Document Image Processing Techniques

Tuning Fork Tests

• Tests include the Rinne and Weber tests.
• In a patient with right conductive hearing loss, the Weber test will lateralize to the right ear, and the Rinne test will show bone conduction greater than air conduction in the affected ear.

Pediatric Hearing Management

• For a 3-year-old child with no speech development and no response to sound, manage with a comprehensive audiological evaluation, including otoacoustic emissions (OAEs) and auditory brainstem response (ABR) testing to determine the degree and type of hearing loss.
• Early intervention with hearing aids or cochlear implants, combined with speech therapy, is crucial.

Ototoxicity

• Refers to the damage of the inner ear caused by certain medications.

Nasal Function

• The nose warms, humidifies, and filters inspired air; provides sense of smell, and drains paranasal sinuses and tears.

Management of Nasal Obstruction

• For a middle-aged patient with bilateral nasal obstruction, sneezing, itching, and breathlessness for 10 years, consider allergic rhinitis/perennial rhinitis.
• Management includes allergy testing, intranasal corticosteroids, antihistamines, and possible immunotherapy.

Nasal Fracture Management

• For a nasal fracture with deviation, manage with closed reduction if seen within 1-2 weeks.
• Perform septoplasty/rhinoplasty may for persistent deviation.

Types of Thyroid Surgery

• Includes hemithyroidectomy, total thyroidectomy, subtotal thyroidectomy, and thyroid lobectomy.

Management of Papillary Carcinoma

• For a 30-year-old lady with papillary carcinoma involving the right lobe and Level IV cervical lymphadenopathy, manage with total thyroidectomy and central neck dissection.
• Radioactive iodine ablation post-operatively and follow-up with thyroglobulin levels and ultrasound are also important parts of management.

Tracheostomy

• Surgical procedure that creates an opening in the trachea to establish an airway.
• Indications include: upper airway obstruction, need for prolonged mechanical ventilation, laryngeal trauma, neuromuscular disorders, and sleep apnea.

Types of CSOM

• Chronic suppurative otitis media can be classified as tubotympanic (safe) or atticoantral (unsafe).
• Tubotympanic CSOM has a central perforation and mucopurulent discharge, while atticoantral CSOM has a marginal or attic perforation, cholesteatoma, and potential for complications.

Management of Acute Otitis Media

• For a 7-year-old boy with severe right earache and fever following a common cold, the diagnosis is likely acute otitis media.
• Treat with antibiotics (amoxicillin), analgesics, and decongestants.

Cranial Nerve in Middle Ear

• The facial nerve (CN VII) passes through the middle ear.
• It can be affected in conditions like Bell's palsy, trauma, or cholesteatoma.

Inferior Nasal Turbinate

• Functions to humidify, filter, and warm the air passing through the nasal cavity, directing airflow and increasing the surface area for these processes.

Progressive Nasal Blockage

• For a young lady with progressive right nasal blockage for 2 years becoming bilateral, consider nasal polyps or sinonasal malignancy.
• Investigate with nasal endoscopy and CT scan.
• Management depends on the diagnosis, potentially including topical nasal steroids or surgical excision.

Septoplasty Complications

• Can include septal hematoma, septal perforation, saddle nose deformity, and anosmia

Goiter

• Enlargement of the thyroid gland.
• Common causes include iodine deficiency, Hashimoto's thyroiditis, Graves' disease, and thyroid nodules.

Solitary Thyroid Nodule

• For a 30-year-old lady with a solitary thyroid nodule, evaluate with thyroid function tests, ultrasound, and fine needle aspiration (FNA) to rule out malignancy.

Neck Dissection

• Is a surgical procedure to remove lymph nodes and other tissues from the neck, typically performed to remove cancerous tissue.
• Types include radical, modified radical, and selective neck dissections, each involving removal of different sets of lymph nodes and structures.

Middle Ear Cleft

• Components include the tympanic membrane, ossicles (malleus, incus, stapes), middle ear cavity, Eustachian tube, and mastoid air cells.
• The aditus ad antrum connects the middle ear cavity and the mastoid air cells.

Bilateral Hearing Loss in Child

• For a 10-year-old girl with a history of frequent colds and bilateral hearing loss but no ear discharge, investigate with audiometry and tympanometry to assess hearing thresholds and middle ear function.
• Treatment may include hearing aids or addressing underlying causes like otitis media with effusion.

