From Precise ENT book and it's protected by Copyright ©

⭕️Indications of modified radical mastoidectomy.
✔️Cholesteatoma involving the epitympanum.
✔️Chronic otitis media (localized).

⭕️Anatomically ear has three parts:External ear, Middle Ear and inner Ear.
✔️Incisura terminalis is an important landmark for incision for mastoid surgery, this area has no cartilage.
✔️External Auditory Canal.
✔️Tympanic membrane is mobile, has 2 parts:Pars tensa which form most of membrane and pars flaccida which is the lower part of membrane.
✔️Middle ear cavity is divided into: Mesotympanum , Epitympanum and Hypotympanum.
✔️Middle ear is like a six sided box which has roof, floor, medial wall, lateral wall, anterior wall, posterior wall.
✔️Footplate of stapes attach to the oval window.
✔️Bony labyrinth filled with perilymph.
✔️MEMBRANOUS labyrinth filled with endolymph.

⭕️Cauliflower ear it is deformity result from trauma to ear which lead to accumulation of blood between the auricular cartilage and its perichondrium, which is known as hematoma.

⭕️Malignant otitis externa mostly occur in in diabetic patients and caused by pseudomonas aeruginosa.

⭕️Herpes zoster oticus also called Ramsay Hunt syndrome caused by viral agent lead to form painful vesicles.

⭕️Otitis externa haemorrhagica form bullae on the tympanic membrane and most commonly caused by influenza virus.

⭕️Keratosis obturans it is Cholesteatoma of external auditory meatus.

⭕️Acute Suppurative Otitis Media (ASOM).
it is acute inflammation of middle ear cleft caused by pyogenic organisms mostly seen in children.

⭕️Serous otitis media is due to presence of a middle ear effusion without evidence of an acute infection, commonly patient present with conductive hearing loss, impedance audiometry shows Type B curve.

⭕️Otitic barotrauma or Aero otitis media occur due to sudden changes in pressure.

⭕️CSOM is chronic infection of the middle ear and mastoid.
✔️characterize by:tympanic membrane perforation, otorrhea and hearing loss.

⭕️Tubotympanic Type (Safe CSOM) involves anteroinferior part of middle ear cleft.

⭕️Atticoantral Type (Unsafe CSOM) Involves posterosuperior part of middle ear cleft.

⭕️Myringotomy performed by incision in anteroinferior quadrant.

⭕️Gradenigo’s syndrome characterized by: otorrhoea ,diplopia and deep retro-orbital pain.

⭕️Cholesteatoma is an abnormal growth of squamous epithelium in the middle ear.

⭕️Glomus tumour arises from preganglionic cells of nerves.

⭕️Rising sun sign and Brown’s sign are classical features in glomus tumour.

⭕️Acoustic neuroma, also called vestibular schwannoma cause sensorineural hearing loss.

⭕️Exostosis is the most common benign tumor of the external auditory meatus.

⭕️Facial nerve has both Motor and sensory components.

⭕️Bells palsy is the most common cause of facial palsy in adults.

⭕️Eye prevention is necessary to protect cornea and conjunctiva.

This table is from Precise ENT book and it's under protection by copyright ©

⭕️Melkersson syndrome is idiopathic syndrome characterizes by swelling of the lips, fissured tongue and facial palsy.

⭕️Varicella-zoster virus causes herpes zoster oticus.

⭕️Schirmer test used to detect site of LMNL.

⭕️Preauricular sinus can be unilateral or bilateral and simple discharge.
✔️is treated with oral antibiotics (Augmentin), while surgical excision can be done if the sinus becomes recurrently infected.

⭕️Auricular hematoma results from blunt trauma and treated by aspiration and drainage with the antibiotic course.

⭕️Perichondritis caused by pseudomonas bacterial infection and treated with IV broad-spectrum antibiotics, analgesia, 4% aluminum acetate application and abscess drainage.

⭕️Atresia associated with external and middle ear anomalies, Goldenhar syndrome and Treacher Collins syndrome.

⭕️Localized otitis externa is caused by staphylococcus bacterial infection and treated with analgesia, antibiotics and 10% Ecthammol glycerin pack.

