CORRECTEDtomax.pdf

ORL 2023 questions YES = green NO = red Weber’s exam is lateralized by a patient with a suddenly arising surdity to the right to: - Left ear - Both ears equally - Right ear It is used to determine the location of rhinoliquor: - Rhinoendoscopic examination - Rhinoendoscopic examina...

ORL 2023 questions YES = green NO = red Weber’s exam is lateralized by a patient with a suddenly arising surdity to the right to: - Left ear - Both ears equally - Right ear It is used to determine the location of rhinoliquor: - Rhinoendoscopic examination - Rhinoendoscopic examination + intrathecal administration of florescein - HRCT, CT cisternography, MRI cisternography - Evidence of B-2 transferrin Nystagmus may refer to: - Spontaneous - After air irritation 24C - After water irritation temperature 37C - After water irritation 44C Chronic otitis is charecterized by: - Opacity of the cell system - The presence of fluid behind the intact eardrum - Eardrum perforation - Sensorineural hearing loss Hearing loss in otosclerosis is caused by dense sclerotic bone in: - Mucosa of attic - Basal turn of cochea - Head of the hammer - Oval window Acoustic Reflex Testing (stapedial reflex) investigate: - Defense Mechanism against Noise-Induced Hearing Loss - Function of sacculus - Function of cochlear nerve - Function of facial nerve Sialadenitis: - The patient presents with painful, diffuse swelling of the affected gland - Generally, the disease doesn’t respond well to medical management with antibiotics - The most common viral pathogen is the mumps virus - Can’t be caused by poor oral and dental hygiene - the first line modality for further investigation is ultrasonography - generally acute bacterial sialadenitis is treated by antibiotics - is typically present with suppurative discharge in patient - salivary stone stasis can lead to infection of the excretory duct and gland Hypopharyngeal carcinoma: - They are usually diagnosed in the early stages - Induction chemotherapy with radiotherapy and surgical treatment with radiotherapy have the same results - An important etiological factor is the consumption of concentrated alcohol and tobacco smoking - The most often symptoms are the sensation of a foreign body in the pharynx and dysphagia Bullous myringitis: - Paracentesis is performed, after which the patient has less pain - Caused by herpes zoster virus - Treatment is symptomatic, analgesics, scarification of bullae - Caused by influenza virus Malignant otitis externa is usually caused by: - Streptococcus pyogenes - Pseudomonas aeruginosa - E-coli Laryngomalacia: - After birth it should always be investigated with microlaryngoscopy - Caused an inspiratory stridor - Is due to prolapse of issue into the larynx during inspiration - Tends to get better after 3-4 months Neck diseases: - In children, the most common causes of neck masses are inflammatory lymph nodes - Lateral cysts and fistulae are classified as branchial cleft abnormalities - Medial cyst is the most common congenital lesion - Deep neck space complication include jugular vein thrombosis If the patient has bone conduction at the level of 40 dB and air conduction at the level of 55 dB on the tone audiogram, we are talking about: - Conductive Hearing Loss - Combined Hearing Loss - Normal Hearing - Sensorineural Hearing Loss Mark the functions of the auditory ossicles: - Transmission of the vibrations from the eardrum to the inner ear - Sound amplification - To maintain the position of the eardrum What is used for correction of severe conductive hearing loss: - Cochlear implant - BAHA - Strong hearing aid Imaging methods: - The lateral projection of conventional radiographs provides the most information usually without the need of the frontal projection - For the evaluation of the head and neck cancers, PET/CT is superior to either PET or CT alone - Intravenous contrast in CT has an importance in the neck because enlarged lymph nodes may be difficult to distinguish from unenhanced vessels - MRI is an essential modality for the staging, monitoring, and surveillance of pharygeal carcinomas Salivary glands: - Saliva contains an antimicrobial agents - Submandibular duct opens into the floor of the mouth on the summit of the sublingual papilla - Parotid gland consists of 2 layers: superficial and deep - Wharton and Stensen ducts can’t be evaluated by inspection Myringotomy in AOM is performed: - During the treatment of antibiotics and persistence of temperature - Always - If spontaneous perforation is present - Mastoiditis Tumor in salivary glands: - Evidence of tumor infiltrating muscle, skin or nerves is sign suggesting a malignant tumor - The most serious surgical complication of parotidectomy is facial nerve injury - Treatment consist of surgical removal - 80% of salivary gland tumors occur in the parotid gland - pleomorphic adenoma is the most common benign tumor of the salivary glands - approximately 90% of salivary glands are malignant - benign tumors presentt with rapid growth - treatment is radiotherapy Cochleovestibular disorders: - Are usually healed ad integrum - Hearing loss + peripheral vestibular disorder - The etiology is a circulatory disorder, ototoxic substances - Bilateral is manifested by oscillopsia For epistaxis: - One of the reasons is M. Rendu-Osler - The most common source of bleeding is the nasopharynx - Recurrent epitaxis is an indication for FESS - Locus Kiesselbachi is rarely a source of bleeding Nystagmus can be clinically investigated by using: - Electrocardiography (EKG) - Electroencephalography (EEG) - Electronystagmography (ENG) - Videonystagmography (VNG) Inflammation in oral cavity: - Oral mucositis is the common side effect of radiotherapy and chemotherapy - Herpetic aphthous gingivostomatitis is caused by the human herpesvirus HSV-2 - Oral candidiasis occurs in children exceptionally under 1 year only - Recurrent inflammation of oral cavity can be the results of deficiency of cobalamin Neuronitis vestibularis: - Sensorineural hearing loss is also typif4cal - In treatment, in addition to corticoids, antiviral drugs are important - The picture of acute unilateral peripheral vestibular disorder is typical - Inflammation of the n. Vestibularis based on activation of HSV 1 infection The main goal of surgical treatment in chronic otitis media is to improve hearing - Correct - False mastoidectomy is indicated in: - Viral otitis media - Secondary meningitis to acute otitis media  - Acute otitis media with facial nerve palsy Audiometric examination in vestibular schwannoma: - stapedial reflexes missing - conductive hearing loss - speech audiometry - without decrease word discrimination - BERA - supracochlear hearing disorder CT before surgery of chronic epitympanic otitis media is: - Is necessary when sensorineural hearing loss and vertigo is present - It is not always necessary - Is necessary in revision surgery Vocal Cord Paresis: - with adductor paresis, the vocal cords are in an abducted position, breathing is difficult, the voice is resonant - bilateral paresis of the vocal cords immediately after surgery is an acute condition that must be solved immediately by coniotomy - myopathic paresis manifests as a weakened voice - myopathic paresis is a consequence of chronic inflammation of the phonation muscle Patient after stapedectomy develops tinnitus, ear fullness, disequilibrium and fluctuant hearing loss. Which is possible caused: - perilymph fistula due to slippage of prothesis - patient has developed Meniere's disease - post op psycho somatic symptoms - cochlear otosclerosis component Vestibulocochlear nerve neurina (n. VIII): - Hearing loss with tinnitus and vertigo may be present - There is conductive hearing loss - Impaired innervation may be present n. VII. - It is a malignant tumor Benign tumors of the nasal cavity: - They are relatively rare - They are manifested by purulent secretion from the nose - They typically cause unilateral nasal obstruction - They are mostly treated conservatively, exceptionally surgically For congenital diseases of the nasal mucosa:  - Cystic fibrosis is a disease of the endocrine glands - Samter's triad is typical for cystic fibrosis - In ASA syndrome, polyposis of the nasal cavity is usually massive, the so-called "whiteout effect" on CT scan - The presence of nasal polyps in children raises the suspicion of cystic fibrosis Pituitary gland tumors: - they are only functional - indication for surgical treatment is visual field defects - can be micro and macroadenomas - transcranial approach is preferred Temporal bone fractures: - injury to n. VIII (n. vestibulocochlearis) is often present - transverse fractures are more common - diagnostics is based on HRCT examination - treatment is mostly conservative For chronic bacterial rhinosinusitis: - USG is the main radiology method for diagnosis - Treated with targeted antibiotics based on microbacterial results - The basic cause is pathological hyperplastic changes in ostiomeatal complex - During a rhinoendoscopic examination is detected the discharge of pus from some nasal meatus Laryngeal carcinoma: - glottic carcinomas have a better prognosis, due to their early diagnosis and less tendency to metastasize - glottic carcinoma metastasizes later due to poor lymphatic supply - glotic carcinoma has late onset of symptoms - supraglottic carcinoma is initially asymptomatic - supraglottic carcinoma is less likely to metastasize than glottic - supraglottic carcinoma tends to grow into pharynx - subglottic carcinoma is rare and the lower it is below the vocal cords the later the development of symptoms - subglottic carcinoma usually does not metastasize Examination of the pharynx: - clinical appearance of unilateral hypoglossal palsy inculdes deviation of the tongue during protrusion opposite to weak side  - symmetry of oropharyngeal ishmus is a result of bilateral intact function of the