Question: Cadaveric position of vocal cords is

As all the laryngeal muscles are paralyzed, both cords lie in cadaveric position. There is also total anaesthesia of the larynx. This is the neutral position of the cricoarytenoid joint. It is about 3.5 mm from the midline. The healthy cord is unable to approximate the paralyzed cord, thus causing glottic incompetence. This results in hoarseness of voice and aspiration of liquids through the glottis. Cough is ineffective due to air waste. Ref: PL Dhingra Textbook of Ear, Nose and Throat, Edition 7, page - 338


Question: Lymphatics of Tonsils drain into


Question: Commonest cause for acute otitis media in children is

Most common organisms in infants and young children are Streptococcus pneumonia (30 c/o ), Haemophilus influenza(20%) and Moraxella catarrhalis(12%). Other organisms include Streptococcus pyogenes, Staphylococcus aureus and sometimes Pseudomonas aeruginosa. (Ref: Textbook of diseases of ENT, PL Dhingra, 7th edition, pg no. 67)


Question: A children presents with recurrent upper respiratory tract infection with mouth breathing and impairment of hearing. Treatment is

(Adenoidectomy + Grommet insertion) (228- Dhingra 4th)* Recurrent URTI + mouth breathing and impairment of hearing reflects - diagnosis is ADENOIDSClinical featuresAetiology - Physiological enlargement* Recurrent attack of rhinitis, sinusitis or chronic tonsillitis* URTI** Nasal symptoms Aural Symptoms General Symptoms* Nasal obstruction is the commonest symptoms. This leads to mouth breathing*** Nasal discharge* Sinusitis - chronic maxillary sinusitis* Epistaxis* Voice change - toneless(i) Tubal obstruction 1/t conductive hearing loss**(ii) Recurrent attacks of Acute otitis media(iii) CSOM(iv) Serous otitis media**(1) Adenoid facies(2) Pulmonary hypertension and cor pulmonale* Adenoidectomy + Grommet insertion is treatment of choice


Question: Most common source of hemorrhage during Tonsillectomy

M/c cause of hemorrhage during tonsillectomy is external palatine vein / paratonsillar vein.
M/c cause of hemorrhage of arterial origin during tonsillectomy is tonsillar branch of facial artery.

Injury to tonsillar branch of facial artery

Injury to tonsillar branch of Ascending pharyngeal artery

Injury to tonsillar branch of Lingual artery


Question: Red line in pure tone audiometry is for

Red line: Right ear Blue line: Left ear Continuous line: Air Conduction Dotted line: Bone conduction Ref: Dhingra; 6th Edition; pg no 30


Question: Tragal sign is elicited in


Question: Fluctuating deafness is seen in

Hearing loss usually accompanies veigo or may precede it. Hearing improves after the attack and may be normal during the periods of remission.This fluctuating character of hearing loss is quite characteristic of Meniere's disease. Ref: Diseases of EAR, NOSE and THROAT by PL Dhingra; 7th Edition; page no.111,112


Question: The most common site for squamous cell carcinoma in oral cavity is

Site distribution showed that the most common location of the tumors was 1. Border of the tongue (37%) 2. Alveolarmucosaand gingiva (20%) and 3. Floor of the mouth and ventral tongue (19%). Carcinoma tongue - Carcinoma involving anterior two-thirds of the tongue is commonly seen in men in the age group of 50-70 years. It may also occur in the younger age group and in females. It may also develop on a pre-existing leukoplakia, long-standing dental ulcer or syphilitic glossitis. The vast majority are squamous cell type. Site: Most common site is middle of the lateral border or the ventral aspect of the tongue. Uncommonly, the tip or the dorsum may be involved. (Ref: Textbook of diseases of ENT, PL Dhingra, 7th edition, pg no. 255)


Question: The complication of trauma to the danger area of the face among the following is

The area of the upper lip and the lower pa of the nose is the danger area of the face. It is due to that this area is the common site of infectionThis area is drained by facial vein which communicates with the cavernous sinus through the superior ophthalmic vein and pterygoid venous plexus through the emissary veinIn case of any infection of this area, it may spread to the cavernous sinus causing infection and/or thrombosisRef: PL Dhingra, Diseases of Ear, Nose & Throat, 7th edition, pg no. 225 - 226


Question: Citelli angle is

Citelli angle is also called as sinodural angle.Citelli&;s angle (Sinodural angle)- is an angle between the sigmoid sinus and middle fossa dural plate. Ref- Dhingraa textbook for ENT 6th edition.


