ENT: Core Knowledge

323 Pages·2017·3.411 MB·English

by  Petros Koltsidopoulos, Charalampos Skoulakis, Stilianos Kountakis (auth.)

Petros Koltsidopoulos
Charalampos Skoulakis
Stilianos Kountakis
ENT
Core Knowledge
123
ENT
Petros Koltsidopoulos
Charalampos Skoulakis
Stilianos Kountakis
ENT
Core Knowledge
Petros Koltsidopoulos Charalampos Skoulakis
Department of Otolaryngology- University Hospital of Larissa
Head and Neck Surgery Larissa, Larissa
Iaso Thessalias General Hospital Greece
Larissa
Greece
Stilianos Kountakis
Department of Otolaryngology-
Head and Neck Surgery
Medical College of Georgia-
Augusta University
Augusta, GA
USA
ISBN 978-3-319-56329-9 ISBN 978-3-319-56330-5 (eBook)
DOI 10.1007/978-3-319-56330-5
Library of Congress Control Number: 2017945401
© Springer International Publishing AG 2017
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Preface
Although there are many large textbooks on Otolaryngology,
there is a lack of brief books suitable for revision. Thus, we
decided to fill up this gap. We wrote a book that contains
basic information on most of the ENT diseases; that is, we
made an attempt to provide in a highly organized way the
symptoms, diagnostic procedure and therapeutic approach of
more than two hundred diseases.
Apart from its exceptionally brief way of structure, this
book is updated with new treatment modalities, giving the
reader the opportunity to keep in touch with the edge of
knowledge. Moreover, we tried to make it attractive, in order
to make studying easier and more pleasant, by including
many images, enriching the clinical experience of the reader.
We are sure that this book would be useful for residents
who are preparing for Board exams, for specialists who want
to refresh and update their knowledge, and even for General
Practitioners with special interest in ENT. In general, it could
be an important asset for all ENT professionals as it gives
them the ability to get a quick look at the basic information
on most of the ENT diseases.
Larissa, Greece Petros Koltsidopoulos
Larissa, Greece Charalampos Skoulakis
Augusta, GA Stilianos Kountakis
Contents
1 Ear . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
1.1 Microtia-Anotia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
1.2 Prominent Ears . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
1.3 Otitis Externa . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
1.4 Otomycosis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
1.5 Malignant External Otitis . . . . . . . . . . . . . . . . . . . . 4
1.6 Exostoses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
1.7 Osteoma. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
1.8 External Fibrous Otitis. . . . . . . . . . . . . . . . . . . . . . . 6
1.9 Keratosis Obturans. . . . . . . . . . . . . . . . . . . . . . . . . . 7
1.10 Traumatic Perforation of Tympanic
Membrane . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
1.11 Myringitis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
1.12 Otitis Media with Effusion. . . . . . . . . . . . . . . . . . . . 9
1.13 Acute Otitis Media. . . . . . . . . . . . . . . . . . . . . . . . . . 10
1.14 Complications of Acute Otitis Media. . . . . . . . . . . 11
1.15 Acute Mastoiditis . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
1.16 Chronic Otitis Media . . . . . . . . . . . . . . . . . . . . . . . . 19
1.17 Cholesteatoma. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
1.18 Barotrauma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
1.19 Patulous Eustachean Tube (PET). . . . . . . . . . . . . . 25
1.20 Otosclerosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