glossopharyngeal nerve - tonsilloliths are signs of acute tonsillitis - flexible or rigid endoscopy provides direct visualization of pathologies and enables early diagnosis Hearing loss in otosclerosis is: - Conductive - Sensorineural The Bezold triad consist of : - Umbo, prominentia mallearis, light reflex - Prominentia mallearis, stria mallearis, light reflex - Umbo, stria mallearis, light reflex Serous otitis media: - in adult patients, it may be a symptom of nasopharyngeal carcinoma - in children, adenoid vegetations play an important role in the pathogenesis - the most common symptoms are elevated body temperature, throbbing ear pain - the most common symptoms are a feeling of fullness of the ear, hearing loss, crackling in the ear, tinnitus The following applies to intracranial complications of rhinosinusitis: Do not appear in the antibiotics era The spread of infection is hematogenous or per continuitatem This is not a life threatening condition Neurological symptoms predominate over nasal symptoms Imaging methods for examining of paranasal sinuses: - The Watters projection is best X-ray for examination the maxillary sinus - On CT scan we recognize 3 planes - coronal, axial, sagittal - CT scan of paranasal sinuses is the method of choice in chronic polyposis rhinosinusitis - The lateral X-ray image is most suitable for examining frontal sinus Glomus tymapnicum: - pulsating tinnitus is not one of the symptoms - during otoscopy as a red tumor behind the intact tympanic membrane - may manifest as bleeding from ear  - the hearing impairment is of sensorineural type In children cochlear implant is suitable: - In congenitally deaf children at younger age than 6 years - For children with retrocochlear hearing loss - For congenitally deaf in adult age - For those using gesture language Esophagus: - foreign bodies typically become lodged in the middle constriction of the esophagus - whenever an ivestigated foreign body is suspected flexibile esophagoscopy shoud be performed - the third phase of swallowing is under voluntary control - passes through posterior mediastinum Allergic rhinitis: - A severe form can cause disturbed sleep and cause problems at work or school - According to the duration of the symptoms, it is divided into intermittent and persistent - It is a inhalation allergy - It is an immune reaction mediated by specific IgA antibodies It is valid for inflammation of the external nose: - Rhinophyma is an infectious disease of the skin of the face - The entrance gate for erysipelas of the nose is a fissure in the area of the nasal vestibule - With a furuncle there is a risk of intracranial spread of inflammation - Erysipelas is caused mostly by staphylococci Treatment of vestibular schwannoma: - TL approach allows preservation of hearing - Cushing's triad - possible postoperative bleeding - watch and wait - for small tumors, advanced age - approach - translabyrinthine, retrosigmoid, through middle fossa Foreign body aspiration: - with a foreign body completely obstructing the larynx the Heimlich maneuver can be used  - acute symptoms may be followed by a temporary quiescent phase in which the patient may not have any symptoms - aspirated foreign bodies are found more often in the left main bronchus than in the right main bronchus - there are three distinct clinical phases that occur after a foreign body is aspirated The movement of the stirrup in the oval window causes in the peri- and endolymph: - Hair cell compression - The emergence of a standing wave - Neither of the - The emergence of the wandering wave Treatment of serous otitis media: - antihistamines, topical decongestants and nasal corticosteroid sprays are recommended - in the relapsing form, adenoidectomy is performed in children - topical antibiotic drops and oral antibiotics are recommended - in the chronic form, paracentesis is performed Symptoms and signs of chronic epitympanic otitis media are: - Bone erosion - Hearing loss and smelling discharge from the ear - Perforation in anterior quadrant of pars tensa - Perforation in pars flaccida BPPV Benign paroxysmal positional vertigo: - It arises most often with involvement of the lateral semicircular canal - It arises most often with involvement of the posterior semicircular canal - Therapy is reposition maneuvers - Therapy is primarily operational In a patient with sudden sensorineural hearing loss: - audiometric examination confirms perceptual hearing loss - normal otoscopic findings are typical - corticosteroid therapy is absolutely contraindicated - audiometric examination confirms conductive hearing loss Congenital defects of the ear include: - apostasis auriculae - glomus tympanicum - othematoma - preauricular fistula Weber test- right-handed patient localizes the tone:  - In the left ear - Equal in both ears - In the right ear Earache: - It is a manifestation of otitis media - It is related to the inertive region n. IX in diseases of the pharynx. - It is not a common symptom in patients after tonsillectomy - It can be a manifestation of inflammation around the tooth roots Secretory otitis media is characterised by: - Frequent acute infection - Otorrhea - Hearing loss - Ear fullness Mark evoked potentials used in audiometry: - Visual evoked potentials VEP - Brainstem auditory evoked potentials BAEP - Somatosensoric evoked potentials SEP - Electric activity of brain is constantly Inflammation of the external ear canal: - treatment with oral antibiotics is more effective than topical treatment - the most common agent in mycotic infection is Aspergillus niger - the predisposing factor is diabetes mellitus - the n. VII (n. facialis) is often affected in external ear infection caused by herpes zoster virus Vestibuloocular reflex: - HIT is normal in peripheral vestibular disorder - its disturbance is manifested by spontaneous nystagmus - Halmagyi's maneuver (Head impulse test -HIT) is used to examine VOR - maintaining the image at the point of sharpest vision during movement ВАНА: - Works through direct stimulation of the eight nerve - Works through direct air conduction - Works through direct bone conduction Complications of transnasal transphenoidal endoscopic approach: - damage to optic nerve - Rhinoliquorea - bleeding from sigmoid sinus - bleeding from internal carotid artery Endoscopic endonasal dacryocystorhinostomy - DRS: - The principle is to cut the lacrimal gland and open it into the nasal cavity - It is a surgical treatment of stenosis of the tear ducts - It is a surgical treatment of ophthalmopathy in Graves-Basedow disease - It is performed using an endoscope in the orbit under general anesthesia Mastoiditis: - occurs after untreated otitis externa is the most common intracranial complication of acute otitis media - it is a suppurative inflammation of the mucous membrane and bone of the pneumatic system of the processus mastoideus - the typical symptom is rotational vertigo Choose the correct statement for congenital disease of the nose and paranasal sinuses: - If nasal encephalomeningocele is suspected, we make CT and MR scan of rhinobase - Insufficient closure of the rhinobase results in choanal atresia - A dermoid cyst is a cystic formation containing skin nexus and epithelium - Unilateral choanal atresia is a life-threatening condition A 60 yr old diabetic woman complains of severe otalgia) On examination, she has granulation tissue in ear: - Malignant Otitis Externa - Otitis Externa - Lymphoma - Otitis media with glue ear - Nasal Polyposis One of the complications of rhinosinusitis is: - Paresis n. facialis - Brain abscess - Cavernous sinus thrombosis - Submandibular abscess Presbyacusis: - tonal and verbal audiometry is used for diagnostics - it is an occupational disease - is typical in a patient with vestibular schwannoma - is caused by the effect of ototoxic drugs Caustic ingestion: - alkalis cause more severe injury pattern - there is risk of cancer developing - strictures caused by scarring are common sequelae - acids cause a coagulation necrosis Pharynx is a fibromuscular tube that is lined by: - columnar epithelium - stratified columnar epithelium - nonkeratinizing stratified squamous epithelium Tracheal stenosis: - less severe stenosis can be treated endoscopically - congenital tracheal stenosis is not a rare condition - may resulting in expiratory stridor - tracheotomy can't lead to stenosis Tracheal stenosis: - is most commonly a result of external trauma and prolonged intubation - may resulting in inspiratory stridor - severe stenosis require an external surgical approach - may occur as a result of radiotherapy Tracheal stenosis: - Less severe stenosis can be treated endoscopically. - Congenital tracheal stenosis is not a rare condition. - May result in expiratory stridor. - Tracheotomy can’t lead to stenosis. OAE - Otoacoustic emissions: - They record the electrical activity of the auditory nerve - They record the electrical activity of the auditory nuclei - TEOAE are used as a screening method for hearing testing newborns - They are the result of healthy hair cell motility Congenital malformations of oral cavity and pharynx: - the least severe from cleft defects is cheilognathopalatoschisis: - treatment of symptomatic Tornwaldt's cyst consists of curettage of the nasopharynx - children with cleft palate and oral cavity have higher probability of otitis media - Tornwaldt's cyst is a blind sac in nasal part of pharynx Imaging methods: - intravenous contrast in CT has an importance in the neck because enlarged lymph nodes may be difficult to distinguished from unenhanced vessels - MRI is an essential modality for the staging, monitoring, and surveillance of pharyngeal carcinomas - for the evaluation of head and neck cancers, PET/CT is superior to either PET or CT alone - the lateral projection of conventional radiographs provides the most information usually without the need of the fri projection