DO-HNS (RCSI) key terms

A tuning fork test comparing air conduction with bone conduction. Air conduction is normally better than bone conduction; a negative Rinne (bone conduction better than air conduction) suggests a conductive hearing loss in that ear.

A tuning fork placed on the midline of the forehead. In a unilateral conductive loss the sound lateralises to the affected ear; in a unilateral sensorineural loss it lateralises to the better ear.

Behavioural hearing test measuring the softest sound heard at each frequency, plotted as air and bone conduction thresholds. It quantifies hearing loss and helps separate conductive from sensorineural patterns.

Low-level sounds produced by the healthy cochlea, especially outer hair cells, and recorded in the ear canal. Their absence suggests cochlear dysfunction and they are used for newborn hearing screening.

An electrophysiological test recording neural activity from the auditory pathway in response to sound. It estimates hearing thresholds objectively and helps screen for retrocochlear lesions.

A benign tumour arising from Schwann cells of the vestibular division of the eighth cranial nerve. It typically causes progressive unilateral sensorineural hearing loss, tinnitus and imbalance, and is diagnosed on MRI.

An abnormal collection of keratinising squamous epithelium in the middle ear or mastoid. It is not a true tumour but expands and erodes bone, causing chronic discharge, hearing loss and possible complications.

Surgical repair of the tympanic membrane, often combined with reconstruction of the ossicular chain. It aims to close a perforation, improve hearing and prevent recurrent middle ear infection.

Surgical removal of mastoid air cells, commonly performed to eradicate cholesteatoma or chronic infection. Variants include cortical, canal wall up and canal wall down procedures.

Assessment of the vestibulo-ocular reflex by irrigating each ear with warm or cool water. It identifies a unilateral vestibular weakness and helps localise the side of a peripheral vestibular disorder.

Brief episodes of spinning vertigo triggered by specific head movements, caused by displaced otoconia within a semicircular canal. It is diagnosed by positional testing and treated with repositioning manoeuvres.

A bedside positional test in which the patient lies back with the head turned and extended. It provokes characteristic nystagmus in posterior canal benign paroxysmal positional vertigo.

Surgery to straighten or reposition the nasal septum. It is performed to relieve nasal obstruction and may be combined with turbinate reduction or sinus surgery.

Reduction in volume of the inferior nasal turbinates, by methods such as submucosal diathermy, radiofrequency ablation or resection. It relieves obstruction caused by turbinate hypertrophy.

Minimally invasive surgery using an endoscope through the nostrils to open sinus drainage pathways and remove diseased tissue. It is used for chronic rhinosinusitis and nasal polyposis.

Benign inflammatory outgrowths of nasal and sinus mucosa causing obstruction, loss of smell and discharge. It is associated with asthma, aspirin sensitivity and chronic rhinosinusitis.

Bleeding from the nose. Most cases arise from Little's area on the anterior septum; posterior bleeding is more often from branches of the sphenopalatine artery and can be severe.

Functional endoscopic sinus surgery: an endoscopic approach that restores sinus ventilation and drainage while preserving normal mucosa. It is a common treatment for medically refractory chronic rhinosinusitis.

Surgical removal of cervical lymph node levels for staging or treatment of head and neck cancer. It may be radical, modified radical or selective, depending on which levels and structures are removed.

Identification and removal of the first draining lymph node from a tumour using dye or radiotracer. If that node is free of cancer, more extensive neck dissection may be avoided.

The commonest cancer of the upper aerodigestive tract, linked to tobacco, alcohol and human papillomavirus. It commonly presents as a persistent neck lump, oral ulcer or hoarseness.

Creation of a surgical opening in the front of the neck into the trachea, usually with a tube inserted. It secures the airway and is used for prolonged ventilation or upper airway obstruction.

An emergency airway procedure opening the cricothyroid membrane to allow ventilation. It is used when the upper airway is obstructed and intubation or tracheostomy cannot be performed quickly.

Examination of the nose, pharynx and larynx with a flexible fibreoptic or chip-tip endoscope passed through the nostril. It allows assessment of the airway and vocal cords at the bedside.

A non-invasive hearing screen in newborns that detects sounds generated by healthy cochlear outer hair cells. A 'refer' result requires repeat testing and formal audiological assessment.

Otitis media with effusion: persistent fluid behind an intact tympanic membrane without acute infection. It causes conductive hearing loss and is common in young children, often resolving spontaneously.

Placement of a small ventilation tube through the tympanic membrane, usually with myringotomy. It aerates the middle ear and is used for persistent glue ear or recurrent acute otitis media.

Surgical removal of the adenoid pad from the nasopharynx. It is performed for nasal obstruction, sleep-disordered breathing or recurrent otitis media, often with tonsillectomy.

Surgical removal of the palatine tonsils. Indications include recurrent tonsillitis, obstructive sleep apnoea and suspected malignancy; postoperative bleeding is an important complication.

Acute viral inflammation of the larynx and subglottis in young children, causing a barking cough, hoarseness and inspiratory stridor. It is usually managed with corticosteroids and supportive care.

Acute inflammation of the epiglottis, now rare because of Hib vaccination. It causes rapid-onset fever, drooling, muffled voice and airway obstruction, and requires urgent airway management.

A harsh breathing sound caused by turbulent airflow through a narrowed airway. Inspiratory stridor suggests laryngeal obstruction, expiratory stridor suggests tracheal or lower airway narrowing, and biphasic stridor suggests subglottic narrowing.

The seventh cranial nerve, supplying the muscles of facial expression and carrying taste from the anterior tongue. It runs through the temporal bone and is at risk in parotid and middle ear surgery.

Weakness of the muscles of facial expression due to dysfunction of the facial nerve, most commonly Bell's palsy. The site of the lesion can be assessed by testing taste and lacrimation.

The three middle ear bones (malleus, incus and stapes) that transmit sound from the tympanic membrane to the oval window. Disruption or fixation causes conductive hearing loss.

The channel connecting the nasopharynx to the middle ear that equalises pressure and clears secretions. Dysfunction predisposes to glue ear and middle ear infection.

The organ in the neck containing the vocal cords, responsible for voice production, airway protection and breathing. It is commonly examined for hoarseness and cancer.

The largest salivary gland, lying in front of and below the ear, drained by Stensen's duct. It is a common site for benign tumours and is crossed by the facial nerve.