Question: Occipitomental x ray view of paranasal sinuses with open mouth is Known as


Question: Vestibular evoked myogenic potential detects lesion of

Vestibular evoked myogenic potentials: It is to study function of otolith organs - sacule and utricle These are supplied by inferior vestibular nerve and superior vestibular nerve respectively These potentials can be picked up from either sternocleidomastoid or ocular muscles Ref : Dhingra 7e pg 46.


Question: Angular movement is sensed by

Semicircular canals respond to Angular acceleration and deceleration Utricle and Saccule maintain static equilibrium The cochlea is the auditory poion of the inner ear Ref: PL Dhingra 6th edition of Ear, Nose and Throat; Pg no 17


Question: Tripoid fracture is seen in

Fracture of zygoma is otherwise called tripod fracture.Here zygoma is separated at its three processes; Fracture line passes through zygomaticofrontal suture, orbital floor, infraorbital margin and foramen, the anterior wall of maxillary sinus and zygomaticotemporal suture. (Ref: Textbook of ENT; Dhingra; 7th edition; Page no 205)


Question: The dotted line has clinical significance in case of

The above line is OHNGREN'S line - extending from medial canthus of the eye to the angle of mandible Maxillary carcinoma arising anteroinferior to this line has a better prognosis than posterosuperior carcinoma Ohngren's classification. An imaginary plane is drawn, extending between medial canthus of eye and the angle of mandible . Growths situated above this plane (suprastructural) have a poorer prognosis than those below it (intrastructural). Ref : Diseases of ENT by Dhingra 6th edition Pgno : 207


Question: Endolymphatic hydrops is seen in

Normally endolymph is carried by the endolymphatic duct to the sac where it is absorbed. Defective absorption is by the sac maybe responsible for raised endolymph pressure. Experimental obstruction of the endolymphatic sac and its duct produces endolymphatic hydrops in Meniere's disease. Ref: Diseases of EAR, NOSE and THROAT by PL Dhingra; 7th Edition; page no.111


Question: Heamorrhagic external otitis media is caused by

Otitis externa haemorrhagica It is characterized by for mation of haemorrhagic bullae on the tympanic membrane and deep meatus. It is probably viral in origin and may be seen in influenza epidemics. The condition causes severe pain in the ear and blood-stained discharge when the bullae rupture. Treatment: with analgesics is directed to give relief from pain. Antibiotics are given for secondary infection of the ear canal, or middle ear if the bulla has ruptured into the middle ear. Ref:- Dhingra; pg num:-52


Question: Mode of trauma in petrous bone fracture

(Longitudinal) (97-Dhingra 4th) (698- Bailey & Love 25th)* The otic capsule is the hardest bone in the body. If trauma to the head is severe. Temporal bone fractures may occur. These tends to be either longitudinal (80%) or Transverse (20%)* Transverse fracture usually involve the labyrinth and lead to a sensorineural hearing loss that is permanent* Fracture of temporal bone may be longitudinal, transverse or mixed* Facial palsy is seen in more often in transverse fracture (50%)


Question: Epley's manoeuvre is used in

Epley's manoeuvre : This is to reposition the otoconial debris from the posterior semicircular canal back into utricle. Done in benign paroxysmal positional veigo Ref : Dhingra 7e pg 47.


Question: The most common cause of fungal sinusitis is( REPEAT QUESTION)

Fungal infections of the paranasal sinuses are uncommon and usually occur in individuals who are immunocompromised. Aspergillus fumigatus is most commonly involved in allergic fungal sinusitis and sinus mycetoma. (Ref: Textbook of diseases of ENT, PL DHINGRA, 7th edition, pg no. 220)


Question: Tripod fracture is the name given for

Zygoma fracture is also known as tripod fracture. Clinical features of zygoma fracture Considerable swelling over zygomatic arch is common and makes clinical diagnosis more difficult. Flattening of malar prominence. Step-deformity of infraorbital margin. Anaesthesia in the distribution of infraorbital nerve. Trismus, due to depression of zygoma on the underlying coronoid process. Oblique palpebral fissure, due to the displacement of lateral palpebral ligament. Restricted ocular movement, due to entrapment of inferior rectus muscle. It may cause diplopia. Periorbital emphysema, due to escape of air from the maxillary sinus on nose-blowing. The mucosa of the maxillary sinus may be lacerated and cause epistaxis on that side. Fracture of the zygoma may or may not be painful to palpation and running a finger along the zygomatic arch may give a feel of a depressed fracture or a small dimple. The cheek may appear flattened compared to symmetry with the opposite side. This may be obvious immediately following trauma or several days later once swelling has subsided.