Tracheobronchoscopy: - if there is the least suspicion of an aspirated foreign body generally there is no substitue for endoscopy of the upper aerodigestive tract - allows to obtain tissue specimens of the lung in a variety of disorders - rigid bronchoscopes allow easier retrieval of foreign bodies than flexible bronchoscope - is an endoscopic technique of visualizing the inside of the airways for only diagnostic purposes - Can be perform to evaluate a person with chronic cough - Possible complication is bleeding The integrity of the membrane of the eardrum is found: - Otoscopic examination - Tympanometric examination - Otomicroscopic examination - Rhinoendoscopic examination Choose the correct statement: - Antrochoanal formation is a polypous formation typically growing out of the sphenoid cavity - Cysts in paranasal sinuses often malign - Non-invasive fungal sinusitis has been clinically silent for a long time - In dentogenic rhinosinusitis is typical a unilateral patology in the frontal cavity Stapedial reflex is absent in: - Otosclerosis - Extratemporal damage of the facial nerve, for ex. Carcinoma parotic gland - M. Menieri Stapedial reflex is absent in: - Deafness - Cochlear nerve damage with hearing threshold over 65dB - Non-cooperative patient Tympanometry: - It is an indirect method of evaluating auditory tube function - It is not possible to catch the perforation of the membrane of the eardrum. - It detects the volume of the external auditory canal. - Detects resistance of the middle ear transmission system Audiometry: if the Bone Conduction Threshold is 20dB and the Air Conduction Threshold is 40dB, then we speak about: - Conductive hearing loss - Sensorineural hearing loss - Normal hearing in ear fullness Injury to the ear: - by otoscopic examination we can find hemotympanum - when the tympanic membrane is ruptured, the patient has a conductive hearing loss - ossicular chain injury can caused severe rotational vertigo - perforation of the tympanic membrane is treated surgically Malignant external otitis: - histological confirmation of basal cell carcinoma - finding of a skin ulcer with cylindrical margins on the auricle - is caused by Pseudomonas aeruginosa - occurs in diabetic patients For examination of the vestibular apparatus we use: - VEMP examination - EEG examination - VNG examination - BERA examination The treatment of choice of Peritonsillar abscess is: - Puncture - Tonsillotomy - Interval tonsillectomy - Quinsy tonsillectomy Tinnitus: - May be a symptom of HERE PC angle - Most often, is subjective  - Tinnitus Identification Is Used to Determine the Pitch and Volume of the - Most often it is objective Tinnitus: -is treated medically only -an external noise generator is used to mask tinnitus -can also be treated surgically -vascular anomalies may be the cause of tinnitus Chemodectoma: - Occurs sporadically and hereditary - Is poorly vascularized and does not bleed - Radiotherapy is the method of choice - Can occur multicentrically Congenital cholesteatoma symptom is: - Conductive hearing loss - Malodorous otorrhea - Cholesteatoma behind intact TM - Perforation in posterosuperior quadrant Ablation treatment M. Meiner: - Labyrinthectomy - Intratympanic administration of corticosteroids - Decompression of saccus endolymphaticus - N. vestibular section Audiometric examination: - A threshold curve in the range of 0-20dB at all frequencies examined represents a normal hearing threshold - Tonal audiometry is an objective investigative audiological method - Masking is not necessary - Narrowband noise is used to mask the unexamined ear Otitis externa: - Hyperemia of the tympanic membrane dominates in the local findings - The treatment of choice is local therapy - It is an inflammation of the skin of the external ear canal - Occurs with poor ear hygiene For examination of the vestibular apparatus we use: - VEMP examination - EEG examination - VNG examination - BERA examination  Otoscopic signs in acute otitis media: - Hyperemic, bulging tympanic membrane - Grey tympanic membrane with perforation - hyperemic , retracted TM Pharynx: - Laryngeal part of pharynx is located in front of the inlet of the larynx - Interior of the pharynx is typically divided into three parts - nasal, oral, laryngeal - Tubal tonsils are paired and part of the oropharynx - Waldeyers ring of lymphoid tissue is situated in the naso- and oropharynx Diagnosis of serous otitis media: - In the early stage, a superficial injection is seen on the malleus - On tympanometric examination we detect a B curve - Otoscopically - a thickened and hyperemic tympanic membrane is typical - Audiometric examination confirms conductive hearing loss Nervus laryngeus recurrens: - Bilateral vocal cord palsy requires emergency airway management - branch of XI cranial nerve - unilateral vocal cord palsy requires foniatric treatment - can be damaged during surgical intervention on thyroid gland What belongs to the examination of the vestibular apparatus: - BERA - Electrocochleography - cVEMP - videonystagmography- VNG, electronystagmography - ENG In acute suppurative otitis media: - perforation of the tympanic membrane closes spontaneously - the patient has throbbing ear pain and elevated body temperature - the tympanic membrane perforation needs to be covered with a prosthesis - epitympanic perforation of the tympanic membrane is typical Malignant lesions in oral cavity: - MR or CT scan is used to assess the extent of the involvement of the floor of the mouth and tongue - the most common localization of SCC of the oral cavity is the edge of the body of the tongue - as part of surgical treatment, block dissection of the neck lymph nodes is not necessary - a typical symptom is painless swelling or non-healing mucosal ulceration Barotrauma (during a plane flight): - is caused by a sudden change in pressure - there is temporary damage to the inner ear - otoscopic examination- retraction of the tympanic membrane, transudate retromyringically, - audiometry confirms perceptual hearing loss Laryngeal papillomatosis: - the etiological agent is HPV type 6 or 11 - the main symptom is progressive sore throat - non -cancerous tumors of the larynx of infectious origin - treatment is surgical, without a tendency to relapse - The juvenile type is conditioned by the transmission HPV from mother to child during childbirth - The treatment is surgical laser removal with a high risk of recurrence - The typical symptom is progressive dysphonia - the etiological agent is hpv type 11 Symptoms in temporal bone fracture are: - liquorrhoea - hearing loss - Hemotympanicum - swelling and hematoma of the preauricular area Head Impulse test examines: - Nystagmus Stability of eyes during head motion - Acceleration of head and eyes - Semicircular canals - sacculus and utriculus Intracranial hypertension: - spinal pain is not part of the symptoms of IC hypertension - Cushing's triad: art. hypertension, bradycardia, irregular breathing - vision disorder, diplopia, papilla oedera are not part of the symptoms - typical for late stages (large) vestibular schwannoma Acute pharyngitis and tonsilitis: - penicillin is the antibiotic of choice  - group A B-hemolytic streptococci is the most frequently isolated pathogen - treatment of recurrent tonsillitis should be surgical, including tonsillectomy or tonsillotomy - usual symptom of pharyngitis is cough Polyps of the nasal cavity: - They are always unilateral in nasal cavity - 3rd degree are massive, they also fill common nasal meatus - They are caused by hyperplasia of the nasal mucosa - They are benign, multiple pedunculated messes Carhart notch Is a sign which can be seen in the: - Otoscopy. - Objective audiometry - Pure tone audiometry - Otomicroscopy Rinne test with fluid in the middle ear space, is: - Positive - Negative In case of acute rhinitis: - Rhinitis is commonly caused by rhinoviruses, influenza and parainfluenza viruses - CT scan is indicated - Epistaxis never occurs during the disease - Antibiotics are the first choice of treatment Auditory bones: - They mediate the transmission of sound from the membrane of the eardrum to the inner ear without amplification - They mediate the transmission of sound from the membrane of the eardrum to the inner ear while amplifying it - They maintain the position of the membrane of the eardrum - The smallest bone is anvil Positive Fistula sign is present in: - Otosclerosis - Commotio labyrinthi - Cholesteatoma with lateral semicircular canal erosion Glomus jugulare: - usually asymptomatic for a long time - the transmeatal approach is mainly used in surgical treatment - angiographic examination has no significance in preoperative preparation - is manifested by a lesion of the cranial nerves IX. X, XL, XI Stapedial reflex will be in otosclerosis: - Absent - Present Special examination methods: - 24-hour ambulatory pharyngeal pH monitoring provides useful information for understanding of the exraesophageal manifestation o GERD - chronic hoarsness is not an indication to perform 24-hour pharyngeal pH monitoring - flexible endoscopic evaluation of swallowing (FEES) is done under general anesthesia - FEES uses real food and it is particularly important in evaluating the pharyngeal phase of deglutition Deviation of the nasal septum: - May cause headaches - Causes difficulty breathing through the nose - Serious deviation is solved surgically even in childhood - it is never a cause of epistaxis Cochlear implant is used in: - Severe sensorineural hearing loss - Congenital deafness - Acquired deafness - Severe conductive hearing loss Which of the following complications are otogenic intracranial complications: - Extradural abscess - Mastoiditis - Sigmoid sinus thrombosis - Brain abscess - Bezold Abscess Which of the following complications are NOT otogenic intracranial complications: - Extradural abscess - Mastoiditis - Sigmoid sinus