Content & veins draining the Cavernous Sinus with Rule of 3

3 Afferent veins: Sphenoparietal sinus (Vault veins), Supf Middle cerebral Vein (Brain), Ophthalmic vein (Orbit)
3 Efferent Veins: Superior petrosal sinus, Inferior Petrosal Sinus, Communicating vein to pterygoid plexus
3 Contents; Cranial Nerves (III,IV, V1,V2 & VI)
3 Areas Drain into it: Vault Bones, Brain (Cerebral Hemisphere), Orbit
3 Nerves: Motor(III,IV,VI),Sensory (V1,V2), Sympathetic

Branches of Vagus nerve

(shared by Taishan Medical University )

"APE-SCRAP"

A- Auricular nerve
P- Pharyngeal nerve
E- Esophageal plexus
S- Superior laryngeal nerve (Gives internal 'sensory' and external 'motor' LN)
C- Cardiac branches
R- Recurrent laryngeal nerve
A- Anterior Vagal Trunk
P- Posterior Vagal Trunk

CHARGE SYNDROME

Coloboma
Heart defects
choanal Atresia
Retarded growth
Genital hypoplasia
Ear anomalies

Types of DNS (Deviated Nasal Septum)

'SCAN your nose'

• S -shaped deformity
• C -shaped deformity
• Anterior dislocation
• Nasal spur

Deviation may involve only the cartilage,bone or both. S -shaped deformity may cause bilateral nasal obstruction.

Recurrent laryngeal nerve injury

Recurrent laryngeal nerve injury can cause 'ABCD' (besides hoarsness of voice)

Aphonia
Bronchopneumonia (due to aspiration)
Cough (ineffective)
Dysphonia

Indications for Tonsillectomy

Tonsillectomy is indicated when a Tonsil 'HARMS'

Hypertrophy with hoarseness
Abscess (Peritonsillar - Quinsy)
Recurrent sore throat
Malignancy is suspected
Seizures (Febrile seizures due to Tonsillitis)

Otogenic Brain Abscess : stages

"INLET"

Stage of INvasion - headache, low grade fever, malaise and drowsiness
Stage of Localisation - formation of a capsule to localise the pus
Stage of Enlargment - zone of edema around the abscess, raised intracranial tension
Stage of Termination - ruptures into the ventricle or subarachnoid space

Tubercular otitis media : clinical features

5 P's

Painless ear discharge
Perforation
Profound hearing loss
Paralysis of face
Pale granulation

Rinne's test

NNN - Normally Rinne's test is Not Negative it's BACkwards test (Bone conduction better than Air Conduction)

Embryology of ear ossicles

Maleus and Incus forms from mesoderm of I arch
Stapes from Second arch.

Fluctuating hearing loss in . . .

"SPAM"
Syphilic labyrinthitis
Perilmph fistula
Autoimmune disorder of inner ear
Meniere's disease

Tonsils: Blood supply

'Love Father And Mother'

• Lingual artery 
• Facial artery
• Ascending pharyngeal artery
• Maxillary artery

Little's area: Arteries

" LEGS "

• L - superior Labial artery
• E - anterior Ethmoidal artery
• G - Greater palatine artery
• S - Sphenopalatine artery

The four arteries anastamose at Little's area to form a vascular plexus called Kiesselbach's plexus.

Auditory Pathway

E.COLI-MA'

• Eighth nerve
• Cochlear nuclei
• Olivary complex
• Lateral lemniscus
• Inferior colliculus
• Medial geniculate body
• Auditory cortex

The area of cortex, concerned with hearing is Brodmann's area located in the Superior temporal gyrus.

Each ear is represented in both cerebral hemispheres.

Oropharyngeal cancers: aetiology

6 S's:
Smoking
Spicy food
Syphilis
Spirits [booze]
Sore tooth
Sepsis

SEQUELAE OF CSOM-

O - CART
 
Ossicular necrosis
Cholesterol granuloma
Atrophic tympanic membrane and atelactatic middle ear
Retraction pockets and cholesteatoma
Tympanosclerosis

D/D of membrane over the tonsil

M2-VIDAAL (form Widal test for Typhoid)
It is:
- Membranous tonsillitis
- Malignancy
- Vincent's angina
- Infectious mononucleosis
- Diptheria
- Apthous ulcers
- Agranulocytosis
- Ludwig's angina
- T: Trauma

Indications of tympanoplasty

ABCDES

Age should be above 10yrs when sufficient resistance develops
Benign (tubotympanic disease) can be corrected
Conductive deafness can corrected
Dry perforation gives best results
Eustachian tube should be functioning properly
Stapes should be mobile

causes of SNHL

1.Congenital
-Prenatal factors
-Paranatal factors

2.Acquired

Nakshatra Makes FANSI TOPS

Noise induced HL
Meniere's dz
Familial Prog HL
Ac. Neuroma
Noise Induce HL
Sudden HL
Infections
Trauma to labyrinth/ VIIITH nv
Ototoxic drugs
Presbyacusis
Systemic Dz.

Sequelae of Otitis media

SCALP COST

S-SNHL
C-Cholesteatoma
A-Atelectasis
L-Learning Disability
P-Perforation of TM
C-Conductive HL
O-Ossicular Necrosis
S-Speech Impairment
T-Tympanosclerosis