Question: Swelling between tonsillar area and superior constrictor muscle is known as

Ans. a (Quinsy). (Ref. Disease of ENT by PL Dhingra 3rd /pg. 318)PERITONSILLAR ABSCESS (QUINSY)# It is collection of pus between capsule of tonsils and superior constrictor muscle.# It is characterized by hot potato voice and odynophagia and halitosis.# While draining it should be opened at the point of maximum bulge above upper pole of tonsil or just lateral to point of junction of anterior pillar, with a line drawn through the base of uvula.# Tonsils are removed 5-6 weeks following an attack of Quinsy.6# Quinsy tonsillectomy vs. Interval tonsillectomy- Quinsy tonsillectomy can be a treatment option in pediatric patients to young to withstand bedside aspiration or * I&D for recurrent PTA.- Quinsy tonsillectomy can be surgically easier than interval tonsillectomy as fibrosis has not had time to set into themtonsillar capsule.- Interval tonsillectomy can be considered after successful abscess drainage, usually from recurrent PTA after 4-6 weeks.


Question: A 17 years male presented with swelling in the cheek with recurrent epistaxis. Most likely diagnosis is

A. i.e. (Angiofibroma) (230 - Dhingra 4th) (296 - maqbool 11th)NASOPHARYNGEAL ANGIOFIBROMA* Benign but locally invasive lesion of the nasophagrynx* Exclusively in males 10 and 25 years of age* Lesions arise from the ventral periosteum of the skull as a result of hormonal (imbalance or persistence of embryonic tissue* Gradually increasing nasal obstruction and recurrent attacks of epistaxis are the common presenting symptoms* Probing or palpation of the nasopharynx should not be done (Biopsy is contraindicated)*** ** CT scan of head with contrast enhancement is now the investigation of choice* **Surgical excision - Transpalatine + sublabial (Sardanas approach) is now the treatment of choice* Concomitant RT and cisplatin, followed by adjuvant chemotherapy is currently considered the best treatment of naso pharyngeal carcinoma.


Question: Trismus is commonly seen in

Quinsy (Peritonsillar abscess) is a collection of pus in the peritonsillar space which lies between the capsule of tonsil and the superior constrictor muscle. Clinical Features: (a) Severe pain in the throat. Usually unilateral.(b) Odynophagia. It is so marked that the patient cannot even swallow his own saliva which dribbles from the angle of his mouth. The patient is usually dehydrated. (c) Muffled and thick speech, often called "hot potato voice." (d) Foul breath due to sepsis in the oral cavity and poor hygiene. (e) An ipsilateral earache. This is referred pain CN IX which supplies both the tonsil and the ear. (f) Trismus due to spasm of pterygoid muscles which are in close proximity to the superior constrictor. (Ref: Textbook of diseases of ENT, PL Dhingra, 7th edition, pg no. 298)


Question: Palatine Tonsils are lined by

Palatine tonsil Palatine tonsils are two in number. Each tonsil is an ovoid mass of lymphoid tissue situated in the lateral wall of oropharynx between the anterior and posterior pillars. Actual size of the tonsil is bigger than the one that appears from its surface as pas of tonsil extend upwards into the soft palate, downwards into the base of tongue and anteriorly into palatoglossal arch. A tonsil presents two surfaces--a medial and a lateral, and two poles--an upper and a lower. Medial surface of the tonsil is covered by nonkeratinizing stratified squamous epithelium. Ref:- Dhingra; pg num:-257

Non keratinized Stratified squamous epithelium


Question: Stensons duct of parotid opens opposite to


Question: Strawberry appearance is seen in

Rhinosporidiosis caused by rhinosporidium seeberi, mostly affects nose and nasopharynx, other sites such as lip, conjunctiva, epiglottis, larynx, trachea, bronchi, skin, vulva and vagina. In the nose, the disease is presented as leafy, polypoidal mass, pink to purple in colour and attached to the nasal septum or lateral wall.
The mass is very vascular and bleeds too easily to touch. Its surface is studded with white dots representing the sporangia of fungus. hence giving it a "strawberry " appearance.


