ENT

Question 1

The most common audiometric finding in early Meniere’s is?

Answer 1

Low frequency sensorineural hearing loss (SNHL).

Question 2

Perilymphatic fistulas

Answer 2

Rare complications from head injuries or barotrauma, causing endolymph leakage from the semicircular canals and cochlea. Progressive sensorineural hearing loss from cochlear hair cell damage and episodic vertigo with nystagmus, triggered by pressure changes in the inner ear.
The Tullio phenomenon can demonstrate this by inducing nystagmus with a loud clap near the ear.

Question 3

Ludwig angina

Answer 3

Fast-progressing cellulitis affecting the submandibular and sublingual areas, usually due to the spread of dental infections from mandibular molars.

Question 4

Conductive hearing loss may result from?

Answer 4

Issues in the external auditory canal, tympanic membrane, middle ear space, or ossicular chain (osteosclerosis).

Question 5

Otosclerosis

Answer 5

Caused by an imbalance in bone resorption and deposition, leading to stapes fixation and reduced sound transmission.
It may worsen during pregnancy and is inherited in an autosomal dominant manner with incomplete penetrance. Treatment: hearing aids or surgical stapes reconstruction.

Question 6

Oropharyngeal dysphagia

Answer 6

Difficulty initiating swallowing, often due to conditions like stroke, dementia, malignancy, or neuromuscular disorders. Coughing, choking, and nasal regurgitation, aspiration pneumonia and weight loss.
Videofluoroscopic modified barium swallow study.

Question 7

Vestibular neuritis

Answer 7

Inflammatory disorder of the vestibular branch of the eighth cranial nerve, often following a viral infection.
Nausea/vomiting and gait impairment, with swaying towards the affected side.
VN with unilateral hearing loss is called labyrinthitis.

Dx: clinical findings.
TX: symptomatically.
Corticosteroids may aid short-term recovery, and vestibular rehabilitation can improve residual imbalance.

Question 8

Torus palatinus

Answer 8

Benign bony growth on the hard palate’s midline suture.
Congenital or develop later in life
Chronic and asymptomatic; surgery is needed if it becomes symptomatic.

Question 9

Ototoxicity and chemotherapy

Answer 9

Platinum-based chemotherapy causes irreversible, bilateral high-frequency hearing loss, often with tinnitus and/or imbalance.

Question 10

Sialadenosis

Answer 10

Benign, noninflammatory salivary gland swelling resulting from secretory granule overaccumulation in acinar cells, often seen in chronic alcohol use, bulimia, or malnutrition, as well as fatty infiltration in diabetes mellitus or liver disease.

Question 11

Ménière disease treatment

Answer 11

Lifestyle modifications for include: dietary salt restriction (2-3 g/day), limitation of caffeine, nicotine, and alcohol, avoidance of allergy triggers, and improving sleep hygiene and stress management.
If these do not control symptoms, diuretics (e.g., hydrochlorothiazide) and/or vasodilators (e.g., betahistine) are used, along with vestibular suppressants (e.g., benzodiazepines) and/or antiemetics (e.g., promethazine) during acute attacks.