thrombosis - Brain abscess - Bezold Abscess Harmonic vestibular syndrome:  - vestibulospinal reflexes towards affected side - typical for central vestibular disorders - spontaneous horizontal rotational nystagmus towards the healthy side - Halmagyi maneuver (HIT) with saccade on affected side - nausea and vomiting is not directly proportional to the intensity of symptoms Dysharmonic vestibular syndrome: -typical for central vestibular disorder -nystagmus is different from horizontal rotatory -halmagyu's manouver is usually negative -usually also neurological symptomatology Trachea: - the trachealis muscle allows the trachea to contract and decrease its diameter - left main bronchus is a short, wide air passageway into left lung - lies just anterior the esophagus - prominentia tracheae is an important landmark during tracheobronchoscopy - Tracheobronchoscopy is indirect technique for the diagnosis and management of a wide spectrum of respiratory tract disease - Receives its nerve supply from the vagus nerve and sympathetic trunk Tumors of the salivary glands: - pleomorphic adenoma is the most common benign tumor of the salivary glands - approximately 90% of salivary glands are malignant - benign tumors present with rapid growth - treatment is by radiotherapy - treatment consist of surgical removal - 80% of salivary gland tumors occur in the parotid gland - evidence of tumor infiltrating muscle, skin or nerves is sign suggesting a malignant tumor - The most serious surgical complication of parotidectomy is facial nerve injury Vestibular schwannoma - tinnitus can be the first symptom - attacks of rotational vertigo are typical - ear pain and facial paresthesias are typical for intrameatal tumor - progressive or sudden hearing impairment is typical Inflammation in oral cavity: - reccurent inflammation of oral cavity can be the result of deficiency of cobalamin - oral mucositis is the common side effect of radiotherapy and chemotherapy - oral candidiasis occurs in children exceptionally under 1 year only - herpetic aphthous gingivostomatitis is caused by the human herpesvirus HSV-2 During endoscopic decompression of the orbit: - it is the treatment of orbitopathy in Graves-Basedow disease - During the procedure, the lateral wall of the orbit is removed while preserving the  periosteum - During the procedure, the medial wall of the orbit is removed while preserving the periosteum - Post-operative is exophthalmos reduced Tumors of the salivary glands: - 80% of salivary gland tumors occur in the parotid gland - evidence of tumor infiltrating muscle, skin or nerves is sign suggesting a malignant tumor - the most serious surgical complication of parotidectomy is facial nerve injury - treatment consist of surgical removal Rupture of the tvmpanic membrone: - is manifested by severe rotational vertigo - may occur after a blow (slap) to the ear area - may occur when injured by a foreign body - causes sensorineural hearing loss Tinnitus: - is treated medically only - an external noise generator is used to mask tinnitus - Can also be treated surgically - vascular anomalies may be the cause of tinnitus Curve A of tympanometry is found in - Obturation of auditory canal with cerumen - Tympanic cavity is airy - Perforated tympanic membrane - Fluid is present in tympanic cavity - In patient with othematoma+ The head impulse test (HIT, halmagyi maneuver) investigates the function: - Sakula and utricula - Semicircular canals - Vestibular nuclei - Nystagmus Esophagus: - if there is a danger of esophageal perforation, barium should never be used in oral contrast examination - has two areas of anatomic narrowing - proximal third of the esophagus consist of smooth muscle fibers - during the pharyngeal phase of swallowing food is broken down and moistened to form a bolus Treatment of sudden hearing loss includes: - Antibiotics  - Oxygen therapy or hyperbaric therapy. - Vasodilators - Antihistaminicum - Systemic steroids Rombert exam - In acute neuronitis of the vestibular nerve is not disturbed - It is the exam for vestibulospinal reflexes - It is being investigated for nystagmus - Is the vestibulookular reflexes exam Air conduction is - Conduction of the sound via Eustachian tube - Conduction of the sound via skull bones - Conduction of the sound via TM and ossicles Unilateral secretoric otitis media in adults causes suspicion of - Sphenoid Sinusitis - Adenoid vegetation - Nasopharyngeal cancer - Nasal Polyps Choose the correct statement about the nasal cavity: - The front part of the nasal septum is formed by bone - Natal septum consists of cartilaginous and bony part - the patency of the nasal cavity in determined by olfactometry - The middle turbinate is formed by a separate bone Superior semicircular canal dehiscence syndrome - dizziness is caused by a change in the position of the head - dizziness is caused oy a change in pressure in the ear canal - Heneberd’s sign - the diagnosis is confirmed by HRCT of temporal bones - dizziness will cause a loud sound - Tullio phenomenon Disease of esophagus: The most common symptoms of GERD is Zenker diverticulum belongs to the Achalasia is characterized by Esophageal atresia result in Otoscopic finding in secretory otitis media is Bubbles in the middle ear Perforation in anterior superior quadrant Redness and bulging of the TM Honey. Colored ™ Orbital complications of sinusitis They are less common than intracranial complicatio… According to the localisation and ext… They can lead to blindness … They appear only in childhood. Valsalvas attempt It is used to examine the function of the Eust… For the detection of menie… For the detection of otosclerosis It is accompanied by a sound sensation… Vesicles and hemorrhagic blisters on the tympanic membrane are typical for Hemotympanum Acute tubotympanic catar.. Bullous myringitis Acute otitis media Labyrinthitis Manifested by rot.. Therapy includes administration of.. Painfull swelling behind the.. Is an inflammation of the inner ear Peripheral vestibular apparatus Upward and downward movement… Utriculus detects linear acc… N. vestibularis inferior…. Semicircular canals detect… 11.Neuronitis vestibularis in treatment, in addition to corticoids, antiviral drugs are important the picture of acute unilateral peripheral vestibular disorder is typical inflammation of the n. vestibularis based on activation of HSV 1 infection sensorineural hearing loss is also typical 16.Auditory bones: They mediate the transmission of sound from the membrane of the eardrum to the inner ear without amplification They maintain the position of the membrane of the eardrum They mediate the transmission of sound from the membrane of the eardrum to the inner ear while amplifying it The smallest bone is anvil 14.Symptoms in temporal bone fracture are: hemotympanum liquorrhoea hearing loss swelling and hematoma of the preauricular area Temporal bone fractures: Injury to n.VIII is often present Transverse fractures are more common Diagnosis is based on HRCT examination Treatment is mostly conservative 12. Esophagus: proximal third of the esophagus consist of smooth muscle fibers during the pharyngeal phase of swallowing food is broken down and moistened to form a bolus if there is a danger of esophageal perforation, barium should never be used in oral contrast examination has two areas of anatomic narrowing Esophagus: Passes through posterior mediastinum The third phase of swallowing is under voluntary control Whenever an investigated foreign body is suspected flexible esophagoscopy should be performed Forein bodies typically become lodge in the middle constriction of the esophagus 13. Tympanometry investigates: The reflected Sound from the Eardrum Movement of auditory ossicles Movements of tympanic membrane Function of hair cells Function of eustachian tube Tympanometry It is an indirect method of evaluating auditory tube function It is not possible to catch the perforation of the membrane of the eardrum. It detects the volume of the external auditory canal. Detects resistance of the middle ear transmission system Tinnitus Most often it is objective Most often, subjective May be a symptom of HERE PC angle Tinnitus Identification Is Used to Determine the Pitch and Volume of the 9.During endoscopic decompression of the orbit: During the procedure, the medial wall of the orbit is removed while preserving the periosteum During the procedure, the lateral wall of the orbit is removed while preserving the periosteum It is the treatment of orbitopathy in Graves-Basedow disease Post-operative is exophthalmos reduced 1 0. Larynx. rigid or flexible laryngeal endoscopy provides detailed examination of structures direct laryngoscopy is performed under local anesthesia laryngostroboscopy is used to examine the oscillation of the vocal cords part of the flexible laryngoscopy is NBI, which is used to highlight vessels Acoustic Reflex Testing (stapedial reflex investigate: Function of sacculus Function of facial nerve Defense Mechanism against Noise-Induced Hearing Loss Function of cochlear nerve 26.Tinnitus : vascular anomalies may be the cause of tinnitus an external noise generator is used to mask tinnitus is treated medically only can also be treated surgically What can be the diagnosis of an 8 year old child with bilateral conductive hearing loss: bullous myringitis tubotympanic catarrh serous otitis media adenoid vegetation 1 7.Valsalva's attempt: It is accompanied by a sound sensation, which can be observed by otophone For the detection of otosclerosis It is used to examine the function of the Eustachian tube For the detection of Meniere's disease Laryngeal papillomatosIs: treatment is surgical, without a tendency to relapse non-cancerous tumors of the larynx of infectious origin the etiological agent is HPV type 6 or 11 the main symptom is progressive sore throat it applies to non-infectious non-allergic rhinosinusitis: Stress