Causes of Vertigo

• Include Meniere's disease (episodic vertigo, tinnitus, hearing loss), benign paroxysmal positional vertigo (BPPV) (position-related vertigo), vestibular neuritis (acute, prolonged vertigo), acoustic neuroma (gradual hearing loss and imbalance), and labyrinthitis (vertigo, hearing loss, tinnitus).
• BPPV is differentiated by positional testing (Dix-Hallpike maneuver).

Nasal Sinuses

• Include the maxillary, frontal, ethmoid, and sphenoid sinuses.
• Their function is to lighten the skull, humidify and warm inspired air, increase the resonance of speech, and produce mucus.

Progressive Nasal Obstruction

• For a 65-year-old man with progressive bilateral nasal obstruction, epistaxis, and Level II cervical lymphadenopathy, suspect sinonasal malignancy.
• Diagnose with nasal endoscopy and biopsy.
• Manage with surgery, radiation, and/or chemotherapy.

Caldwell-Luc Operation

• Surgical procedure that involves creating an antrostomy in the canine fossa to improve sinus drainage and remove diseased tissue.
• Indications include chronic maxillary sinusitis, antrochoanal polyp removal, and sinus mucocele.

Indirect Laryngoscopy

• Procedure using a laryngeal mirror to visualize the larynx.

Structures Seen

• Includes the base of the tongue, epiglottis, vallecula, vocal cords, arytenoids, and piriform sinuses.

Hoarseness Management

• For a 55-year-old smoker with hoarseness for 4 months and an exophytic lesion in the right vocal cord, suspect laryngeal cancer.
• Manage with biopsy and staging.
• Treatment options include surgery, radiation, and/or chemotherapy.

Types of Deafness

• Conductive (outer or middle ear), sensorineural (inner ear or auditory nerve), and mixed.
• Conductive deafness mechanisms include cerumen impaction or otosclerosis.

Progressive Hearing Impairment

• For a 70-year-old man with progressive bilateral hearing impairment for 5 years, normal tympanic membrane, and Rinne positive, suspect presbycusis.
• Management includes hearing aids and aural rehabilitation.

Causes of Ear Discharge

• Include otitis externa, acute otitis media with perforation, and chronic suppurative otitis media.
• Otitis media, in particular, is associated with pain.

Epistaxis

• Local causes include nasal trauma, foreign bodies, rhinitis sicca, and nasal tumors.

Nasal Blockage Evaluation

• For a 55-year-old man with progressive right nasal blockage, bloody discharge, and tearing of the right eye, suspect sinonasal malignancy.
• Evaluate with nasal endoscopy, biopsy, and imaging (CT or MRI).

Antrochoanal Polyp

• Management includes surgical excision, typically endoscopic sinus surgery.

Laryngeal Cartilages

• Include the thyroid, cricoid, epiglottis (hyaline cartilage), arytenoid, corniculate, and cuneiform (elastic cartilage).
• The abductor of the vocal cord is the posterior cricoarytenoid muscle.

Progressive Dysphagia

• For a 55-year-old lady with progressive dysphagia for 3 years and severe anemia, consider Plummer-Vinson syndrome or esophageal malignancy.
• Evaluate with endoscopy and biopsy.

Cervical Lymphadenopathy

• Common causes include upper respiratory infections, mononucleosis, tuberculosis, lymphoma, and metastatic cancer.

Referred Earache

• Causes include temporomandibular joint (TMJ) disorders, dental problems, cervical spine issues, tonsillitis, and glossopharyngeal neuralgia.

Differentiating Ear Conditions

• Acute mastoiditis presents with postauricular erythema, tenderness, and fever, while furunculosis presents with localized pain and swelling in the external auditory canal.

Cholesteatoma Complications

• Include hearing loss, vertigo, facial nerve paralysis, intracranial abscess, and meningitis.

Bilateral Nasal Obstruction

• Causes include allergic rhinitis, nasal polyps, deviated nasal septum, adenoid hypertrophy, and choanal atresia.

Pediatric Nasal Obstruction

• For a 10-year-old boy with bilateral nasal obstruction, frequent colds, mouth breathing, and hearing impairment, suspect adenoid hypertrophy.
• Manage with adenoidectomy and/or nasal steroids.

Systemic Causes of Epistaxis

• Include hypertension, bleeding disorders (hemophilia, von Willebrand disease), liver disease, and medications (anticoagulants, NSAIDs).

Throat

• The area extending from the nasopharynx to the larynx, including the oropharynx and hypopharynx.