Question: Commonest site of otosclerosis is

The most common type of otosclerosis is stapedial otosclerosis. Stapedial otosclerosis causes stapes fixation and conductive deafness is the most common variety. Here the lesion mainly stas just in front of the oval window in an area called "fissula ante fenestram". This is the site of predilection( anterior focus). The lesion may sta behind the oval window(posterior focus), around the margin of the stapes footplate( circumferential), in the footplate but annular ligament being free (biscuit type). Sometimes, it may completely obliterate the oval window. ( obliterate type) (Ref: Diseases of EAR, NOSE and THROAT by PL Dhingra; 7th Edition; Page no.95.)


Question: The bifurcation of trachea occurs most commonly at

"The level of bifurcation of the trachea varies from the lower third of the fouh to the middle of the seventh thoracic veebrae. The average position is at the level of the lower third of the fifth thoracic veebra.Ref: PL Dhingra, Diseases of Ear, Nose & Throat, 7th edition, pg no. 319


Question: Most common fungus causing otomycosis is

Otomycosis is a fungal infection of the ear canal most commonly caused by Candida albicans, Aspergillus niger and Aspergillus fumigatus. (Ref: Textbook of diseases of ENT, PL Dhingra, 7th edition, of no. 55)


Question: The effective diameter of the tympanic membrane is

Effective diameter or vibratory area of tympanic membrane is 45mm2; Area of tympanic membrane is 90mm2 Stapes footplate area is 3.2mm2 Ref: PL Dhingra 6th edition of Ear, Nose and Throat; pg no 15


Question: Risk of Aspiration is high in


Question: Luschka's tonsil also know as

Lushka's Tonsil - Adenoids.
Gerlach's Tonsil  - Tubal Tonsil.
Faucial Tonsil - palatine  Tonsil.


Question: Skull base osteomyelitis is


Question: A child presenting with recurrent respiratory tract infections, mouth breathing and decreased hearing. Treatment of choice is

(Adenoidectomy) (228-385- Dhingra 4th, 367- Logan & Turner 10th)* Recurrent RTI, mouth breathing and decreased hearing suggest that child is suffering from adenoids,* Treatment of choice for adenoids is - AdenoidectomyADENOIDS* Adenoids (or nasopharyngeal tonsil / is situated at junction of the roof and posterior wall of the nasopharynx* Adenoids are present at birth, shows physiological enlargement upto the age of 6 years and then tends to atrophy at puberty and almost completely disappears by age of 20 years* Nasal obstruction is the commonest symptoms. This leads to mouth breathing* **. It also interferes with feeding or sucking. As respiration and feeding can not take place simultaneously such a child fails to thrive**** Nasal symptoms - Nasal obstruction, Nasal discharge, chronic sinusitis, Epistaxis, voice change* Aural symptoms - Tubal obstruction, Recurrent attack of acute DM, CSOM, Serous ottitis mediaChronic nasal obstruction and mouth breathing leads to characteristic facial appearance called Adenoid facies the child has an elongatedface with dull expression, open mouth, prominent and crowded upper teeth and hitched up upper lip* Hard palate is highly arched** as moulding action of the tongue or palate is loss* Diagnosis by examination of post nasal space is possible in some children. Soft tissue lateral radiograph will reveal size of adenoids as also the extent to which nasopharyngeal air space which has been compromised.CT scan has no role in diagnosisIndications of Adenoidectomy* Adenoid hypertrophy causing snoring, mouth breathing, sleep apnoea syndrome or speech abnormalities (i.e. rhinolalia)* Recurrent rhinosinusitis* Chronic secretory otitis media a/w adenoid hyperplasia* Recurrent ear discharge in benign CSOM a/w adenoitis / adenoid hyperplasia* Dental malocclusion (Adenoidectomy does't correct dental abnormalities but will prevent its recurrence after orthodontic treatment)


Question: Posterior epistaxis is commonly seen in

Posterior epistaxis is commonly seen in elderly hypeensive patients. Often due to aeriosclerosis, rarely spontaneously Ref: Dhingra 7e pg 199.