is one of the causes of vasomotor rhinitis These include diseases such as Wegener's granulomatosis, mycobacterial inflammation, sarcoidosis Their only treatment is surgery Long-term use of local decongestants causes rhinitis medicamentosa For an inverted papilloma: Most often it grows bilateral in nasal cavity It is treated surgically, radically The diagnosis is established on the basis of pathological examination It is a benign tumor, never malignant Tumors of the salivary glands: benign tumors present with rapid growth approximately 90% of salivary glands are malignant pleomorphic adenoma is the most common benign tumor od the salivary glands treatment is by radiotherapy Tumors of the salivary glands: Treatment consists of surgical removal 80% occur in parotid gland The most serious surgical complication of parotidectomy is facial nerve injury Evidence of tumor infiltrating mucle, skin and nerves is a sign of malignancy Transient-evoked OAEs are Used to distinguish cochlear and retrocochlear hearing loss Used to determine hearing threshold Used for hearing screening in children 32.Barotrauma (during a plane flight): otoscopic examination- retraction of the tympanic membrane, transudate retromyringically there is temporary damage to the inner ear is caused by a sudden change in pressure audiometry confirms perceptual hearing loss Rhinosinusitis in children: acute respiratory diseases are mostly caused by bacteria ethmoid air cells are present at birth X-ray of paranasal sinuses in acute stage of disease is not necessary typical sign is nasal blockage or congestion 39. Special examination methods: chronic hoarsness is not an indication to perform 24-hour pharyngeal pH monitoring 24-hour ambulatory pharyngeal pH monitoring provides useful information for understanding of the exraesophageal manifestation of GERD FEES uses real food and it is particularly important in evaluating the pharyngeal phase of deglutition flexible endoscopic evaluation of swallowing (FEES) is done under general anesthesia 40. Complications of pharyngeal inflammation: the treatment of peritonsillar abscess is mainly surgical evacuation of purulent content tonsillogenic sepsis can also be a general complication we think of the lymphogenic spread of the infection to the retropharyngeal space in children due to the lymph nodes, which gradually X-ray examination of the neck has the greatest importance in diagnosis of parapharyngeal abscess Laryngeal stenosis: subglottic stenosis is usually circular frequent complication after repeated surgical interventions for laryngeal papillomatosis any kind of surgery on larynx has a high risk of subsequent scaring and therefore restenosis anterior glottic stenosis is most often caused by long-term intubation 5.Sialadenitis: can't be caused by poor oral and dental hygiene the patient presents with painful, diffuse swelling of the affected gland the most common viral pathogen is the mumps virus generally,the disease doesn't respond well to medical management with antibiotics Sialadenitis: the first -line modality for further investigation is ultrasonography generally acute bacterial sialadenitis is treated by antibiotics is typically present with suppurative discharge in patient salivary stone stasis can lead to infection of the excretory duct and gland Hypopharyngeal carcinoma: they are usually diagnosed in the early stages induction chemotherapy with radiotherapy and surgical treatment with radiotherapy have the same results an important etiological factor is the consumption of concentrated alcohol and tobacco smoking the most often symptoms are the sensation of a foreign body in the pharynx and dysphagia 10. Bullous myringitis: paracentesis is performed, after which the patient has less pain caused by herpes zoster virus treatment is symptomatic, analgesics, scarification of bulla caused by influenza virus 11. Malignant otitis externa is usually caused by: Streptococcus pyogenes Pseudomonas aeruginosa E-coli Neck diseases: in children, the most common causes of neck masses are inflammatory lymph nodes lateral cysts and fistulae are classified as branchial cleft abnormalities medial cyst is the most common congenital lesion deep neck space complications include jugular vein thrombosis The Eustachian tube serves to: Aeration of the middle ear Equalising the pressure in front of and behind the eardrum Removing the secretion from the middle-ear 22.Inflammation of the external ear canal: treatment with oral antibiotics is more effective than topical treatment the predisposing factor is diabetes mellitus the n.VIl (n. facialis) is often affected in external ear infection caused by herpes zoster virus, the most common agent in mycotic infection is Aspergillus niger Cochleovestibular disorders are usually healed ad integrum hearing loss + peripheral vestibular disorder the etiology is a circulatory disorder, ototoxic substances bilateral is manifested by oscillopsia 22. For epistaxis: One of the reasons is M. Rendu-Osler The most common source of bleeding is the nasopharynx Recurrent epistaxis is an indication for FESS Locus Kiesselbachi is rarely a source of bleeding 23. Vocal cord paresis: myopathic paresis is a consequence of chronic inflammation of the phonation muscle bilateral paresis of the vocal cords immediately after surgery is an acute condition that must be solved immediately by coniotomy with adductor paresis, the vocal cords are in an abducted position, breathing is difficult, the voice is resonant myopathic paresis manifests as a weakened voice 24. Nystagmus can be clinically investigated by using: Electrocardiography (EKG) Electroencephalography (EEG) Electronystagmography (ENG) Videonystagmography (VNG) 25. Pharynx is a fibromuscular tube that is lined by: columnar epithelium nonkeratinizing stratified squamous epithelium stratified columnar epithelium 26. The Bezold triad consist of: Umbo,stria mallearis, light reflex Prominentia mallearis, stria mallearis, light reflex Umbo, prominentia mallearis, light reflex 27. Mastoidectomy is indicated in: Secondary meningitis to acute otitis media Acute otitis media with facial nerve palsy Viral otitis media 28. Otoscopic finding in secretory otitis media is: Redness and bulging of the tympanic membrane Perforation in anterosuperior quadrant Honey- colored TM bubbles in the middle ear 30. Deviation of the nasal septum: It is never a cause of epistaxis Causes difficulty breathing through the nose Serious deviation is solved surgically even in childhood May cause headaches 31. Bezolds triad in otomicroscopy: It is formed prominence mallearis, anulus fibrocartilagineus, light reflex It is formed prominence mallearis, stria mallearis, trigonum lucis It is part of physiological otoscopic finding Means it's not acute otitis media 31.Congenital neck masses: medial cyst occur in the proximity of the hyoid bone treatment is only surgical removal lateral cysts are infrahyoidal remnants of the thyroglossal duct apparatus most branchial cysts are found in older children and adults Webers exam is lateralized by a patient with a suddenly arising surdity to the right to: Left ear Both ears equally Right ear 6.It is used to determine the location of rhinoliquor rhinoendoscopic examination rhinoendoscopic examination + intrathecal administration of florescein HRCT, CT cisternography, MRI cisternography evidence of B2 transferrin 3. Nystagmus may refer to: Spontaneous After air irritation 24°C After water irritation temperature 37°C After water irritation 44°C 4.Chronic otitis is characterized by: Opacity of the cell system The presence of fluid behind the intact eardrum Eardrum perforation Sensorineural hearing loss 5.Hearing loss in otosclerosis is caused by dense sclerotic bone in: Mucosa of atic Basal turn of cochea Head of the hammer Oval window Acoustic Reflex Testing (stapedial reflex) investigate: Defense Mechanism against Noise-Induced Hearing Loss Function of sacculus Function of cochlear nerve Function of facial nerve Treatment of acute suppurative otitis media: perform paracentesis in the anterior superior quadrant perform paracentesis in the posterior inferior quadrant includes mucolytics under local anaesthesia, insert a ventilation tube to suction the purulent contents It is valid for inflammation of the external nose: Rhinophyma is an infectious disease of skin of the face The entrance gate for erysipelas of the nose is a fissure in the area of the nasal vestibule With a furuncle there is a risk of intracranial spread inflammation Erysipelas is caused mostly by staphylococci 4.Treatment of vestibular schwannoma TL approach allows preservation of hearing Cushing's triad- possible postoperative bleeding watch and wait - for small tumors, advanced age approach- translabyrinthine, retrosigmoid, through middle fossa Foreign body aspiration: with a foreign body completely obstructing the larynx the Heimlich maneuver can be used Acute symptoms may be followed by a temporary quiescent phase in which the patient may not have any symptoms aspirated foreign bodies are found more often in the left main bronchus than in the right main bronchus there are three distinct clinical phases that occur after a foreign body is aspirated 36. Laryngitis: acute infectious laryngitis is primarily caused by bacterial infection acute allergic laryngitis can be the life-threatening condition laryngopharyngeal reflux can cause inflammatory changes in the larynx, especially in the area of the posterior commissure they can be of infectious or non-infectious etiology 37. Duroplasty sandwich technique - it is the least effective is used to close the fistula at oto and rhinoliquorea only autologous material can be used transnasal approach for rhinolicovorey is preferred 38. The movement of the stirrup in the oval window causes in the peri- and endolymph: Hair cell compression Neither of the The emergence of a standing