Sore Throat

• Causes include viral pharyngitis, bacterial pharyngitis (strep throat), tonsillitis, peritonsillar abscess, and epiglottitis.

Exophytic Tongue Lesion

• For a 50-year-old lady with an exophytic lesion on the lateral border of the tongue and palpable Level IIb lymph node, suspect squamous cell carcinoma.
• Manage with biopsy and staging.
• Treatment includes surgery, radiation, and/or chemotherapy.

Ear Parts

• Outer ear (auricle and external auditory canal), middle ear (tympanic membrane, ossicles, Eustachian tube), and inner ear (cochlea and vestibular system).
• Functions include hearing and balance

Causes of Earache

• Include otitis externa (pain with tragal traction), otitis media (throbbing pain, fever), mastoiditis (postauricular tenderness), TMJ disorders (pain with jaw movement), and dental problems (referred pain).

Tinnitus and Hearing Impairment

• For a 30-year-old lady with slowly progressive tinnitus and hearing impairment, consider otosclerosis.
• Manage with audiometry and tympanometry.
• Treatment may include hearing aids or stapedectomy.

Nasal Septum Formation

• Formed by the perpendicular plate of the ethmoid bone, vomer, and the quadrangular cartilage.

Pediatric Nasal Discharge

• For a 5-year-old child with foul-smelling right nasal discharge, suspect a foreign body.
• Manage with removal of the foreign body and antibiotics if secondary infection is present.

Septal Surgery

• Complications include septal hematoma, septal perforation, saddle nose deformity, and anosmia.

Throat

• The region encompassing the pharynx, larynx, and associated structures involved in swallowing, breathing, and speech.

Sore Throat

• Includes pharyngitis, tonsillitis, epiglottitis, peritonsillar abscess, and laryngitis.

Head and Neck (specific to thyroid gland papillary carcinoma)

• Investigate with ultrasound, CT scan of neck, and thyroid function tests.
• Manage with total thyroidectomy, central neck dissection, and radioactive iodine ablation.

Thyroid Surgery

• Complications include hypoparathyroidism, recurrent laryngeal nerve injury, hematoma, infection, and hypothyroidism.

Salivary Glands

• The major salivary glands are the parotid, submandibular, and sublingual glands.
• The most common salivary gland tumor is pleomorphic adenoma.

Sialadenitis

• Infection or inflammation of a salivary gland.
• Differentiate with palpation, cultures, and imaging.

Post-Thyroidectomy Complications

• Tingling and muscle spasms indicate hypocalcemia due to parathyroid damage.
• Manage with calcium and vitamin D supplementation.

Injured Nerves

• The recurrent laryngeal nerve and superior laryngeal nerve can be injured during thyroid surgery.
• Unilateral injury of RLN causes hoarseness, while bilateral injury causes airway obstruction.

Dysphagia

• Causes include: stroke, esophageal strictures, achalasia, esophageal cancer, and neuromuscular disorders.

Barium Swallow

• An X-ray test used to visualize the esophagus, stomach, and duodenum.
• It can diagnose conditions like achalasia, strictures, and tumors.

Achalasia Cardia

• Radiological findings include a "bird's beak" appearance at the lower esophageal sphincter.
• Typical presenting features include dysphagia, regurgitation, and weight loss.

Thyroid Swelling

• Classified by location, size, consistency, and presence of nodules.

Nodular Swelling

• Investigate with thyroid function tests, ultrasound, and fine needle aspiration (FNA).

Diseases Diagnosed with FNAC

• Include thyroiditis, benign nodules, and thyroid cancer.

Lateral Neck Swelling

• Includes branchial cysts, lymphadenopathy, carotid body tumors, and cystic hygromas.

Branchial Cyst

• A congenital epithelial cyst that arises on the lateral part of the neck, due to failure of obliteration of the second branchial cleft in embryonic development.
• Treat with surgical excision.

Pediatric Parotid Swelling

• Most probable diagnosis is mumps.

Midline Neck Swelling

• Includes thyroglossal cysts, thyroid nodules, and dermoid cysts.

Thyroglossal Cyst

• A congenital cyst that occurs along the path of the thyroglossal duct.
• Treat with Sistrunk procedure (excision of cyst, the middle portion of hyoid bone, and a core of tongue tissue to the foramen cecum).

Thyroglossal Cyst

• Complications of thyroglossal cyst surgery include recurrence, infection, and injury to the hypoglossal nerve.