Question: Hyperacusis in Bell's palsy is due to the paralysis of the following muscle

Hyperacusis is noise intolerance due to stapedial paralysis in bells palsy. Ref: Dhingra 6th edition Pg.95


Question: A diabetic patients presents with black necrotic mass filling the nasal cavity. Most likely fungal infection is

(Mucormycosis) (151 -Dhingra 4th)Mucormycosis - common in uncontrolled DM or taking immuno compressive drugs* Invade arteries an causes endothelial damage and thrombosis* Typical finding - presence of a black necrotic mass** filling the nasal cavity and eroding the septum and hard palate* Treatment - Amphotericin - B & Surgical debridement** filling the nasal cavity and eroding the septum and hard palate* Treatment - Amphotericin - B & surgical debridement* Commonest fungeal infection in nose - Aspergillosis* Rhinosporidiosis - is a fungal granuloma- caused by Rhinosporidium seeberi**


Question: Identity the lesion of oral cavity


Question: Fordyce spots are from


Question: Maxillary sinus epithelium is

The sinus is lined with mucoperiosteum, with cilia that beat down the ostia. This membrane is referred to as the Schneiderian membrane, which is histologically a bilaminar membrane with ciliated columnar epithelium cells on the internal side and periosteum. Paranasal sinuses are lined by the mucous membrane which is continuous with that of the nasal cavity through the ostia of sinuses. It is thinner and less vascular compared to that of the nasal cavity. Histologically, it is ciliated columnar epithelium with goblet cells which secretes mucus. Cilia is more marked near ostia of the sinuses and help in drainage of mucus into the nasal cavity. (Ref: Diseases of ENT, PL. Dhingra, 7t edition, pg no. 188)


Question: Investigation of choice for choanal atresia


Question: An antrochoanal polyp is associated most commonly with

Antrochoanal polyp arises from the mucosa of the maxillary antrum near its accessory ostium, comes out of it and grows in the choana and nasal cavity.
Hypertrophied middle turbinate, one of the important differential diagnosis, which is differentiated by its pink appearance and hard feel of the bone on probe testing.
Antrochoanal polyps are most commonly associated with middle meatus.


Question: 'T' staging of Glottic cancer with fixed vocal cords is


Question: Subjective test of hearing is

Uses of Pure Tone Audiogram (a) It is a measure of threshold of hearing by air and bone conduction and thus the degree and type of hearing loss. (b) A record can be kept for future reference. (c) Audiogram is essential for prescription of hearing aid. (d) Helps to find degree of handicap for medicolegal purposes. (e) Helps to predict speech reception threshold. Ref : Dhingra 7e pg 25.


Question: Muller's manoeuver is

Muller's manoeuvre: Used to find the level and degree of obstruction in sleep-disordered breathing. It is performed while using flexible nasopharyngoscope. First, the examiner sees the upper airways at rest and then during the time when the patient makes a maximal inspiratory effo with nose and mouth closed. The base of tongue, lateral pharyngeal wall and palate are examined for collapsibility and then rated from 0 (minimal collapse) to 4+ (complete collapse). Ref: Textbook of ENT, Dhingra; 6th edition; Pg no: 449

Forceful expiration against closed glottis

Forceful inspiration against closed glottis

Forceful expiration against open glottis


Question: "Luc's abscess" is

Luc's abscess - Under periosteum of the roof of bony external auditory canal Ref : ENT textbook by Dhingra 6th edition Pgno : 51-53

Abscess involving external auditory canal


Question: SADE classification is for

Sade classification: Retraction of Pars Tensa.
Tos classification: Retraction of Pars Flaccida

Rectraction of pars Tensa of Tympanic membrane

Rectraction of Pars Flaccida of Tympanic membrane


Question: Not a Boundary of Jackson's Triangle used in Tracheotomy


Question: Fitzgerald&;s caloric test uses temperature at

TESTS OF VESTIBULAR FUNCTION Fitzgerald-Hallpike test (bithermal caloric test): In this test, patient lies supine with head tilted 30deg forward so that horizontal canal is veical. Ears are irrigated for 40 s alternately with water at 30degC and at 44degC (i.e. 7deg below and above normal body temperature) and eyes observed for appearance of nystagmus till its end point. Time taken from the sta of irrigation to the end point of nystagmus is recorded and chaed on a calorigram. Ref:- Dhingra; pg num:-43


