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Trauma A haematoma of the pinna occurs when blood collects under the perichondrium. The cartilage receives its blood supply from the perichondrial layer and will die if the haematoma is not evacuated, resulting in a so-called cauliflower ear. A generous incis...

Acute epiglottitis In children acute epiglottitis is of rapid onset. It tends to occur in children of 2 years of age and over. Stridor is usually associated with drooling of saliva. The condition is caused by Haemophilus influenzae infection, which initiall...

Acute laryngitis This often occurs as part of an upper respiratory tract infection in association with a cough and pharyngitis. Usually viral, it may be localised to the larynx and it settles quickly if the voice is rested during the acute inflammation. Steam...

Adenoidectomy Adenoid tissue can be removed alone or in conjunction with a tonsillectomy . The indications for adenoidectomy are: /uni25CF OSA associated with postnasal obstruction; /uni25CF recurrent acute otitis media or prolonged serous otitis me - dia, usu...

Anatomical relationships of the pharynx Some of these are illustrated in Figure 52.5 . Parapharyngeal space This potential space lies lateral to the pharynx and is shaped like an inverted pyramid with its base at the base of the skull - and its apex at the l...

Angiography or digital subtraction vascular imaging These techniques may be indicated if a vascular lesion such as a carotid body tumour is suspected. Angiography may have a therapeutic role to play by facilitating embolisation of vascu - lar tumours prior to...

Angiography or digital subtraction vascular imaging These techniques may be indicated if a vascular lesion such as a carotid body tumour is suspected. Angiography may have a therapeutic role to play by facilitating embolisation of vascu - lar tumours prior to...

Barium swallow and videofluoroscopy Barium (or water-soluble contrast if a pharyngeal or oesoph - ageal perforation is suspected) is used to perform dynamic videofluoroscopic studies, which record the movement of a small quantity of radio-opaque food of vari...

Branchial cyst A branchial cyst ( Figure 52.63 ) develops from the vestigial remnants of the second branchial cleft, is lined by squamous epithelium and contains thick, turbid fluid. The cyst usually presents in the upper neck in early or middle adulthood and ...

Branchial fistula A branchial fistula ( Figure 52.64 ) may be unilateral or bilateral and is thought to represent a persistent second branchial cleft. The external orifice is nearly always situated in the lower third of the neck near the anterior border of the ...

CLINICAL ANATOMY AND PHYSIOLOGY The pharynx The pharynx is a fibromuscular tube forming the upper part of the respiratory and digestive passages. It extends from the base of the skull to the level of the sixth cervical vertebra at the lower border of the crico...

CLINICAL EXAMINATION Pharynx and larynx Before examination of the pharynx, the oral cavity should be examined with the aid of a good light and tongue depressors. Historically , a reflecting mirror on the head was used as a source of examination light. However...

Cervical lymphadenitis Cervical lymphadenitis is common owing to infection or inflammation in the oral and nasal cavities, pharynx, larynx, ear, scalp and face. Acute lymphadenitis The a ff ected lymph nodes are enlarged and tender, and there may be varying degr...

Chronic retropharyngeal abscess This condition is now rare and is most commonly the result of an extension of tuberculosis (TB) of the cervical spine, which has spread through the anterior longitudinal ligament to reach the prevertebral space. In addition t...

Chronic tonsillitis Chronic tonsillitis usually results from repeated attacks of acute tonsillitis in which the tonsils become progressively damaged by inflammatory processes and provide a reservoir for infective organisms. Tonsillectomy The indications for a ...

Clinical features The cysts almost always arise in the midline but, when they are adjacent to the thyroid cartilage, they may lie slightly to one side of the midline. Classically , the cyst moves upwards on swallowing and with tongue protrusion, but this can ...

Complications of tracheostomy The intraoperative, early and late postoperative complications of tracheostomy are listed in Table 52.2 . /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF - /uni25CF /uni25CF - TA...

Computed tomography scanning Computed tomography (CT) scanning provides high- resolution imaging of disease in the pharynx, larynx and neck. Intravenous contrast given at the same time as the CT scan (dynamic scanning) further improves the demonstration of di...