IMPORTANT NOTES BY dr.Ahmed Gaber collected by dr.

Ahmed Gaber *************************** Important notes added in ENT lectures ----------et2akkedo mn elkalam da wento betzakro 3shan el ENT wa5do mn zaman w nasih we7temal ykoun fih 2a5ta2 basita:) ---------

-hemangioma :ttt> medical : corticosteroid + beta blockers (indral) surgical : tracheotomy & follow up (2-4) spont. regression laser endoscopic surgery (KTP/CO2) surgical excision NB:never radiation> more. aggressive NB:never biopsy

-chondroma : ttt> total laryngectomy NB :never radiation >more aggressive NB : DD chondrosarcoma by behaviour not histopathology ____________________________ development of larynx : * embryonic phase (0-8wks) > organogenesis/4th arch>epiglottis/ 6th arch >arytenoids, cricoid , trachea. * fetal phase (9wks-7mnths) >organ maturation

- infantile larynx > mohema gedan , maktoba fe stridor

- congintal vocal cord paralysis ttt> 1- treat cause (eg:shunt op.) 2- tracheostomy &foloow up (1-2yrs) > spont. recovery (>50%)>decannulation or>no recovery > VC lateralization procedure/arytenoidectomy/ laser cordotomy.

-cong. SG stenosis ttt> * soft tissue : - follow up( child out grow the problem) - tracheostomy and follow up -endoscopic laser dilation - surgical ttt * cartilagenous : - anterior cricoid split(ACS) -larngeotracheal reconstruction(LTR) -pearson's operation .

-----------------------de bardo notes , kanet bett2al >

**nasopharyngeal swellings ( congintal ) > - thornwaldt's cyst

- chordoma( not chordal in origin) - tratoma ______________ **comparison bet. JNA & adenoids (imp.) _______________ **concerning sinusitis : de kanet w hoa bymley , kan by2ool enha mohema

1- in acute rhinosinusitis : **take care of : when the extension of infection from teeth (dental)> it is predisposed by - dental infection of upper 2nd premolar or1st molar tooth (vip) -dental inf. of same teeth complicated by fistula.(oroantral fistula)

** in C/P :fe el pain and headace ( inc.with coughing or bending (VIP)) ** in ttt : fe al antibiotic ( at least 10 days)VIP

2- in chronic rhinosinsitis: ** radiologic investigation in chronic sinusitis > CT scan ** fe el etiology > el point beta3et persistence of predisposing factors > canet general factors & and local factors > fe local factors ,( ethmoiditis & or anatomical abnormalities in ethmoids (vip)) ** no fever ** in ttt : lazem awel 7aga tektab elimination of any predisposing factor ** name of surgery > functional endoscopic sinus surgery .

3- complications:

**point el brain abscess : in frontal lope ( mohem gedan 3shan afra2 3an brain abscess of otitis media which is where in temporal , cerebellar , mesh faker bel zabt :) ) _______________ ** treatment of hypopharyngeal tumor : hoa el dr. 3aml scheme dah w hoa a7san men el ketab awy : http://www.mediafire.com/i/?d7wfmrcw9wajsqc