1.21 Traumatisms of Temporal Bone . . . . . . . . . . . . . . . 28
1.22 Squamous Cell Carcinoma of the
Temporal Bone . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
1.23 Vestibular Schwannoma. . . . . . . . . . . . . . . . . . . . . . 32
1.24 Meningioma. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
1.25 Paragangliomas of Temporal Bone. . . . . . . . . . . . . 34
1.26 Petrous Bone Cholesteatoma . . . . . . . . . . . . . . . . . 36
1.27 Petrous Apex Cholesterol Granuloma. . . . . . . . . . 37
viii Contents
1.28 Zoster Oticus (Ramsay Hunt Syndrome) . . . . . . . 38
1.29 Labyrinthitis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
1.30 Labyrinthine Concussion. . . . . . . . . . . . . . . . . . . . . 41
1.31 Otoliquorrhoea—Otorhinoliquorrhoea. . . . . . . . . 42
1.32 Perilymphatic Fistula . . . . . . . . . . . . . . . . . . . . . . . . 43
1.33 Superior Semicircular Canal Dehiscence
Syndrome (SCDS) . . . . . . . . . . . . . . . . . . . . . . . . . . 44
1.34 Sudden Sensorineural Hearing Loss . . . . . . . . . . . 45
1.35 Benign Paroxysmal Positioning Vertigo. . . . . . . . . 46
1.36 Meniere’s Disease. . . . . . . . . . . . . . . . . . . . . . . . . . . 47
1.37 Vestibular Neuritis . . . . . . . . . . . . . . . . . . . . . . . . . . 48
1.38 Autoimmune Inner Ear Disease (AIED) . . . . . . . 49
1.39 Tinnitus. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
1.40 Ototoxicity. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
1.41 Presbyacusis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56
1.42 Occupational Hearing Loss. . . . . . . . . . . . . . . . . . . 57
1.43 Acute Acoustic Trauma . . . . . . . . . . . . . . . . . . . . . . 57
1.44 Migraine Associated Vertigo. . . . . . . . . . . . . . . . . . 58
1.45 Idiopathic Facial Palsy . . . . . . . . . . . . . . . . . . . . . . . 59
1.46 Traumatic Facial Palsy . . . . . . . . . . . . . . . . . . . . . . . 63
1.47 Facial Nerve Schwannoma. . . . . . . . . . . . . . . . . . . . 65
Further Reading . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66
2 Nose . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
2.1 Nasal Dermoid Cyst . . . . . . . . . . . . . . . . . . . . . . . . . 70
2.2 Encephalocele . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
2.3 Choanal Atresia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72
2.4 Furuncle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
2.5 Atrophic Rhinitis . . . . . . . . . . . . . . . . . . . . . . . . . . . 74
2.6 Midline Granuloma . . . . . . . . . . . . . . . . . . . . . . . . . 75
2.7 Rhinolith . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
2.8 Wegener’s Granulomatosis . . . . . . . . . . . . . . . . . . . 76
2.9 Sarcoidosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
2.10 Systemic Lupus Erythematosis . . . . . . . . . . . . . . . . 78
2.11 Nasal Fracture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79
2.12 Nasal Septum Deviation . . . . . . . . . . . . . . . . . . . . . 81
2.13 Septal Haematoma . . . . . . . . . . . . . . . . . . . . . . . . . . 82
2.14 Saddle Nose Deformity . . . . . . . . . . . . . . . . . . . . . . 83
Contents ix
2.15 Epistaxis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85
2.16 Rendu Osler Weber Syndrome (Hereditary
Hemorrhagic Telangiectasia—HHT) . . . . . . . . . . 86
2.17 Non- Allergic Rhinitis. . . . . . . . . . . . . . . . . . . . . . . 87
2.18 Allergic Rhinitis . . . . . . . . . . . . . . . . . . . . . . . . . . . 88
2.19 Acute Sinusitis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90
2.20 Cronic Rhinosinusitis . . . . . . . . . . . . . . . . . . . . . . . 92
2.21 Fungus Ball (Mycetoma) . . . . . . . . . . . . . . . . . . . . 93