wave The emergence of the wandering wave 39. Weber test, with fluid in the left middle ear space: Is lateralized to the left Is lateralized to the right 40. Which type of treatment is use in chronical otitis media: Ossiculoplasty Myringotomy Myringoplasty Mastoidectomy 35. The main goal of surgical treatment in chronic otitis media is to improve hearing Correct False 32.Audiometric examination: Narrowband noise is used tom mask the unexamined ear. Tonal audiometry is an objective investigative audiological method) Masking is not necessary. A threshold curve in the range of 0-20dB at all frequencies examined represents anormal hearing threshold) Acute auditory trauma (after a gunshot): hearing loss may also be permanent there is damage to the inner ear audiometry confirms perceptual hearing loss hearing loss caused by sound waves 35.Tracheal stenosis: is most commonly a result of external trauma and prolonged intubation may resulting in inspiratory stridor severe stenosis require an external surgical approach may occur as a result of radiotherapy The following applies to intracranial complications of rhinosinusitis: Do no appear in the antibiotics era The spread of infection is hematogenous or percontinuitatem This is not a life threatening condition Neurological symptoms predominate over nasal symptoms 1 3. Imaging methods for examining of paranasal sinuses: The Watters projection is best X-ray for examination the maxillary sinus On CT scan we recognize 3 planes- coronal, axial, sagittal CT scan of paranasal sinuses is the method of choice in chronic polyposis rhinosinusitis The lateral X-ray image is most suitable for examining frontal sinus 14. Allergic rhinitis: A severe form can cause disturbed sleep and cause problems at work or school According to the duration of the symptoms, it is divided into intermittent and persistent It is a inhalation allergy It is an immune reaction mediated by specific IgA antibodies Vocal cord paresis: with adductor paresis, the vocal cords are in an abducted position, breathing is difficult, the voice is resonant bilateral paresis of the vocal cords immediately after surgery is an acute condition that must be solved immediately myopathic paresis manifests as a weakened voice myopathic paresis is a consequence of chronic inflammation of the phonation muscle Benign tumours of the nasal cavity: typically cause unilateral nasal obstruction they are mostly treated conservately, exceptionally surgically they are relatively rare they are manifested by purulent secretion from the nose Functions of the pharynx: the pharynx forms the physical connection that connects the air tract and the digestive tract. pharynx plays important role in swallowing mechanism pharyngeal phase of swallowing includes movement of the bolus from the oropharynx into the esophagus and it's voluntary helps to define the tone of your voice 32. Myringotomy in AOM is performed: During the treatment of antibiotics and persistence of temperature If spontaneous perforation is present Always Mastoiditis 33. Tracheobronchoscopy: can be perform to evaluate a person with chronic cough flexible endoscopy is superior to rigid endoscopy for mobilizing and removing the foreign material the rigid scope eliminates the risks of mucosal injury and perforation that are associated with a flexible endoscope Possible complication is bleeding Tracheobronchoscopy if there is the least suspicion of an aspirated foreign body generally there is no substitue for endoscopy of the upper aerodigestive tract allows to obtain tissue specimens of the lung in a variety of disorders rigid bronchoscopes allow easier retrieval of foreign bodies than flexible bronchoscope is an endoscopic technique of visualizing the inside of the airways for only diagnostic purposes Inflammation in oral cavity Oral mucositisis is the common side effect of radiotherapy and chemotherapy Herpetic aphthous gingivostomatitis is caused by the human herpesvirus HSV-2 Oral candidiasis occurs in children exceptionally under 1 year only reccurent inflammation of oral cavity can be the result of deficiency of cobalamin 12 Rinne test, with fluid in the middle ear space, is: Negative Positive 14.Laryngomalacia: causes an inspiratory stridor tends to get better after 3-4 months after birth it should always be investigated with microlaryngoscopy is due to prolapse of issue into the larynx during inspiration Congenital defects of the ear include: preauricular fistula apostasis auriculae othematoma glomus tympanicum 33.Audiometric examination in vestibular schwannoma stapedial reflexes missing conductive hearing loss speech audiometry - without decrease word discrimination BERA - supracochlear hearing disorder 14. If the patient has bone conduction at the level of 40 dB and air conduction at the level of 55 dB on the tone audiogram, we are talking about: Conductive Hearing Loss Combined Hearing Loss Normal Hearing Sensorineural Hearing Loss 15.Mark the functions of the auditory ossicles: Transmission of the vibrations from the eardrum to the inner ear Sound amplification To maintain the position of the eardrum 16.What is used for correction of severe conductive hearing loss: Cochlear implant BAHA Strong hearing aid Imaging methods: the lateral projection of conventional radiographs provides the most information usually without the need of the frontal projection for the evaluation of head and neck cancers, PET/CT is superior to either PET or CT alone intravenous contrast in CT has an importance in the neck because enlarged lymph nodes may be difficult to distinguish from unenhanced vessels MRI is an essential modality for the staging, monitoring, and surveillance of pharyngeal carcinomas 18.Salivary glands: saliva contains an antimicrobial agents submandibular duct opens into the floor of the mouth on the summit of the sublingual papilla parotid gland consists of 2 layers: superficial and deep Wharton and Stensen ducts can't be evaluated by inspection Symptoms and signs of chronic epitympanic otitis media are: Bone erosion Hearing loss and smelling discharge from the ear Perforation in anterior quadrant of pars tensa Perforation in pars flaccida 2. BPPV Benign paroxysmal positional vertigo It arises most often with involvement of the lateral semicircular canal It arises most often with involvement of the posterior semicircular canal Therapy is reposition maneuvers Therapy is primarily operational 3. In a patient with sudden sensorineural hearing loss: audiometric examination confirms perceptual hearing loss normal otoscopic findings are typical corticosteroid therapy is absolutely contraindicated audiometric examination confirms conductive hearing loss Weber test-right handed patient localizes the tone: In the left ear Equal in both ears In the right ear Intracranial hypertension spinal pain is not part of the symptoms of IC hypertension Cushing's trad: art. hypertension, bradycardia, irregular breathing vision disorder, diplopia, papilla edema are not part of the symptoms typical for late stages (large) vestibular schwannoma Stapedial reflex is absent in Extratemporal damage of the facial nerve, for ex. Carcinoma parotic gland Otosclerosis M. Menieri Stapedial reflex will be in otosclerosis Absent Present 19. Which of the following symptoms are typical for AOM in young children: Vomiting Fever Papillary oedema 20. Salivary glands: xerostomia =increased flow of saliva X-ray is the first imaging procedure used parotid gland is the smallest of the major salivary glands the production of saliva is also important in the prevention of gum disease and dental caries 21. Caustic ingestion alkalis cause more severe injury pattern there is risk of cancer developing strictures caused by scarring are common sequelae acids cause a coagulation necrosis Caustic ingestion Cant lead to perforation In severe caustic injury dilation should be started one week after surgery Alkalis cause coagulation necrosis The extent of the injuries to the oral mucosa reflect the severity of damage to… 22. Tracheal stenosis less severe stenosis can be treated endoscopically congenital tracheal stenosis is not a rare condition may resulting in expiratory stridor tracheotomy can't lead to stenosis 23. OAE - Otoacoustic emissions They record the electrical activity of the auditory nerve They record the electrical activity of the auditory nuclei EOAE are used as a screening method for hearing testing newborns They are the result of healthy hair cell motility Congenital malformations of oral cavity and pharynx: the least severe from cleft defects is cheilognathopalatouvuloschisis treatment if symptomatic Tornwaldt's cyst consists of curettage of the nasopharynx children with cleft palate and oral cavity have higher probability of otitis media Tornwaldt's cysti is a blind sac in nasal part of pharynx 20.Malignant external otitis: histological confirmation of basal cell carcinoma finding of a skin ulcer with cylindrical margins on the auricle is caused by Pseudomonas aeruginosa occurs in diabetic patients 23. Vertical acceleration (lift) stimulates: Saccule Semicircular canals Utricle The head impulse test (HIT, halmagyi maneuver) investigates the function: Nystagmus Semicircular canals Vestibular nuclei Sakula and utricula Curve A of Tympanometry is found in: Obturation of external auditor canal with Cerumen Tympanic cavity is airy Perforated Tympanic Membrane Fluid is present in tympanic cavity Vestibuloocular reflex Halmagyi's maneuver (Head impulse test -HIT) is used to examine VOR HIT is normal in peripheral vestibular disorder maintaining the image at the point of sharpest vision during movement its disturbance is manifested by spontaneous nystagmus 25. Nervus laryngeus reccurens: unilateral vocal cord palsy requires foniatric treatment branch of X.L cranial nerve bilateral vocal cord palsy requires emergency airway management can be damaged during