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CONDITIONS OF THE INNER EAR Congenital sensorineural hearing loss Half of congenital sensorineural hearing loss is genetic and half is acquired. Of the genetic hearing loss 75% is non-syndromic, of which the most common is a connexin 26 gene mutation. Syn...

CONDITIONS OF THE INNER EAR Congenital sensorineural hearing loss Half of congenital sensorineural hearing loss is genetic and half is acquired. Of the genetic hearing loss 75% is non-syndromic, of which the most common is a connexin 26 gene mutation. Syn...

CONDITIONS OF THE MIDDLE EAR Congenital anomalies Aural atresia and congenital anomalies of the middle ear occur in 1/10 /uni00A0 000 to 1/20 /uni00A0 000 births and are typically unilateral and Pierre Robin , 1867–1950, Professor, The French School of Denti...

Chronic otitis media Chronic otitis media (COM) is a persisting (at least 2 weeks to 3 months) abnormality of the tympanic membrane from previ ous recurrent AOM and/or OME. It is classified as active (i.e. inflammation and pus present), inactive (potential to b...

Chronic rhinosinusitis CRS is common, a ff ecting around 11% of the population. The aetiology is multifactorial and a number of factors have been linked to CRS, including ciliary dyskinesia, allergy , asthma, bacteria ( Staphylococcus aureus ), fungi and a nu...

EPISTAXIS The causes of epistaxis are listed in Table 51.2 . The most common site of bleeding is from Kiesselbach’s plexus in Little’s area of the anterior portion of the septum ( Figure 51.37 ). Anterior bleeding is common in children and young adults owi...

EXAMINATION OF THE EAR The instruments required for examination are shown in Figure 51.5 . Examination of the ear is part of the general ear, nose and throat (ENT) examination. Rinne and Weber tuning fork tests are used to distinguish between a conductive an...

EXAMINATION OF THE NOSE AND EXAMINATION OF THE NOSE AND

IMAGING OF PARANASAL SINUSES Plain radiographs are of limited value in the assessment of sinus disease. CT is far superior in demonstrating sinus pathol ogy and for assessing bony anatomy to plan any surgical inter vention. CT scans are acquired and reconstru...

INTRODUCTION Disorders a ff ecting the ear, nose and sinus are common reasons for primary care attendance; however, few surgeons will encounter such diseases in day-to-day practice. Nonethe less, traumatic, infective and neoplastic processes can impact on these...

Inflammation and infection Otitis externa is very common and consists of generalised inflammation of the skin of the external auditory meatus. The cause is often cotton bud use, a moist environment, immunocompromise, allergies or skin disorders, such as psori...

Learning objectives To be familiar with: The anatomy of the ear • The conditions of the outer, middle and inner ear • The examination of the ear, including hearing tests • The basic anatomy of the nose and paranasal sinuses • The principles of managing post-tr...

Malignant tumours The most common malignant tumours to occur within the nasal cavity and paranasal sinuses are squamous cell carcinomas ( Figure 51.57 ), adenoid cystic carcinomas and adenocarcinomas. Adenocarcinoma has been linked to exposure to hard wood dus...

Management of epistaxis Anterior bleeding from Kiesselbach’s plexus may be controlled by silver nitrate cautery under local anaesthesia. Even in more posterior epistaxis, the bleeding point can often be identified using rigid nasendoscopy and controlled with th...

Neoplasms Exostosis is an area of hyperostosis rather than a neoplasm that arises from the bone of the ear canal in individuals who swim in cold water (synonym ‘surfer’s ear’) ( Figure 51.14 treatment is required unless the exostosis obstructs the canal. Oste...

Otitis media with effusion (glue ear) Otitis media with e ff usion (OME) is a middle ear e ff usion with no evidence of infection. It has a bimodal incidence a ff ecting 40% of 2-year-olds (age of starting nursery) and 20% of 5-year-olds (age of starting schoo...

Otosclerosis This is an autosomal dominant condition of variable pene - trance in which excess bone is laid down around the footplate of the stapes, impeding mobility of the stapes and resulting in a conductive hearing loss ( Figure 51.23 ). A diagnosis sho...

PARANASAL SINUSES Internal inspection of the nasal fossae can be achieved to a limited extent with the use of a Thudichum speculum. The anterior nasal septum, nasal vestibule and anterior inferior turbinate can be assessed. A more detailed examination of the...