Question: Quinsy is also known as

The medical term for quinsy is peritonsillar abscess. It's an uncommon complication of tonsillitis that can happen when a throat abscess develops after infection spreads from the tonsils. If the abscess grows large enough, it can block the airways, causing breathing difficulties, so it's impoant it's treated early. What are the symptoms of Quinsy? The main symptom is a sore throat that gets gradually worse, usually only on one side. Other symptoms include: Fever (temperature of 38degC or above) difficulty or pain on swallowing 'hot potato' voice, sounding as though you're speaking with a - hot potato in your mouth difficulty opening your mouth bad breath earache headache swelling on the affected side dehydration because of difficulty swallowing


Question: In the right middle ear pathology, weber's test will be

Right middle ear pathology means right conductive deafness. In conductive deafness, Weber is lateralized to the worse ear. (in question right ear) In SN deafness, Weber is lateralized to the better ear. Ref: Dhingra; 6th Edition; pg no 22


Question: Wagner and Grossman theory is related to

Wagner and Grossman hypothesis which states that cricothyroid muscle which receives innervation from superior laryngeal nerve keeps the cord in paramedian position due to its adductor function. Ref: PL Dhingra Textbook of Ear, Nose and Throat, Edition 7, page - 338


Question: Cause of myringosclerosis is

Grommet inseion is preferred if myringotomy and aspiration combined with medical measures have not helped and fluid recurs, a grommet is inseed to provide continued aeration of the middle ear. It is left in place for weeks or months or till it is spontaneously extruded. Ref - PL DHINGRA diseases of ear nose and throat, 6th edition, page no 65


Question: Treatment of choice in nasopharyngeal carcinoma

NASOPHARYNGEAL CANCER TREATMENT :- 1. Radiotherapy:- It is the treatment of choice for nasopharyngeal cancer. Stage I and II are treated by radiotherapy alone while stage III and IV require concomitant radiation and chemotherapy or radiation followed by chemotherapy. External beam radiation of 6000-7000 cGy can be delivered by linear accelerator to the primary and both sides of neck. More advanced techniques of radiotherapy such as three-dimensional conformal radiotherapy and intensity modulated radiotherapy (IM) are now being used more and more. They allow higher dose delivery to the tumour with reduced damage to the adjacent normal structures such as spinal cord, brainstem and parotid glands. IM has also been used for recurrent disease where conventional radiotherapy produces more serious side effects such as transverse myelitis. Ref:- Dhingra; pg num:-252


Question: Thumb printing sign is seen in

(Acute epiglottitis): (309-Dhingra 5th; 599-P-Hazarika 3rd/edition)ACUTE EPIGLOTTITIS(Syn - Acute supraglottic laryngitis)* Caused by Hemophilus influenza type BClinical FeaturesSymptomsSignsGeneral - usually starts as URTISigns* High grade fever* General - fever, toxic appearance and flushed skin, lethargic* Dribbling saliva* On auscultation decreased air entry Local* Sore throad* Dysphagia/odynophagia* Muffled (Hot potato) voice* F B sensation in the throat* Breathing difficulty -Inspiratory stridor is variably present and may be associated with expiratory rottles ORAL* Pharynx is usually congested and pooling of saliva* Red and edematous epiglottis popping up "Cherry red epiglottis"* Stridor is inspiratory and increases on supine position. Patient tends it sit up leaning forward supporting on upper limbs (Tripod sign) which relieves stridor to some extent* Inspiratory stritor if severe causes intermittent retraction, active accessory respiratory muscles and perioral cyanosis Differences between acute epiglottis and acute laryngo-tracheo-bronchitis in children Acute epiglottisAcute laryngo-tracheo-bronchitis (or group)* Causative organismHaemophilus influenza type BParainfluenza virus type I and II* Age2-7 years3 months to 3 years* PathologySupraglottic larynxSubglottic area* Prodromal symptomsAbsentPresent* OnsetSuddenSlow* FeverHighLow grade or no fever* Patient's lookToxicNon-toxic* CoughUsually absentPresent, (Barking seal-like)* StridorPresent and may be markedPresent* OdynophagiaPresent with drooling of secretionsUsually absent* RadiologyThumb sign on lateral viewSteeple sign on anteroposterior view of neck* TreatmentHumidified oxygen, third generation cephalosporin (ceftriaxone) or amoxicillinHumidified 02 tent, steroids