surgical intervention on thyroid gland 26.Laryngeal papillomatosis: the juvenile type is conditioned by the transmission of the HPV virus from mother to child during childbirth the etiological agent is HPV type 16 the treatment is surgical laser removal with a high risk of recurrence the typical symptom is progressive dysphonia 27. A 60 yr old diabetic woman complains of severe otalgia. On examination, she has granulation tissue in ear Nasal Polyposis Lymphoma Otitis media with glue ear Otitis Externa Malignant Otitis Externa 28. Sudden hearing loss (SHL) is defined as: Hearing reduction greater than 30 dB, over at least three continuous frequencies Hearing reduction greater than 30 dB at least on 1 frequency Hearing reduction occurring over a period of last 3 days 29. Harmonic vestibular syndrome typical for central vestibular disorders vestibulospinal reflexes towards affected side nausea and vomiting is not directly proportional to the intensity of symptoms. spontaneous horizontal rotational nystagmus towards the healthy side For juvenile angiofibroma: Typical clinical symptoms are recurrent epistaxis and nasal obstruction It is a malignant vascular tumor of the nasal cavity It affects both boys and girls between the ages of 9 and 29 Tumor embolization is used before surgery to help reduce intraoperative bleeding Treatment of sudden hearing loss includes: Systemic steroids Vasodilators Antibiotics Antihistaminicum Oxygen therapy or hyperbaric therapy Treatment of serous otitis media: in the chronic form, paracentesis is performed antihistamines, topical decongestants and nasal corticosteroid sprays are recommended topical antibiotic drops and oral antibiotics are recommended in the relapsing form, adenoidectomy is performed in children Choose the correct statement about the nasal cavity Nasal septum consists of cartilaginous and bony part The middle turbinate is formed by a separate bone The patency of the nasal cavity is determined by olfactometry The front part of the nasal septum is formed by bone Trachea: is connected to the thyroid cartilage is lined by squamous epithelium tracheobronchoscopy is indirect technique for the diagnosis and management of a wide spectrum of respiratory tract diseases receives its nerve supply from the vagus nerve and sympathetic trunk Spontaneous nystagmus in peripheral vestibular disorder eye fixation has no effect on it horizontally rotatory the fast component goes to the affected side spontaneous nystagmus when looking in the direction of the fast component is 3. Grade 7. Menieres disease ablation surgical methods are not used in the treatment attack of rotational vertigo, with hearing impairment, tinnitus, feeling of fulness and pressure in ear supracochlear sensorineural hearing loss electrocochleography - important in confirming diagnosis Treatment Betahistine, diuretics, corticosteroids Choose the correct statement Antrochoanal formation is a polypous formation typically growing out of the sphenoid cavity In dentogenic rhinosinusitis is typical a unilateral patology ni the frontal cavity Cysts in paranasal sinuses often malign Non-invasive fungal sinusitis has been clinically silent for a long time 14.The type B tympanogrammetric curve is at: Presbyvacuse Cerumene Otosclerosis Secretory otitis Examination of the stirrup muscle reflex: The contraction of the stirrup muscle is unilateral. Part of the reflex is mediated through n. VI. Part of the reflex is mediated through n. VII. The contraction of the stirrup muscle is bilateral. The absence of reflex is when the chain of bones is broken. Hearing loss in otosclerosis is: Sensorineural Conductive Characterize hearing in chronic otitis media Sensorineural hearing loss Normal hearing Conductive hearing loss Hearing examination with tuning forks: Weber test - compares air conduction in both ears. Rinné test - in conductive hearing loss Is negative Rinne test - with normal hearing in a healthy ear is negative Weber test - in conductive hearing loss, the patient lateralizes into the affected ear. With the Eustachian tube open (tuba patents): Autophony Autophobia arises Tympanometric examination with A curve type Patients report hearing disturbing sounds - their own breathing 27. The treatment of choice of Peritonsillar abscess is: Quinsy tonsillectomy Interval tonsillectomy Puncture Tonsillotomy Unilateral secretoric otitis media in adults causes suspicion of: Nasal polyps Nasopharyngeal cancer Adenoid vegetation Sphenoid Sinusitis Patient after stapedectomy develops tinnitus, ear fullness, disequilibrium and fluctuant hearing loss. Which is possible patient has developed Meniere's disease perilymph fistula due to slippage of prothesis post op psycho somatic symptoms cochlear otosclerosis component Vestibulocochlear nerve neurina (n.VIII) Pathological finding in BERA examination CT has greater diagnostic benefit than NMR Perceptual Supraclear Hearing Loss Present Mismatch between Hearing Loss on Tone Audiogram and Verbal Audiometry Result Vestibulocochlear nerve neurina (n.VIII) Is a malignant tumour Hearing loss with tinnitus and vertigo may be present There is conductive hearing loss Impaired innervation may be present n.VII Presbycusis. sudden sensorineural hearing loss age-related hearing loss hearing loss is caused by prolonged noise exposure temporary hearing loss due to barotrauma Presbyacusis tonal and verbal audiometry is used for diagnostics it is an occupational disease is typical in a patient with vestibular schwannoma is caused by the effect of ototoxic drugs Foreign bodies in the airway: rarely found in the larynx and trachea organic are more dangerous than anorganic foreign bodies usually the object provokes and immediate coughing fit the most common complication is pneumonia Chronic rhinosinusitis: Characterized by symptoms lasting more than 12 weeks It is not possible to treat surgically According to etiology, we divide into 6 groups Dental focus cannot cause it Otoliquorea when examining the fluid, the test for B2 transferrin, B trace protein is negative most often from the area of tegmen tympani and tegmen antri discharge of cerebrospinal fluid always only from the external auditory canal treatment can be conservative and surgical Transnasal transphenoidal endoscopic approach is preferred in pituitary tumor surgery it is usually performed by neurosurgeon minimally invasive compared to the microscope, it allows a better overview in the operative field Complications of transnasal transphenoidal endoscopic approach: Damage to optic nerve Rhinoliquorea Bleeding from sigmoid sinus Bleeding from internal carotid artery Mark evoked potentials used in audiometry: Electric activity of brain is constantly Visual evoked potentials VEP Somatosensoric evoked potentials SEP Brainstem auditory evoked potentials BAEP Neck diseases: in adults over 40 years, the first consideration must be a viral infection palpable cervical lymph nodes are unusual in adults but common in children in acute lymphadenopathy, lymph nodes will enlarge and become tender lymphomas often present as firm, rubbery, nontender masses Obstructive acute laryngitis Subglottic laryngitis is manifested with high body temperature Subglottic laryngitis manifests as barking cough and does not require laryngoscopic examination Significant odynophagia to aphagia is typical for epiglottis, cough is absent Epiglottitis is a viral disease Polyps of nasal cavity: They are always unilateral in nasal cavity 3rd degree are massive, they also fill common nasal meatus They are caused by hyperplasia of the nasal mucosa They are benign, multiple pedunculated masses examination of the pharynx clinical appearance of unilateral hypoglossal palsy includes deviation of the tongue during protrusion opposite to weaker side symmetry of oropharyngeal isthmus is a result of bilateral intact function of glossopharyngeal nerve tonsiloliths are signs of acute tonsilitis Flexible or rigid endoscopy provides direct visualization of pathologies and enables early diagnosis Acute pharyngitis and tonsilitis: penicillin is the antibiotic of choice group A B-hemolytic streptococci is the most frequently isolated pathogen treatment of recurrent tonsillitis should be surgical, including tonsillectomy or tonsillotomy usual symptom of pharyngitis is cough Head impulse test examines: Nystagmus Stability of eyes during head motion Acceleration of head and eyes Malignant lesions in oral cavity - MR or CT scan is used to assess the extent of the involvement of the floor of the mouth and tongue the most common localization of SCC of the oral cavity is the edge of the body of the tongue as part of surgical treatment, block dissection of the neck lymph nodes is not necessary A typical symptom is painless swelling or non-healing mucosal ulceration In acute suppurative otitis media: Perforation of the tympanic membrane closes spontaneously The patient has throbbing ear pain and elevated body temperature The tympanic membrane perforation needs to be covered with a prosthesis Epitympanic perforation of the tympanic membrane is typical What belongs to the examination of the vestibular apparatus cVEMP BERA Electrocochleography Videonystagmography- VNG, ENG For examination of the vestibular apparatus we use: VEMP examination EEG examination VNG examination BERA examination Cochlear implant is used in: Severe sensorineural hearing loss Congenital deafness Acquired deafness Severe conductive hearing loss Which of the following complications are otogenic intracranial complications: Extradural abscess Mastoiditis Sigmoid sinus thrombosis Brain abscess Mastoiditis: occurs after untreated otitis externa is the most common intracranial complication of acute otitis media it is a suppurative inflammation of the mucous membrane and bone of the pneumatic system of the processus mastoideus the typical symptom is rotational vertigo Mastoiditis: The