WACS ORL Membership flashcards

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

Rinne test

A tuning fork test comparing air and bone conduction. Positive (air > bone) indicates normal or sensorineural hearing loss; negative (bone > air) indicates conductive hearing loss.

Weber test

A tuning fork test lateralizing to the affected ear in conductive hearing loss, and to the better ear in sensorineural hearing loss.

Sudden sensorineural hearing loss

≥30 dB hearing loss across three consecutive frequencies within 72 hours. Treat with high-dose corticosteroids (oral or intratympanic) within two weeks of onset.

Cholesteatoma

Keratinizing squamous epithelium in the middle ear, causing foul-smelling otorrhea and conductive hearing loss. Treatment is surgical (tympanomastoidectomy).

BPPV

Benign paroxysmal positional vertigo. Diagnosed with Dix-Hallpike maneuver; treated with Epley canalith repositioning maneuver.

Meniere disease

Episodic vertigo, fluctuating sensorineural hearing loss, tinnitus, and aural fullness. Treat with low-salt diet, diuretics, and intratympanic steroids or gentamicin.

Otosclerosis

Conductive hearing loss with normal tympanic membrane due to stapes fixation. Treatment is stapedotomy or hearing aid.

Acute bacterial rhinosinusitis

Symptoms >10 days or worsening after initial improvement. First-line antibiotics: amoxicillin-clavulanate or doxycycline.

Chronic rhinosinusitis

≥12 weeks of symptoms. Diagnose with nasal endoscopy and CT scan. Treat with saline irrigation, intranasal corticosteroids, and antibiotics for exacerbations.

Nasal polyps

Bilateral polyps associated with asthma and aspirin sensitivity (Samter triad). Treat with intranasal or systemic corticosteroids; surgery for refractory cases.

Epistaxis

Most commonly from Kiesselbach's plexus (anterior). Initial treatment: pressure, topical vasoconstrictors, and cautery. Posterior packing or embolization for severe cases.

FESS

Functional endoscopic sinus surgery. Indicated for chronic rhinosinusitis refractory to medical therapy. Complications include CSF leak, orbital injury, and hemorrhage.

Vocal fold nodules

Bilateral symmetric lesions at the junction of anterior and middle thirds of vocal folds, caused by voice abuse. Treatment is voice therapy.

Vocal fold polyps

Unilateral lesions often due to smoking or trauma. Treatment is surgical excision and voice therapy.

Recurrent laryngeal nerve injury

Causes vocal fold paralysis with breathy dysphonia and aspiration risk. Treatment includes voice therapy, injection laryngoplasty, or medialization thyroplasty.

Spasmodic dysphonia

Focal dystonia; adductor type causes strained-strangled voice. Treatment is botulinum toxin injection into vocal folds.

Laryngeal cancer

Squamous cell carcinoma most common. Risk factors: smoking and alcohol. Presents with persistent hoarseness, odynophagia, or neck mass. Diagnosis by biopsy.

Head and neck SCC

Most common malignancy. Risk factors: tobacco, alcohol, and HPV (especially oropharyngeal).

Neck mass in adult

Rule out malignancy until proven otherwise. Fine-needle aspiration is the first-line diagnostic test.

Thyroid cancer

Papillary carcinoma most common. Treat with total thyroidectomy and radioactive iodine for high-risk features.

Parotid tumors

Pleomorphic adenoma most common benign; mucoepidermoid carcinoma most common malignant. Superficial parotidectomy with facial nerve preservation.

Acute otitis media

Treat with high-dose amoxicillin for 10 days in children <2 years or severe symptoms; observe 48-72 hours in older children with mild symptoms.

Otitis media with effusion

Middle ear fluid >3 months. Hearing test required. Tympanostomy tubes if hearing loss or speech delay.

Tonsillectomy indications

Recurrent throat infections (7 in 1 year, 5 per year for 2 years, or 3 per year for 3 years) or obstructive sleep apnea.

Croup

Barking cough and inspiratory stridor. Treat with dexamethasone and nebulized epinephrine for severe cases.

Epiglottitis

Medical emergency with drooling, tripod position, and high fever. Do not examine throat; secure airway in operating room.

Rhinoplasty approaches

Open approach for complex deformities; closed approach for simple dorsal hump. Complications include bleeding, infection, and nasal obstruction.

Facial nerve paralysis

Graded with House-Brackmann scale. Treat Bell's palsy with corticosteroids; surgical decompression for traumatic paralysis.

Cleft lip and palate

Repair lip at 3-6 months, palate at 9-12 months. Multidisciplinary team care.

Obstructive sleep apnea

Diagnosed with polysomnography; AHI ≥5 with symptoms or ≥15 alone. CPAP first-line; alternatives include oral appliances, weight loss, and surgery.

Pediatric OSA

Most common cause is adenotonsillar hypertrophy. Adenotonsillectomy is first-line treatment.

Pure tone audiometry

Air and bone conduction thresholds. Sensorineural loss: air-bone gap <10 dB. Conductive loss: air-bone gap >10 dB.

Tympanometry types

Type A normal; type B flat (effusion or perforation); type C negative pressure (Eustachian tube dysfunction).

Vestibular neuritis

Acute vertigo without hearing loss. Treat with corticosteroids and vestibular rehabilitation.

Informed consent

Must include diagnosis, proposed treatment, risks, benefits, alternatives, and consequences of no treatment.

Surgical safety checklist

Verify patient identity, procedure, site, and allergies; use time-out before incision.