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Clinical Methods of Otorhinolaryngology, Skull Base & Head Neck Surgery
SushilKumarKashyap • SharmisthaSagar
Clinical Methods of Otorhinolaryngology, Skull Base & Head Neck Surgery
SushilKumarKashyap Department of ENT & Head Neck Surgery MLB Medical College Jhansi, Uttar Pradesh, India
SharmisthaSagar Department of Anatomy Autonomous State Medical College Lalitpur, Uttar Pradesh, India
ISBN 978-981-96-1764-7 ISBN 978-981-96-1765-4 (eBook)
https://doi.org/10.1007/978-981-96-1765-4
© The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2025
This work is subject to copyright. All rights are solely and exclusively licensed by the Publisher, whether the whole or part of the material is concerned, specically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microlms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specic statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, expressed or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional afliations.
This Springer imprint is published by the registered company Springer Nature Singapore Pte Ltd. The registered company address is: 152 Beach Road, #21-01/04 Gateway East, Singapore 189721, Singapore
If disposing of this product, please recycle the paper.
Dedicated to my Godfather and parents

Foreword

This book titled Clinical Methods of Otorhinolaryngology, Skull Base and Head Neck Surgery is the rst edition and author has included clinical history,
examination and interpretation of these ndings in making diagnosis of disorders of general otorhinolaryngology, and allied subspecialties like head neck oncology, thyroid gland, salivary gland, maxillofacial trauma, skull base, facial plastic surgery, and skin diseases of head and neck. This book has also included approach to patient in emergency and trauma. This book is sheer hard work of author to include comprehensive knowledge of clinical methods like history taking and examination. Wherever needed author has explained the situation with the help of diagrams and tables. There are two chapters in this book to explain the emergency and trauma of this eld. The various clinical images have been included to undersatnd disease.
Dr. Kashyap has worked with me as assistant professor in LHMC, New Delhi. At present, he is working as Professor and Head of the Department of Otorhinolaryngology and Head Neck Surgery in MLB Medical College, Jhansi. His knowledge about otorhinolaryngology and head neck is very extensive. The depth of his knowledge helps him in formatting this book. He has limited the contents of this book to the clinical aspect of ear, nose, throat, head, neck, and skull base.
Otorhinolaryngologist and head neck surgeon deal not only with patients of general otorhinolaryngology but also with patients of head neck oncology, nasal and facial structural deformities, maxillofacial trauma, and diseases of lateral, anterior, and middle skull base. The endoscopic skull base surgery is emerging eld for both ENT and neurosurgeon. Most of clinical books of this eld do not include these subspecialties. This book has included all these specialties to help readers in making correct diagnosis. I recommend this book to all postgraduate students, ENT surgeon, and head neck surgeon. This book will help young ENT and head neck surgeon in making diagnosis in routine and emergency situation.
Thank you
Lady Hardinge Medical College SunilKumar New Delhi, India
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Preface

