EBEORL-HNS flashcards

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

Rinne test positive

Air conduction exceeds bone conduction in the tested ear, indicating normal hearing or sensorineural loss. A negative Rinne, where bone conduction exceeds air conduction, indicates conductive hearing loss.

Weber test lateralization

A tuning fork on the midline forehead lateralizes to the ear with conductive hearing loss, or to the better-hearing ear in unilateral sensorineural loss, because bone conduction is relatively enhanced on the conductive side.

Pure-tone average

The average of air-conduction thresholds at 500, 1000, and 2000 Hz, used to grade hearing loss severity from mild (26-40 dB) through profound (greater than 90 dB).

Cochlear tonotopic organization

High-frequency sounds are encoded at the basal turn of the cochlea and low frequencies at the apex, so basal lesions preferentially impair high tones while apical lesions affect low tones.

Outer hair cell function

Outer hair cells provide the active cochlear amplifier, sharpening frequency tuning; their loss causes recruitment, reduced frequency selectivity, and poor speech discrimination out of proportion to pure-tone thresholds.

Recurrent laryngeal nerve course

The right nerve loops under the subclavian artery and the left under the aortic arch at the ligamentum arteriosum, making the left nerve longer and more vulnerable to mediastinal disease.

Kiesselbach plexus

An anterior nasal septal vascular network fed by branches of the internal and external carotid systems; it is the source of most anterior epistaxis and is accessible to cautery.

Sphenopalatine artery hemorrhage

Posterior epistaxis typically arises from the sphenopalatine artery and presents with blood flowing down the pharynx; it responds poorly to anterior packing and may require endoscopic ligation.

Pleomorphic adenoma

The most common benign salivary gland tumor, most often in the parotid; it has a pseudocapsule and a tendency to recur if ruptured, so superficial parotidectomy with facial nerve preservation is standard.

Vestibular schwannoma

A benign Schwann cell tumor of the vestibular division of cranial nerve VIII at the internal acoustic meatus, causing unilateral sensorineural hearing loss, tinnitus, and imbalance; gadolinium MRI is diagnostic.

COWS mnemonic

Cold water irrigation of the ear produces nystagmus with the fast phase opposite the irrigated side; warm water produces the fast phase toward the irrigated side, reflecting the vestibulo-ocular reflex.

Superior laryngeal nerve risk

The external branch of the superior laryngeal nerve runs near the superior thyroid artery and supplies the cricothyroid; injury during superior pole ligation lowers vocal pitch and reduces vocal projection.

Sudden sensorineural hearing loss

Hearing loss of at least 30 dB across three contiguous frequencies developing within 72 hours; it is an emergency treated with high-dose corticosteroids, with intratympanic salvage and MRI to exclude retrocochlear causes.

Anterior epistaxis management

Apply pressure with a topical vasoconstrictor, identify the bleeding point, and cauterize a visible anterior vessel; persistent bleeding escalates to anterior packing and then posterior packing or arterial ligation.

Posterior packing precautions

Posterior nasal packing can compromise the airway and cause hypoxia, so patients require monitoring, supplemental oxygen, and antibiotics; bilateral posterior packs may necessitate airway protection.

Deep neck abscess drainage

Fascial space abscesses with airway compromise or rapid spread require incision and drainage plus broad-spectrum intravenous antibiotics covering aerobes and anaerobes; aspiration alone is inadequate.

Peritonsillar abscess treatment

Confirm with needle aspiration or imaging, then incise and drain under local anesthesia and give antibiotics; interval tonsillectomy is reserved for recurrent tonsillitis, not routinely after one abscess.

Malignant otitis externa

A skull base osteomyelitis of the external auditory canal, usually caused by Pseudomonas aeruginosa in elderly diabetics, presenting with severe otalgia and granulation tissue; treat with prolonged antipseudomonal therapy.

Acute mastoiditis signs

Postauricular erythema, tenderness, and swelling with fever and a bulging tympanic membrane; intravenous antibiotics and drainage are required, and facial palsy or intracranial signs demand urgent imaging.

Stridor airway emergency

Stridor with impending obstruction calls for a controlled approach in the operating room, such as awake fiberoptic intubation or tracheostomy; blind instrumentation and paralysis before securing the airway are hazardous.

Neck node evaluation

A persistent neck mass in an adult warrants fine-needle aspiration and upper aerodigestive endoscopy; open excision of a suspected metastatic node before diagnosis can seed the neck and complicate definitive treatment.

Triple endoscopy

Panendoscopy of the pharynx, larynx, esophagus, and bronchus, used to identify synchronous second primaries and stage head and neck squamous cell carcinoma before treatment planning.

Peripheral versus central vertigo

Peripheral vertigo shows horizontal-rotatory nystagmus suppressed by visual fixation without focal deficits; vertical or direction-changing nystagmus with neurological signs suggests central pathology requiring urgent imaging.

Tracheostomy placement

Elective tracheostomy is placed below the first tracheal ring, avoiding the cricothyroid membrane and first ring to prevent subglottic stenosis; emergency cricothyrotomy is the exception.

Facial nerve in parotid surgery

The facial nerve divides the parotid into superficial and deep lobes; identifying the nerve at the stylomastoid foramen and preserving its branches is the central step in parotidectomy.

Warthin tumor features

A benign parotid tumor composed of oncocytic epithelium and lymphoid tissue, strongly associated with smoking, occurring bilaterally in about 10 percent and most often in the parotid tail.

Vocal fold leukoplakia

A white mucosal plaque of the vocal fold that may harbor dysplasia or carcinoma; it requires biopsy and microlaryngoscopy rather than observation, especially in smokers.

Benign paroxysmal positional vertigo

Brief positional vertigo with torsional nystagmus provoked by head movement, caused by displaced otoconia in a semicircular canal; the Dix-Hallpike test confirms it and canalith repositioning is curative.

Meniere disease triad

Episodic vertigo lasting minutes to hours, fluctuating sensorineural hearing loss, tinnitus, and aural fullness; endolymphatic hydrops is the presumed mechanism, treated first with salt restriction and diuretics.

Cholesteatoma management

Keratinizing squamous epithelium in the middle ear that erodes bone and causes conductive loss, otorrhea, and complications; treatment is surgical removal via tympanomastoidectomy, not medical therapy alone.

Thyroidectomy nerve injury

Recurrent laryngeal nerve injury causes vocal fold paresis with hoarseness and aspiration risk; bilateral injury can obstruct the airway, while external superior laryngeal nerve injury mainly affects pitch.