- •In an adult by pulling the auricle upwards, outwards and backwards. Inconstant
- •Incudis in the aditus, and the annular ligament attaches the footplate of the
- •Inferior tympanic branches of the sympathetic plexus of the internal carotid
- •Via the cochlear aqueduct.
- •Internal Ear
- •Intensity of the stimulating source. These are known as cochlear microphonics
- •Inferior turbinate is a separate bone attached to the maxilla. Each turbinate
- •In the normal nose these parts can rarely be seen from the front. Between these
- •Venous drainage from the nasal cavity is through the sphenopalatine foramen to
- •Vasoconstriction and diminished secretion, arise from the superior cervical
- •Infection to the meninges.
- •In the adult. The lateral wall is contiguous with the internal carotid artery,
- •Immunoglobulin a (IgA), immunoglobulin m (IgM), and immunoglobulin g (IgG).
- •Vertebra.
- •Internal and external ligaments and membranes unite the cartilages and stabilise
- •Vein and for the internal branch of the superior laryngeal nerve which supplies
- •Internal laryngeal musculature. In addition, it provides sensation to the
- •Vital and Communicative Functions of the Larynx
- •Is therefore of interest to the otolaryngologist. Furthermore, endoscopic
- •Is held open by 16 to 20 horseshoe-shaped cartilaginous rings. The posterior
- •Vascular supply. The trachea is mainly supplied by the inferior thyroid artery
- •In combination with other non-pathogenic organisms. Less often Staphylococcus
- •Infection may be seen as a small, red, circumscribed and very tender swelling on
- •Injected along the upper wall of the meatus. Excessive force should not be
- •Infection entering the middle ear through the perforation from the external
- •It is in the upper respiratory tract that the source of infection will be found.
- •In all cases the aim of the treatment is to produce a safe, dry ear and, if
- •In addition the tympanic membrane and ossicles were removed, and the Eustachian
- •It is diseased, a homograft incus, to reconstitute the ossicular chain. Where
- •Incus are removed and, if this mobilizes the malleolar handle, the drum
- •Intramuscular injection starting with 1 million units (benzylpenicillin)
- •Incision is made, the mastoid bone is exposed and Shipo's triangle identified.
- •I.E. Cholesteatomatous erosion of the bony capsule of the labyrinth, usually the
- •Initial stages. Sedation with labyrinthine sedatives is required, dimenhydrinate
- •Intracranial complications. It is more common in the posterior than in the
- •Is associated with deep-seated boring pain, tenderness on tapping over the
- •Infections although more frequently in the latter. The local inflammation in the
- •Intervals between the rigors the patient is free from symptoms, although in
- •Is recommended. When active surgical intervention is required this consists of
- •Intracranial pressure. The patient's initial conscious level may be normal but
- •5Ml may be introduced is turbid. Surgery of the underlying ear disease should be
- •Venous system of the neck via the facial vein, but also drain via the angular
- •Initial catarrh occurs in influenza and infection with other types of viruses
- •Includes decongestant nose drops or oral decongestants. Antibiotics should only
- •Inflammation with gradual irreversible to the mucosa; infection in the sinuses,
- •Vascular-type face-aches arise.
- •Is a common problem, and rather than blindly instigating medical or surgical
- •Is affected, it can be removed locally. Only a very limited portion of the
- •Infection, particularly of the sinuses, should be sought and treated. Twenty
- •In more severe cases there is a vascular-type face-ache which throbs and becomes
- •Increasing around midday and decreasing in the afternoon. Sphenoidal sinusitis,
- •Inhalation of dust or fumes, is a further predisposing factor.
- •Infection, but is unlikely to be found unless the X-ray is carried out during an
- •1. Lavage of the sinus.
- •In the floor of the maxillary sinus if the cyst is small. When the cyst fills
- •Vary greatly in their tolerance of nasal obstruction, some complaining bitterly
- •In the young, but when it is successful a smooth, greyish-white, spherical mass
- •Inflammations of the pharynx
- •In localized forms, the disease is restricted to the tonsil, the nose, the
- •Injuring the major vessels of the neck. The incision is made parallel to the
- •If these measures fail and there is increasing dyspnea, the child must be
- •In addition to redness, this type displays a hypertrophy in the supraglottis and
- •Investigation is indicated, whose objective is shown in Table 1.
- •In appearance. The skin is coarse and pitted, and has an oily appearance due to
- •Intense headaches. In later disease pain is a prominent feature. Spread to lymph
- •Very least of maxillectomy with the fitting of an obturator, and before
- •If the soft tissues of the cheek are infiltrated by tumour, this area will have
- •Vessels. In later stages there is swelling of the lateral part and the face of
- •Immediately to further surgery if massive bleeding occurs.
- •Investigations. Radiography is not usually helpful except to see if there has
- •Vocal cord either on a pedicle or sessile. It is seroedematous and occasionally
- •Immunologic and antiviral treatment are used. Today there is no alternative to
- •Ventricles
- •Inherited Syphilis
- •Infiltration, dark red in colour, involving one or both sides of the septum.
