Most common tuning fork used in clinical practice is of frequency?
A. 512hz
B. 1024hz
C. 128hz
D. 4024hz

Middle ear ossicles
Weight of the middle ear ossicles are as follows:

Malleus – 25mg
Incus – 27mg
Stapes – 3mg

Reference: Middle ear surgery: recent advances and future directions By Klaus Jahnke

Laryngeal papillomas constitute 80% of the neoplastic lesions of the larynx
Juvenile laryngeal papillomas are a type of squamous papillomas seen in infants and children

Juvenile nasopharyngeal angiofibroma is the most common benign tumour of the nasopharynx
It is usually seen in males in the second decade of life and usually presents with recurrent profuse epistaxis

Etiology:

Since it occurs in the second decade of life, it is proposed that nasopharyngeal angiofibroma is a testosterone dependent tumour
A nidus of hamartomatous vascular tissue in the nasopharynx undergoes proliferation in response to hormonal stimulation

Site of occurence:

The site of occurrence was initially thought to be the posterior wall and roof of nasopharynx
But recent studies indicate that the site of origin is in fact the posterior part of nasal cavity, …

Vocal nodules are the a type of non neoplastic benign lesions of vocal cords
They are nodular lesions located in the free edge of the vocal cords that arises as a result of voice abuse

Etiology:

Voice abuse is the most important etiological factor

Speaking in low tones or high intensity for long periods to time

It is seen in people who tend to use their voice a lot like singers, singers and children
Hence it is also known by the following alternate names:

Singer’s nodules
Speaker’s nodules
Minister’s nodules
Teacher’s nodules
Screamer’s nodules

Pathogenesis:

Voice abuse initially results in oedema and haemorrhage in the …

The different causes of septal perforation are:

Traumatic perforation

Septal surgery
Cautery for epistaxis
Habitual nose picking
Deliberate perforation for putting ornaments

Pathological perforation

Septal abscess
Nasal myiasis
Rhinolith
Chronic granulomatous diseases

Leprosy, Lupus, Tuberculosis – perforation of cartilaginous septum
Syphilis – perforation of bony septum

Wegener’s granuloma

Drugs and Chemicals

Long term use of steroid nasal sprays
Exposure to certain chemicals in industry

eg: chromium

Cocaine addicts

Idiopathic

Clinical features:

Small perforations result in a whistling sound
Large perforations cause crusting which bleed upon removal

Management:

The identification of the cause is essential
Small perforations can be closed by using plastic flaps
In case of large perforations, removal of crusts can be done using alkaline nasal douche and …

CLS stands for:

Congenital Laryngeal Stridor

There are various clinical signs in allergic rhinitis. They are:

Nasal signs

Transverse nasal crease (allergic crease)

A black transverse line across the middle of nose
Occurs due to constant rubbing of the nose in the upward direction resembling a salute – allergic salute

Swollen turbinates
Pale, oedematous, bluish nasal mucosa
Thin watery discharge

Ocular signs

Lid oedema
Cobblestone appearance and congestion of conjunctiva
Dark circles under eyes – allergic shiners

Otologic signs

Retraction of tympanic membrane and serous otitis media due to eustachian tube dysfunction

Pharyngeal signs

Granular pharyngitis due to hyperplasia of submucosal lymphoid tissue

Laryngeal signs

Hoarseness of voice
Oedema of vocal cords

Rhinitis caseosa is a condition in which the nasal cavity is filled with foul smelling, purulent discharge and cheesy material
Epidemiology:

It is an uncommon condition, mostly seen in males

Pathology:

Chronic infection of sinus resulting in production of purulent discharge and inspissated cheesy material which gets collected in nasal cavity
Bony destruction of the sinus walls may be present
Hence it is necessary to differentiate this from malignancy

Treatment:

Removal of the discharge, debris and granulation tissue to allow free drainage of sinuses

Prognosis is good

Ringertz tumour is a benign warty neoplasm that arises from the lateral wall of nasal cavity
Instead of growing outwards, it grows into the stroma
Epidemiology:

Seen in 40-70 yrs age group
More in males

Clinical features:

Red / grey oedematous mass
Always unilateral
May be confused with nasal polyp

Treatment:

Wide surgical excision

Lateral rhinotomy
Medial maxillectomy with en bloc ethmoidectomy

Chance of recurrence
May be associated with squamous cell carcinoma in 10-15% individuals

Alternate names:

Transitional cell papilloma
Schneiderian papilloma