⭕️Malignant otitis externa is caused by pseudomonas aeruginosa and commonly seen in patients on immunotherapy, elderly and diabetic patients.

⭕️Herpes zoster oticus characterizes by painful vesicles.

⭕️Otomycoses is fungal infection caused by aspergillus niger (black growth), aspergillus fumigatus (green or blue growth) and candida albicans (creamy white deposit).

⭕️In otosclerosis compact bone of the labyrinth is replaced by spongy bone.

⭕️The cause of otosclerosis is idiopathic.

⭕️Otosclerosis commonly seen in women.

⭕️Otosclerosis associated with osteogenesis imperfecta.

⭕️Stapedectomy is the treatment of choice for otosclerosis.

⭕️External ear tumors.
oSquamous cell carcinoma is seen in the upper part of the pinna.
oBasal cell carcinoma is nodular or ulcerated lesion seen in the tragus and helix. 
oExostosis is abnormal bony overgrowth in the EAC.
oExostosis is the most common benign tumor of the external auditory meatus.

⭕️Middle ear tumors.
oThe most common benign middle ear tumor is glomus tumor.
oGlomus tumor characterize by pulsatile tinnitus.
oRising sun appearance and pulsation sign (Brown sign) are classical features of glomus tumor.
oThe most common form of middle ear carcinoma is squamous cell type.

⭕️Inner ear tumors.
oAcoustic neuroma is usually unilateral and seen to become bilateral in multiple neurofibromatoses.

⭕️Vertigo is sense of rotation either rotation of objects or the patient himself.

⭕️Vertigo may be peripheral (inner ear) or central (brainstem-cerebellum).

⭕️Ménière’s disease is increasing of volume and pressure of endolymph (endolymphatic hydrops).
✔️characterized by triad: tinnitus , episodic vertigo and sensorineural hearing loss.

⭕️Labyrinthitis is acute infection of the inner may be serous (viral) or purulent (bacterial).

⭕️Hearing loss may be conductive hearing loss, sensorineural hearing loss or mixed.

⭕️Otitis media with effusion is the most common cause of conductive hearing loss in children.

⭕️Presbyacusis is the most common cause of sensorineural hearing loss.

⭕️Tuning fork tests indicate the type of hearing loss.

⭕️Otoacoustic emissions is objective test of hearing used in newborn screening.

⭕️Auditory Brainstem Response : measures neuroelectric potentials (waves) in response to a stimulus.

Radical mastoidectomy 😍🌟🌟
Real patient and 3D animation

⭕️The external nose is pyramidal in shape and consists of the bony part that forms one-third of the external nose and cartilaginous part that form the other two thirds.

⭕️There are four turbinates or conchae and the spaces under turbinates called meatuses.

⭕️Anterior ethmoid, frontal and maxillary sinuses drain in the middle turbinate.

⭕️Posterior ethmoid sinus drain in the superior meatus and sphenoid sinus drain in the sphenoethmoid recess.

⭕️Nasolacrimal duct drain in the inferior meatus.

⭕️The nasal septum divides the nasal cavity into two parts.

⭕️Deviated nasal septum can cause difficulty in breathing.

⭕️Types of the deviated nasal septum are anterior dislocation, S-shaped, C-shaped, spur and increase the thickness of the nasal septum.

⭕️Severe DNS treated by submucous resection operation (SMR).

⭕️The most common cause of septal perforation is trauma.

⭕️Leprosy leads to perforation in the cartilaginous part of the nasal septum, while syphilis leads to perforation in the bony part.

⭕️A septal hematoma usually caused by trauma and the patient complain of bilateral nasal obstruction.

⭕️The most common cause of epistaxis is the idiopathic cause.

⭕️The sphenopalatine artery is the most common site of bleeding.

⭕️Unilateral, severe epistaxis in an adolescent boy may indicate a juvenile angiofibroma.

⭕️The most common site of epistaxis is the anterior septum (Little's area).

⭕️Prolonged bleeding is associated with hypertension, anticoagulants, and NSAIDs.

⭕️The commonest cause of epistaxis in children is F.B and nasal picking, in adults is trauma or idiopathic, in middle age are tumors and in elderly is hypertension.