2.22 Allergic Fungal Rhinosinusitis . . . . . . . . . . . . . . . 96
2.23 Invasive Fungal Rhinosinusitis (RS) . . . . . . . . . . 97
2.24 Complications of Sinusitis . . . . . . . . . . . . . . . . . . . 99
2.25 Paranasal Sinus Mucocele (PSM). . . . . . . . . . . . . 103
2.26 Silent Sinus Syndrome (SSS). . . . . . . . . . . . . . . . . 104
2.27 Frontal Sinus Trauma . . . . . . . . . . . . . . . . . . . . . . . 105
2.28 Fractures of Midface. . . . . . . . . . . . . . . . . . . . . . . . 107
2.29 Zygomatic-Maxillary Complex Fracture . . . . . . . 111
2.30 Fracture of Orbital Floor (Blow Out) . . . . . . . . . 113
2.31 Smell Disorders. . . . . . . . . . . . . . . . . . . . . . . . . . . . 115
2.32 Fibrous Dysplasia . . . . . . . . . . . . . . . . . . . . . . . . . . 118
2.33 Pyogenic Granuloma (Lobular
Capillary Hemangioma). . . . . . . . . . . . . . . . . . . . . 118
2.34 Squamous Papilloma . . . . . . . . . . . . . . . . . . . . . . . 120
2.35 Inverted Papilloma (IP). . . . . . . . . . . . . . . . . . . . . 122
2.36 Juvenile Naso-Pharyngeal Angiofibroma . . . . . . 123
2.37 Malignant Tumours. . . . . . . . . . . . . . . . . . . . . . . . . 124
Further Readings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 128
3 Larynx. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131
3.1 Laryngomalacia. . . . . . . . . . . . . . . . . . . . . . . . . . . . 131
3.2 Neonatal Laryngeal Paralysis . . . . . . . . . . . . . . . . 132
3.3 Laryngeal Hemangioma. . . . . . . . . . . . . . . . . . . . . 133
3.4 Laryngeal Web or Atresia . . . . . . . . . . . . . . . . . . . 133
3.5 Subglottic Stenosis . . . . . . . . . . . . . . . . . . . . . . . . . 134
3.6 Acute Laryngitis . . . . . . . . . . . . . . . . . . . . . . . . . . . 135
3.7 Candidiasis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 136
3.8 Epiglottitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 136
3.9 Croup Acute . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 138
3.10 Vocal Nodules . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139
x Contents
3.11 Vocal Fold Polyp. . . . . . . . . . . . . . . . . . . . . . . . . . . 140
3.12 Reinke’s Edema . . . . . . . . . . . . . . . . . . . . . . . . . . . 141
3.13 Vocal Cord Cysts. . . . . . . . . . . . . . . . . . . . . . . . . . . 143
3.14 Laryngocele . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 144
3.15 Laryngeal Papillomatosis. . . . . . . . . . . . . . . . . . . . 146
3.16 Laryngeal Chondroma . . . . . . . . . . . . . . . . . . . . . . 147
3.17 Hyperplastic Epithelial Lesions . . . . . . . . . . . . . . 148
3.18 Spasmodic Dysphonia (SD). . . . . . . . . . . . . . . . . . 148
3.19 Rheumatoid Arthritis. . . . . . . . . . . . . . . . . . . . . . . 150
3.20 Relapsing Polychondritis . . . . . . . . . . . . . . . . . . . . 150
3.21 Amyloidosis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151
3.22 Laryngeal Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . 152
3.23 Verrucous Carcinoma. . . . . . . . . . . . . . . . . . . . . . . 156
3.24 Laryngeal Nerve Disorders . . . . . . . . . . . . . . . . . . 156
3.25 Laryngeal Trauma. . . . . . . . . . . . . . . . . . . . . . . . . . 158
3.26 Laryngeal and Tracheal Stenosis. . . . . . . . . . . . . . 159
3.27 Aspiration of Foreign Body. . . . . . . . . . . . . . . . . . 160
Further Reading . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161
4 Salivary Glands . . . . . . . . . . . . . . . . . . . . . . . . . . . . 163
4.1 Mumps . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 163
4.2 Acute Bacterial Sialadenitis . . . . . . . . . . . . . . . . . 164
4.3 Cat Scratch Disease . . . . . . . . . . . . . . . . . . . . . . . . 165