Thyroid Malignancy

• The most common is papillary carcinoma.
• Clinical features include a solitary thyroid nodule, cervical lymphadenopathy, and hoarseness.

Neck Dissection

• Surgical procedure to remove lymph nodes in the neck, typically performed for metastatic cancer.

Thyroid Surgery

• Complications include hypoparathyroidism, recurrent laryngeal nerve injury, and hematoma.

Post-Thyroidectomy

• Severe respiratory distress in the immediate postoperative period may be due to hematoma, bilateral recurrent laryngeal nerve injury, or tracheomalacia.

Acute Suppurative Otitis Media (ASOM)

• Pathogenesis involves Eustachian tube dysfunction, viral upper respiratory infection, and secondary bacterial infection (Streptococcus pneumoniae, Haemophilus influenzae, or Moraxella catarrhalis).

ASOM Management

• Manage with antibiotics, analgesics, and decongestants during the pre-perforation stage.

A 30-year-old male with CSOM, sudden vertigo and vomiting is suggestive of labrynthitis.

Ear Picking/Severe Earache

• A possible diagnosis is furunculosis.

Differentiating Mastoiditis

• Acute mastoiditis has inflammation and swelling in the mastoid area.
• Furunculosis auris presents with a localized boil in the external auditory canal.

Furunculosis Location

• Typically found in cartilaginous part of external auditory canal, due to presence of hair follicles and sebaceous glands.

Tuning Fork Tests

• Include the Rinne and Weber tests.

Sensorineural Loss

• In a patient suffering such loss, the findings will show lateralization to unaffected ear and AC>BC.

Tuning Fork Frequency

• Frequency suitable for hearing test is 512 Hz.

Nerve Supply of External Ear Canal & Mechanism of Referred Otalgia

• The great auricular nerve, the auriculotemporal nerve and branches of the facial nerve supply it.

Differentiating True Ear Disease

• Referred otalgia has no physical findings in the ear. True otalgia comes with ear symptoms and visible signs.

Otitis Externa

• Is inflammation of external ear canal.

Cholesteatoma

• An abnormal, noncancerous skin growth that can develop in the middle section of the ear.

Formation of Cholesteatoma Theories

• include squamous metaplasia, migration theory, and implantation theory.

Perforation in CSOM

• The site assists in determination type of CSOM and any complications.

Episodic Vertigo

• Vertigo with fullness is indicative of Meniere's disease.

Vertigo

• It happens as a result of the pathogenesis and management of vestibular system and related pathway.

Vertigo Causes

• Include: BPPV, Meniere's disease, vestibular neuritis, labyrinthitis, and acoustic neuroma.

Types of Otitis Media

• Acute and chronic.

Dull Tympanic Membrane

• Serous Otitis Media is most probable.

Foreign Bodies

Common foreign bodies include beads, insects, cotton.

Management of insects

• A living insect floating in the ear is managed by killing it first and then taking it out through irrigation.

Living Insect

• Complications from foreign body in ear include trauma, infection, perforation, and injury to ossicles.

A 60 Yr diabetic patient

• The most probable diagnosis as malignant otitis externa.

Bacterial Cause

• Name of commnest organism found in the bacterial condition is Pseudomonas Aeruginosa.

Foul Smelling ear

• A 20 yrs housewife with a foul smell and a blackish discharge is suggestive of otymocosis ( fungal ear infections).

Conductive Hearing Loss Causes

• Include ear wax, otitis media and foreign bodies

Cleaning Ear Canal

• Is done with irrigation and micro suction.

Sudden Sensorineural hearing loss

• Its treatment is most commonly using steroids.

Parts of the middle ear

• incldue: malleus, incus, stapes.

Malignant otitis media

• is managed primarily with anti biotics

Stridor

• An abnormal, high-pitched breathing sound resulting from turbulent airflow in the larynx or lower in the airway.
• Likely diagnosis is a congenital abnormality

Stridor causes

• Include laryngomalacia, subglottic stenosis, and vocal cord paralysis.

Hoarseness With Age

• in children the most common causes are congenital abnormalities

Dysphagia

• Name pharyngeal causes such as tonsillitis.

Definition Of JORP

• Juvenile Onset Recurrent Respiratory Papillomatosis.

This covers OCR limitations with low-quality scans and handwriting. Explains how lighting and perspective affect scanned images. Discusses correcting distortion and compression's impact on OCR.