- •Is found on the nasal septum syphilis should be suspected. The diagnosis is made
- •Venerologist. Local hygiene is necessary and the highly contagious nature of the
- •Is a rare complication of the pulmonary lesion. It is characterized by minute
- •It is, however, sound surgical practice to remove the tonsils from children who
- •If a hematoma is not treated, connective tissue organization, secondary
- •Into the bony labyrinth and the internal auditory meatus. In both cases the dura
- •View, tomograms, and possibly ct in patients with facial paralysis or csf
- •Vestibular provocation nystagmus in the presence of vertigo, and more rarely
- •Inflammatory diseases of the eustachian tube should be dealt with. These
- •In gunshot trauma there is a short stabbing pain in the ear, a marked continuous
- •Inevitably cause considerable soft-tissue swelling. This becomes marked very
- •Incisions are again made on both sides of the septum, the pus is removed and a
- •Vomiting, sialorrhea, and at times glottic edema and dyspnea. White corrosive
- •Introduced. Contraindications include shock and suspected perforation. Immediate
- •In any long-standing cases of nasal discharge
- •Impacted foreign bodies cause necrosis of the esophageal wall leading, depending
- •View should be obtained; the nose is less likely to be actively bleeding, and a
- •Is told to swallow it. At the moment at which he does so, just as the larynx is
- •Interesting point about it is that although it was first described over a
- •Is almost no evidence to support this theory. Allergy has been blamed,
- •Infections.
- •In nearly 50% of cases a history of deafness in the family can be obtained. The
- •Is likely to progress rapidly. Paracusis Willisii is frequently present,, I.E.
- •Include allergy, focal infection, biochemical disturbance, vitamin deficiency,
- •Is due to the inability to hear higher frequencies which means that consonant
In any long-standing cases of nasal discharge
Symptoms. These are nasal obstruction and discharge, but if the rhinoliths have
been present for some time they may give rise to considerable destruction of the
nasal mucosa with the formation of sequestra of cartilage or bone, and the
development of an extremely unpleasant odour. Rhinoliths may attain a
considerable size and are often irregular in shape. The diagnosis is usually
easily made by inspection, but if there is any doubt palpation with a probe will
disclose the rough hard object.
Treatment. The treatment is removal under local or general anaesthesia. The
rhinolith may be too large to remove in a single piece and it may require to be
broken with a strong pair of forceps before removal in fragments. There is a
brisk haemorrhage during the removal, and it may require packing with ribbon
gauze for 2-4 hours.
FOREIGN BODIES IN THE PHARYNX
These are less common in the mouth and pharynx than in the esophagus. Small
pointed foreign bodies, such as splinters of bone, fish bones, bristles from a
toothbrush, needles, nails, or bits of wood and glass, impact in the tonsil, the
base of the tongue, the vallecula, or the lateral wall of the pharynx. Larger
foreign bodies, e.g., bits of toys, flat bones, coins, buttons, large fish
bones, bits of false teeth, etc. often impact in the piriform sinus or
hypopharynx before entering the esophagus.
Symptoms. There is pain of varying severity which is worse on swallowing, and
swallowing may be completely obstructed.
Diagnosis. It is based on the history, if the material is suspected to be
radiopaque, radiography is carried out. Radiographically, a swallow is also
carried out with a contrast medium using a colorless medium (not barium!) which
will not influence assessment of the mucosa at subsequent endoscopy. Endoscopy
is then carried out. Small impacted foreign bodies in the tonsil or base of the
tongue are often felt with the finger. Small foreign bodies in the upper pharynx
are best removed without endoscopy, using grasping forceps under direct vision.
Treatment. Instrumental extraction of the foreign body is performed as quickly
as possible because of the danger of pressure necrosis or mucosal injury causing
abscess or mediastinitis.
If a foreign body is suspected, endoscopy should be carried out as quickly as
possible using an open rigid esophagoscope. The search must be continued until
the foreign body is found or until it is certain that no foreign body is
present. Attempts to dislodge foreign bodies by eating foods such as bread is
not justifiable because this often leads to delay and allows complications to
develop.
FOREIGN BODIES IN THE ESOPHAGUS
These are usually unintentionally swallowed objects of various types. Children,
usually those younger than 3 years, swallow coins, toys, etc., whereas adults
swallow bones, glass splinters, fish bones, parts of false teeth, nails,
needles, large fruit stones, or even cutlery (e.g., prisoners).
Symptoms. They include considerable dysphagia (difficulty in swallowing),
sialorrhea, odynophagia (pain on swallowing), localized to the neck or
retrosternal area and rarely the epigastrium, and attacks of coughing.
Lifethreatening symptoms include severe pain in the back between the shoulder
blades and behind the sternum and indicate early mediastinitis.
Pathogenesis. Foreign bodies usually stick in the upper sphincter, the
esophageal orifice, and rarely at the second or third sphincters. Retained or