4.4 Actinomycosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 166
4.5 Sarcoidosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 166
4.6 HIV Pseudocysts. . . . . . . . . . . . . . . . . . . . . . . . . . . 167
4.7 Sialolithiasis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 168
4.8 Recurrent Parotitis in Children. . . . . . . . . . . . . . . 169
4.9 Mycobacteria. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 170
4.10 Sjoegren’s Syndrome . . . . . . . . . . . . . . . . . . . . . . . 171
4.11 Sialosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 174
4.12 Benign Tumours of Salivary Glands. . . . . . . . . . . 176
4.13 Malignant Salivary Glands Neoplasms . . . . . . . . 179
4.14 Frey’s Syndrome . . . . . . . . . . . . . . . . . . . . . . . . . . . 182
Further Reading . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 183
5 Neck . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 185
5.1 Thyroglossal Cyst . . . . . . . . . . . . . . . . . . . . . . . . . . 185
5.2 Dermoid Cyst . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 187
Contents xi
5.3 Ranula . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 187
5.4 Branchial Cyst. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 189
5.5 Hemangioma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 191
5.6 Lymphangioma . . . . . . . . . . . . . . . . . . . . . . . . . . . . 192
5.7 Chronic Lymph Node Diseases. . . . . . . . . . . . . . . 193
5.8 Cervical Necrotizing Fasciitis. . . . . . . . . . . . . . . . . 194
5.9 Cervical Vagal Schwannoma . . . . . . . . . . . . . . . . . 195
5.10 Paraganglioma (Glomus Caroticum) . . . . . . . . . . 196
5.11 Glomus Vagale (Vagal Paraganglioma) . . . . . . . . 198
Further Reading . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 199
6 Carcinomas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 201
6.1 Carcinoma of the Lip . . . . . . . . . . . . . . . . . . . . . . . 201
6.2 Carcinoma of the Oral Tongue . . . . . . . . . . . . . . . 202
6.3 Carcinoma of the Floor of the
Mouth (FOM) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 204
6.4 Carcinoma of the Soft Palate. . . . . . . . . . . . . . . . . 205
6.5 Carcinoma of Tonsils . . . . . . . . . . . . . . . . . . . . . . . 206
6.6 Carcinoma of the Base of Tongue. . . . . . . . . . . . . 207
6.7 Carcinoma of Hypopharynx . . . . . . . . . . . . . . . . . 208
6.8 Nasopharyngeal Carcinoma. . . . . . . . . . . . . . . . . . 210
6.9 Carcinoma of Esophagus. . . . . . . . . . . . . . . . . . . . 213
6.10 Carcinoma of Unknown Primary (CUP)
Syndrome. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 215
6.11 Neck Dissection (ND) . . . . . . . . . . . . . . . . . . . . . . 216
6.12 Classification of Neck Zones. . . . . . . . . . . . . . . . . 218
6.13 Basal Cell Carcinoma. . . . . . . . . . . . . . . . . . . . . . . 221
6.14 Squamous Cell Carcinoma. . . . . . . . . . . . . . . . . . . 222
6.15 Melanoma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 223
6.16 Merkel Cell Carcinoma . . . . . . . . . . . . . . . . . . . . . 225
Further Readings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 227
7 Oesophagus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 229
7.1 Pharyngo-Oesophageal Diverticula
(Zenker Diverticulum). . . . . . . . . . . . . . . . . . . . . . 229
7.2 Gastro-Oesophageal Reflux Disease . . . . . . . . . . 230
7.3 Caustic Ingestion. . . . . . . . . . . . . . . . . . . . . . . . . . . 232
7.4 Oesophageal Perforation. . . . . . . . . . . . . . . . . . . . 233
7.5 Foreign Bodies. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 236
Further Readings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 237