Question: In CSOM commonest operation done is

In CSOM, commonest operation done is modified radical mastoidectomy. It is a modification of a radical mastoidectomy whereas much of the hearing mechanism is preserved. INDICATIONS Cholesteatoma confined to the attic and antrum. Localised chronic otitis media. Ref: Textbook of diseases of ENT, PL Dhingra, 7th edition, pg no. 461


Question: Sclerosing otitis media is diagnosed by

Otoscope is used to view any of the middle ear pathology like granulations, sclerosis, ossicular chain, adhesions. Ref: Dhingra 7e pg 78.


Question: Mouse nibbled appearance of vocal cord is seen in

TUBERCULOSIS OF LARYNX AETIOLOGY :- It is almost always secondary to pulmonary tuberculosis, mostly affecting males in middle age group. Tubercle bacilli reach the larynx by bronchogenic or haematogenous routes. PATHOLOGY:- Disease affects posterior pa of larynx more than anterior. Pas affected are: (i) interarytenoid fold, (ii) ventricular bands, (iii) vocal cords and (iv) epiglottis, in that order. Tubercle bacilli, carried by sputum from the bronchi, settle and penetrate the intact laryngeal mucosa paicularly in the interarytenoid region (bronchogenic spread). This leads to formation of submucosal tubercles which may later caseate and ulcerate. Laryngeal mucosa appears red and swollen due to cellular infiltration (pseudoedema). Stages of perichondritis and cailage necrosis are not commonly seen these days. SYMPTOMS AND SIGNS :- They would greatly depend on the stage of tuberculosis. Weakness of voice is the earliest symptom followed by hoarseness. Ulceration in the larynx gives rise to severe pain which may radiate to the ears. Swallowing is painful with marked dysphagia in later stages. LARYNGEAL EXAMINATION:- 1. Hyperaemia of the vocal cord in its whole extent or confined to posterior pa with impairment of adduction is the first sign. 2. Swelling in the interarytenoid region giving a mamillated appearance. 3. Ulceration of vocal cord giving mouse-nibbled appearance. 4. Superficial ragged ulceration on the arytenoids and interarytenoid region. 5. Granulation tissue in interarytenoid region or vocal process of arytenoid. 6. Pseudoedema of the epiglottis "turban epiglottis." 7. Swelling of ventricular bands and aryepiglottic folds. 8. Marked pallor of surrounding mucosa. Ref:- Dhingra; pg num:-293


Question: Treatment of choice of Bell's palsy is

Prednisolone is the drug of choice. Steroids prevent synkinesis and crocodile tears and shoen recovery time of facial paralysis. Ref: Dhingra 6th edition pg. 95


Question: The earliest sign of tuberculosis of vocal cords is

The weakness of voice is the earliest symptom followed by hoarseness of voice. Ulceration of larynx produces severe pain, which may radiate to ears. Pain during swallowing is seen in later stages. On examination, hyperemia of the vocal cord in its whole extent or confined to posterior pa with impairment of adduction is the first sign. Note the hyperaemia Ref : www.ncbi.nlm.gov


Question: The Transorbital view is carried out for

Transorbital view: This view is taken with occiput on the film with an orbitomeatal line at right angles to the film. X-ray beam passes through the orbit. Structures seen are:(a) Internal auditory canal.(b) Cochlea.(c) Labyrinth.(d) Entire petrous pyramid projected through the orbit. Ref: Textbook of ENT, Dhingra; 6th edition Ref img Transorbital X-ray of patient 1 after the paial explantation of the cochlear implant due to the recurrence of FIPT. The intracochlear pa of the electrode is still in situ.


Question: Laryngocele arises as herniation of laryngeal mucosa through the following membrane

Laryngocele Laryngocele is an air-filled cystic swelling which occurs due to dilatation of saccule. Saccule is a diveiculum arising from anterior pa of ventricle/sinus of larynx. External laryngocele is one in which distended saccule herniates through the thyrohyoid membrane and presents as a reducible swelling in the neck, which increases in size on coughing or performing Valsalva. Ref:- Mohan Bansal; pg num:-487