascular tumour in adolescent males with recurrent epistaxis and nasal obstruction; do not biopsy; treat with embolisation and resection.

Laryngomalacia

Commonest cause of infant stridor; inspiratory stridor worse on lying and feeding; usually resolves by 12-18 months.

Subglottic haemangioma

Vascular lesion causing progressive inspiratory stridor in infancy; treat with propranolol; avoid tracheostomy if possible.

Newborn hearing screening

Automated otoacoustic emissions or auditory brainstem response; positive screen requires diagnostic ABR by 3 months.

Le Fort fractures

Midface fracture classification: I low transverse maxilla, II pyramidal, III craniofacial disjunction; assess midface mobility.

Orbital blowout fracture

Fracture of orbital floor with restricted upward gaze, enophthalmos and infraorbital numbness; CT confirms; repair if entrapment.

Inverted papilloma

Unilateral nasal mass with bleeding; associated with HPV; risk of malignant transformation; treat with endoscopic resection.

Connexin 26 mutation

Commonest genetic cause of non-syndromic sensorineural hearing loss; autosomal recessive inheritance.