Iraqi Board ENT flashcards

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

Cholesteatoma

Keratinising squamous epithelium within the middle ear or mastoid that erodes bone. Typically presents with painless foul otorrhoea and conductive hearing loss. Treatment is surgical excision, as medical therapy alone cannot cure it.

Rinne test

Tuning fork test comparing air versus bone conduction. A positive Rinne means air conduction is greater than bone (normal or sensorineural loss); a negative Rinne means bone conduction is greater, indicating conductive hearing loss on that side.

Epley manoeuvre

A canalith repositioning sequence for posterior canal benign paroxysmal positional vertigo. It moves otoconia from the posterior canal back to the utricle. It is the first-line treatment and is repeated if symptoms persist.

Bell's palsy

Idiopathic acute lower motor neuron facial palsy affecting the whole ipsilateral face, including the forehead. Corticosteroids within 72 hours improve outcomes. Eye protection is essential. Recovery is incomplete in about one-third of cases.

CRSwNP

Chronic rhinosinusitis with nasal polyps: at least 12 weeks of nasal obstruction, discharge, facial pain, or hyposmia plus endoscopic polyps. Strongly associated with asthma and aspirin sensitivity; treated with intranasal and oral steroids, then surgery.

Ostiomeatal complex

The drainage pathway of the maxillary, anterior ethmoid, and frontal sinuses into the middle meatus. Obstruction here is the central mechanism in chronic rhinosinusitis, and opening it is the core of functional endoscopic sinus surgery.

Kiesselbach's plexus

An arterial anastomotic network on the anterior nasal septum formed by branches of the anterior ethmoidal, sphenopalatine, greater palatine, and superior labial arteries. It is the most common site of epistaxis.

Inverted papilloma

A benign but locally aggressive sinonasal epithelial tumour that grows into the underlying stroma. It usually presents as a unilateral nasal mass and carries a risk of malignant transformation, so it is excised completely with close follow-up.

Glottic cancer prognosis

Glottic cancer presents early with hoarseness and has sparse lymphatic drainage, so it metastasises late and has the best prognosis of laryngeal sites. Supraglottic cancer presents late because its rich lymphatics spread early.

Follicular thyroid carcinoma

A thyroid malignancy diagnosed by capsular or vascular invasion on histology, not by cytology. It spreads haematogenously to bone and lung. Treatment is total thyroidectomy, followed by radioiodine ablation in selected cases.

Pleomorphic adenoma

The most common benign salivary gland tumour, most often in the parotid. It is a mixed tumour with epithelial and stromal elements. It requires excision with a margin because of the risk of recurrence and malignant transformation.

Neck dissection levels

Level I is submental and submandibular; II–IV are the jugular chain; V is the posterior triangle; VI is the central compartment. Oral cavity cancer drains to levels I–III, and thyroid cancer to level VI.

Vocal fold nodules

Bilateral benign swellings at the junction of the anterior and middle thirds of the vocal folds, caused by phonotrauma. Voice therapy is the primary treatment, and surgery is reserved for lesions that persist despite therapy.

Recurrent laryngeal nerve

A branch of the vagus that supplies all intrinsic laryngeal muscles except the cricothyroid. On the right it loops around the subclavian artery; on the left around the aortic arch. Injury causes hoarseness and aspiration.

Tracheostomy indications

Prolonged mechanical ventilation, upper airway obstruction, and protection of the airway from aspiration. It is also used for long-term airway access. Early complications include bleeding; late complications include stenosis and fistula.

Subglottic stenosis

Narrowing of the airway below the vocal folds, most often after prolonged intubation or from autoimmune disease such as granulomatosis with polyangiitis. Treatment options are dilation, laser, or resection with end-to-end anastomosis.

Acute otitis media

Acute middle-ear infection with a bulging, opaque tympanic membrane and otalgia, most often caused by Streptococcus pneumoniae, Haemophilus influenzae, or Moraxella catarrhalis. Amoxicillin is the first-line antibiotic.

Sistrunk procedure

Excision of a thyroglossal duct cyst together with the central portion of the hyoid bone and the tract up to the foramen caecum. It is performed because the tract must be removed completely to prevent recurrence.

Laryngomalacia

The most common cause of stridor in infants, caused by floppy supraglottic tissue that collapses on inspiration. The stridor is worse when supine and on feeding. It usually resolves by age 2, and supraglottoplasty is reserved for severe cases.

Tonsillectomy indications

Recurrent throat infection meeting frequency criteria (seven episodes in one year, five per year for two years, or three per year for three years), obstructive sleep apnoea, or suspected malignancy. It is not indicated for minor recurrent sore throats.

Paediatric OSA

Obstructive sleep apnoea in children, usually caused by adenotonsillar hypertrophy. Adenotonsillectomy is first-line treatment. Severe cases, obesity, Down syndrome, or craniofacial anomalies may require post-operative monitoring.

Spreader graft

A cartilage graft placed between the upper lateral cartilages and the septum during rhinoplasty. It widens the middle vault, prevents inverted-V deformity after dorsal reduction, and improves the internal nasal valve.

Le Fort fractures

Midface fractures classified by level: Le Fort I is the low transverse maxillary fracture, Le Fort II is pyramidal through the maxilla and nasal bones, and Le Fort III is craniofacial disjunction through the orbit and zygoma.

Septal haematoma

Blood collection between the septal cartilage and perichondrium after nasal trauma. It can cause cartilage necrosis and a saddle deformity, so it is drained immediately and a splint is placed with antibiotics.

Z-plasty

A scar revision technique using two triangular flaps that transposes tissue. It lengthens a contracted scar, reorients it along relaxed skin tension lines, and releases contracture bands. The limbs are usually 60 degrees.

Peritonsillar abscess

A collection of pus between the tonsillar capsule and the superior constrictor muscle, causing unilateral sore throat, trismus, and a displaced uvula. Treatment is needle aspiration or incision and drainage plus antibiotics.

Ludwig's angina

Bilateral submandibular and sublingual cellulitis, usually from a dental infection. It causes a brawny neck swelling, tongue elevation, and airway compromise. Management is urgent airway control, antibiotics, and surgical drainage.

Button battery impaction

A battery lodged in the nose or oesophagus that causes liquefactive necrosis within hours. It is an emergency requiring immediate removal and evaluation for perforation. Do not delay for imaging if the history is clear.

Tympanometry types

Type A is a normal peak near 0 daPa; type B is a flat trace from effusion or perforation; type C is a peak shifted to negative pressure from eustachian tube dysfunction. The probe tone is usually 226 Hz.

Otoacoustic emissions

Sounds produced by outer hair cells of the cochlea, recorded in the ear canal. They are present in normal cochlear function and absent in sensorineural loss above about 25–30 dB. They are used for newborn screening.

Cochlear implant criteria

Severe-to-profound bilateral sensorineural hearing loss with limited benefit from hearing aids. Children are implanted as early as possible to support language development. A functioning auditory nerve is required.

Recurrent laryngeal nerve anatomy

The right RLN loops around the subclavian artery and the left around the aortic arch. The left is longer and more exposed to mediastinal disease. Both run in the tracheo-oesophageal groove and supply all intrinsic muscles except the cricothyroid.

Aminoglycoside ototoxicity

Aminoglycosides damage cochlear and vestibular hair cells, causing irreversible sensorineural hearing loss and imbalance. Risk increases with prolonged use, renal impairment, and loop diuretics. Intratympanic gentamicin is used therapeutically in Ménière's disease.