In clinical practice, history taking and examination are the rst steps in making diagnosis. ORL and head neck surgery is a rapidly expanding broad specialty which includes subspecialties like head neck oncology, skull base (ventral and lateral) surgery, facial and nasal plastic surgery, and maxillofa­cial surgery. Diagnosis making is a very important task which requires his­tory, examination, and investigation ndings. A book is required on clinical methods which includes all subspecialties.
Otorhinolaryngology and head neck surgery has changed a lot in last few decades. After the newer diagnostic methods, surgical procedure and surgical equipment. The skull base tumours, CSF rhinorrhoea, etc. have also been treated trans nasally with the help of endoscope with less mortality and mor­bidity. The advanced use of endoscope in treating the skull base tumours and brain tumours with the help of neurosurgeon opened new horizon for ENT surgeons. The lateral skull base tumours are treated using trans labyrinthine approach. The disorders and tumours of thyroid gland have been treated via trans vestibular approach without incision on neck. The maxillofacial trauma has been treated by ENT surgeon. The head neck carcinoma has been surgi­cally treated by ENT or head neck surgeon. The otorhinolaryngology is rap­idly changing and growing surgical speciality, require a clinical book to make clinical diagnosis easy of all subspecialities of ORL & HNS. There was a need of a book on clinical methods which include all subspecialties of otorhi­nolaryngology, head neck disease, skull base disease, facial and nasal plastic surgery, and maxillofacial trauma.
This book includes clinical aspects of all subspecialties of ENT and HNS to help students and ENT surgeon, head neck surgeon, endoscopic skull base surgeon in interpretation of history and examination ndings to make diagnosis and also explains how to take proper history and perform the examination.
This rst edition has 18 chapters which include history taking, general examination, systemic examination, and differential diagnosis. This book starts with general history taking and general examination and also includes how to perform examination with a list of probable diagnosis. It is anticipated that this clinical methods of otolaryngology head and neck surgery will pro­vide immediate access to necessary detail information on diagnosis making in otolaryngology and head neck surgery. This book has included all aspects to decrease the amount of time spent on searching for needed information. With that goal in mind, this book is well organized, follows an established
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format, is thoroughly indexed, and in all areas is focused on providing detail information that is likely to be clinically most useful. It is hoped that this book will serve students (UG and PG) and otorhinolaryngologist, head neck surgeon well to the benet of the patient.
This standard organization was chosen to allow the user to review a sub­ject in the typical pragmatic manner in which one approaches a clinical prob­lem. Furthermore, the fact that each chapter follows this same outline should enable the reader to become comfortable nding necessary subjects rapidly. When applicable, tables and images are also used to present and organize key information. The extensive index has been thoughtfully planned as a quick and easy reference. We are condent that this book will serve clinicians well.
This book has been created for otorhinolaryngologist, head neck surgeon, skull base surgeon, postgraduate students, and undergraduate students. We will be pleased to receive comments and suggestion for improved second edition at sushiled20@gmail.com.
Jhansi, Uttar Pradesh, India SushilKumarKashyap
Preface

Acknowledgement

Writing a book is harder than I thought and more rewarding than I could have ever imagined. In completion of this assignment, I had to take the help and guidance of some respected persons, who deserve my deepest gratitude.
The completion of this assignment gave me much pleasure. First and fore­most, I would like to praise and thank my Godfather (Dr. B.R.Ambedkar, the Father of the Constitution of India) and my parents for their efforts made in past and their showers of blessings from heaven throughout.
I would like to show my special gratitudeto my elder brother Mr. Rakesh Kashyap for his untiring encouragement throughout my life and during this project. His dynamism, vision, sincerity, and motivation have deeply inspired me. I would like to thank my wife Dr. Sharmistha Kashyap for giv­ing me a good support throughout the assignment. She stood by me during every struggle and all my success. She helped me a lot in gathering infor­mation, collecting data despite her busy schedules. She gave me different ideas in making this project unique by suggesting to include all elds like skull base, head and neck oncology, facial plastic surgery, craniofacial surgery, and maxillofacial trauma. I am very much thankful to my children for their love, understanding, prayers, and continued support to complete this work.
I would like to express my thanks to all my teachers and special regard to Dr. Sunil Saxena, Professor and Head, Department of ENT and Head Neck Surgery, JIPMER, Pondicherry, India and Dr. Sunil Kumar, Director Professor, Department of ENT, LHMC, New Delhi. It was a great privilege and honour to work and study under their guidance.
Dr. Sharmistha Kashyap and Dr. Shirin Jahan have edited the anatomical part of this book. I would like to thank both of them for their efforts and hard work. Dr. Neeraj Srivastava, Professor, Skin and VD, MLB Medical College, Jhansi has contributed Chap. 14 (History and Examination of Skin, and Hair Disorders of Head and Neck) of this book. Dr. Kuldip Chandel and Dr. Madhurmay helped in preparing the topic on general and systemic examination of this book.
None of this would have been possible without my past students who inspired me to write this book on clinical methods in otorhinolaryngology and head neck surgery. I would also like to expand my gratitude to all those who have directly and indirectly helped me in writing this book.
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Many people, especially my friends, have made valuable comment and suggestions on this book which gave me an inspiration to improve the quality and contents. I would like to say thanks to my friends and con­tributors, for their constant encouragement and support.
Dr. S.K.Kashyap
Acknowledgement