symptom may include facial nerve paresis on the affected side Treatment is surgical- astromastoidectomy Occurs after untreated otitis media Painful swelling behind the auricle is typical Positive fistula sign is present in: Otosclerosis Commotio labyrinthi Cholesteatoma with lateral semicircular canal erosion In case of acute rhinitis CT scan is indicated Epistaxis never occurs during the disease Antibiotics are the first choice of treatment Rhinitis is commonly caused by rhinoviruses, influenza and parainfluenza viruses Carhart notch is a sign which can be seen in the: Otoscopy Objective audiometry Pure tone audiometry Otomicroscopy Injury to the ear: by otoscopic examination we can find hemotympanum when the tympanic membrane is ruptured, the patient has a conductive hearing loss ossicular chain injury can caused severe rotational vertigo perforation of the tympanic membrane is treated surgically glomus tympanicum Pulsating tinnitus is no tone of the symtoms During otoscopy as a red tumour behind the intact tympanic membrane May manifest as bleedind from ear The hearing impairment is of sensoneural type In children cochlear implant is suitable: In congenitally deaf children at younger age than 6 years For children with retrocochlear hearing loss For congenitally deaf in adult age For those using gesture language Serous otitis media: in adult patients, it may be a symptom of nasopharyngeal carcinoma in children, adenoid vegetations play an important role in the pathogenesis the most common symptoms are elevated body temperature, throbbing ear pain the most common symptoms are a feeling of fullness of the ear, hearing loss, crackling in the ear, tinnitus Laryngeal carcinoma: glottic carcinomas have a better prognosis, due to their early diagnosis and less tendency to metastasize supraglottic carcinoma is initially asymptomatic supraglottic carcinoma is less likely to metastasize than glottic subglottic carcinoma is rare and the lower it is below the vocal cords the later the development of symptoms For chronic bacterial rhinosinusitis: USG is the main radiology method for diagnosis Treated with targeted antibiotics based on microbacterial results The basic cause is pathological hyperplastic changes in ostiomeatal complex During a rhinoendoscopic examination is detected the discharge of pus from some nasal meatus Trachea The trachealis muscle allows the trachea to contract and decrease its diameter left main bronchus is a short, wide air passageway into left lung lies just anterior the esophagus prominentia tracheae is an important landmark during tracheobronchoscopy CT before surgery of chronic epitympanic otitis media is: Is necessary when sensorineural hearing loss and vertigo is present it is not always necessary is necessary in revision surgery Pituitary gland tumors: they are only functional indication for surgical treatment is visual field defects can be micro and macroadenomas transcranial approach is preferred For congenital diseases of the nasal mucosa: Cystic fibrosis is a disease of the endocrine glands Samter's triad is typical for cystic fibrosis In ASA syndrome, polyposis of the nasal cavity is usually massive, the so-called "whiteout effect" on CT scan The presence of nasal polyps in children raises the suspicion of cystic fibrosis Benign tumors of the nasal cavity: They are relatively rare They are manifested by purulent secretion from the nose They typically cause unilateral nasal obstruction They are mostly treated conservatively, exceptionally surgically Earache It is a manifestation of otitis media it is related to the inertive region n. IX in diseases of the pharynx. It is not a common symptom in patients after tonsillectomy It can be a manifestation of inflammation around the tooth roots Secretory otitis media is characterised by: Frequent acute infection Otorrhea Hearing lost Ear fullness BAHA: Works through direct stimulation of the eight nerve Works through direct air conduction Works through direct bone conduction Endoscopic endonasal dacryocystorhinostomy- DCRS The principle is to cut the lacrimal gland and open it into nasal cavity It is a surgical treatment of stenosis of the tear ducts It is a surgical treatment of ophtalmopathy in Graves Basedow disease It is performed using an endoscope in the orbit under general anesthesia Choose the correct statement for congenital disease of the nose and paranasal sinuses: If nasal encephalomeningocele is suspected, we make CT and MR scan of rhinobase Insufficient closure of the rhinobase results in choanal atresia A dermoid cyst is a cystic formation containing skin nexus and epithelium Unilateral choanal atresia is a life-threatening condition One of the complications of rhinosinusitis is: Paresis n. facialis Brain abscess Cavernous sinus thrombosis Submandibular abscess The integrity of the membrane of the eardrum is found: Otoscopic examination Tympanometric examination Otomicroscopic examination Rhinoendoscopic examination Audiometry: if the Bone Conduction Threshold is 20dB and the Air Conduction Threshold is 40dB, then we speak about: Conductive hearing loss Sensorineural hearing loss Normal hearing in ear fullness Congenital cholesteatoma symptom is: Conductive hearing loss Malodorous otorrhea Cholesteatoma behind intact TM Perforation in posterosuperior quadrant Ablation treatment M. Meiner: Labyrinthectomy Intratympanic administration of corticosteroids Decompression of saccus endolymphaticus N. vestibular section Chemodectoma Occurs sporadically and hereditary Is poorly vascularized and does not bleed Radiotherapy is the method of choice Can occur multicentrically Otitis externa: Hyperemia of the tympanic membrane dominates in the local findings The treatment of choice is local therapy It is an inflammation of the skin of the external ear canal Occurs with poor ear hygiene Otoscopic signs in acute otitis media: Hyperemic, bulging tympanic membrane Grey tympanic membrane with perforation hyperemic , retracted TM Pharynx: Laryngeal part of pharynx is located in front of the inlet of the larynx Interior of the pharynx is typically divided into three parts - nasal, oral, laryngeal Tubal tonsils are paired and part of the oropharynx Waldeyers ring of lymphoid tissue is situated in the naso- and oropharynx Diagnosis of serous otitis media: in the early stage, a superficial injection is seen on the malleus On tympanometric examination we detect a B curve Otoscopically - a thickened and hyperemic tympanic membrane is typical Audiometric examination confirms conductive hearing loss Glomus jugulare: usually asymptomatic for a long time the transmeatal approach is mainly used in surgical treatment angiographic examination has no significance in preoperative preparation is manifested by a lesion of the cranial nerves IX. X, XL, XI Which of the following complications are NOT otogenic intracranial complications: Extradural abscess Mastoiditis Sigmoid sinus thrombosis Brain abscess Bezold Abscess Dysharmonic vestibular syndrome: typical for central vestibular disorder nystagmus is different from horizontal rotatory halmagyu's manouver is usually negative usually also neurological symptomatology Air conduction is Conduction of the sound via Eustachian tube Conduction of the sound via skull bones Conduction of the sound via TM and ossicles Superior semicircular canal dehiscence syndrome dizziness is caused by a change in the position of the head dizziness is caused oy a change in pressure in the ear canal - Heneberd’s sign the diagnosis is confirmed by HRCT of temporal bones dizziness will cause a loud sound - Tullio phenomenon Disease of esophagus: The most common symptoms of GERD is Zenker diverticulum belongs to the Achalasia is characterized by Esophageal atresia result in Orbital complications of sinusitis They are less common than intracranial complication According to the localisation and extent They can lead to blindness They appear only in childhood Vesicles and hemorrhagic blisters on the tympanic membrane are typical for Hemotympanum Acute tubotympanic catar Bullous myringitis Acute otitis media Labyrinthitis Manifested by rot.. Therapy includes administration of Painfull swelling behind the.. Is an inflammation of the inner ear. Peripheral vestibular apparatus Upward and downward movement… Utriculus detects linear acc… N. vestibularis inferior…. Semicircular canals detect… Stapedial reflex is absent in: Deafness Cochlear nerve damage with hearing threshold over 65dB Non-cooperative patient Rombert exam In acute neuronitis of the vestibular nerve is not disturbed It is the exam for vestibulospinal reflexes It is being investigated for nystagmus Is the vestibulookular reflexes exam Nasal cavity: is most thoroughly examined rhinoendoscopically It is divided into 5 areas according to Cottle Contains upper, middle and lower nasal meatus and one common it is lined by squamous epithelium Semicircular canals are stimulated by: Angular velocity Angular acceleration Linear acceleration Vertical acceleration Estezioneuroblastoma: It is a bone malignant tumor of the nasal cavity It is a neurogenic tumor that originates from the olfactory epithelium It grows quickly and often metastasizes When it grows into the intracranium, the cooperation of a neurosurgeon is necessary In surgical therapy of otosclerosis: Superstructures of the stapes are replaced Stapes is replaced Incus is replaced Hammer is replaced Tracheal injury: signs of injury are pain, swallowing difficulty, hemoptysis acute injuries to the mucosal lining usually heal rapidly without treatment internal mechanical injuries to the trachea are almost always a result of medical procedures such intubation can't result in subglottic stenosis Sudden sensorineural hearing loss (SSHL): it is a hearing loss of at least 30 dB and at least three frequencies usually affects both ears usually is idiopathic may be accompanied by vertigo