Term
| What are the 2nd branchial arch (reichert cartilage) derivatives? |
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Definition
1) Stylohyoid ligament
2) Superior body and lesser corneu of hyoid
3) Manubrium of malleus, long process incus, stapes suprastructure |
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Term
| Describe nystagmus in vestibular neuritis |
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Definition
| Oppose site of origin,, horizontal and rotary, lasting days to weeks |
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Term
| What is utility of flouride in otosclerosis? |
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Definition
| Slows progression, does not reverse |
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Term
| What are the most common patterns spread from prussak's space of cholesteatoma? |
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Definition
Epitympanic cholesteatoma arises in prussaks space (between pars flaccida and neck of malleus)
Most common posterior epitympanum
Less common posterior mesotympanum then anterior epitympanum |
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Term
| What is the most common site of spontaneous perilymphatic fistula? |
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Definition
Anterior to anterior crus
less common is anteroinferior to anterior crus and then anterosuperior to anterior crus |
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Term
| What is the relevance surgically of the cochleaform process? |
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Definition
| Geniculate ganglion lies superior to it (near first geneu distal part of labrynthine segment) |
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Term
| What is Cogan's syndrome? |
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Definition
Interstitial keratitis, recurrent vertigo, unilateral or bilateral SNHL.
Autoimmune disorder. |
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Term
| What vascular anomaly is associated with a persistent stapedial artery? |
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Definition
| Absent middle meningeal, absent foramen spinosum |
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Term
| What is the blood supply of the utricle? |
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Definition
| Anterior vestibular artery (also superior and horizontal SCC and small portion of saccule) |
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Term
| Most vesibulotoxic aminoglycoside |
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Definition
| Streptomycin (followed by Gentamycin) |
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Term
| MRI appearance of cholesteatoma |
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Definition
Isointense on T1 and does not enhance with contrast
Hyperintense on T2 and shows diffusion restriction on DWI |
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Term
| What is Scheibe's anomaly? |
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Definition
- Dysplasia of cochleae and saccule, also known as cochleosaccular dysgenesis.
Involves membranous portion of the pars inferior |
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Term
| What are the contents of the cochlear aqueduct and where does it connect? |
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Definition
Periotic duct
Connects scala tympani at basal turn of cochlea to the SAS. |
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Term
| How do you differentiate peripheral from central vertigo? |
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Definition
1) Peripheral improves with fixation. Central does not
2) Smooth pursuit tracking is most sensitive for central
3) Pure vertical and nystagmus that changes direction in fixed head position suggests central |
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Term
| What are the classic features of Pendred syndrome? |
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Definition
| Thyroid goiter, defective ion transport, bilateral EVA, mondini malformation |
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Term
| Why is the risk of iatrogenic cholesteatoma higher after lateral compared to medial graft tympanoplasty? |
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Definition
| Incomplete removal of squamous epithelium. They take longer to heal and can have blunting. |
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Term
What are the histopathologic features of acoustic neuromas?
How is this different from meningioma? |
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Definition
Densley packed spindle-shaped Schwann cells (Antoni A) interspersed amidst loosely packed connective tissue (Toni B).
Verocay bodies (clear regions surrounded by palisading nuclei)
They are 90% of CPA lesions
Meningiomas instead have spindle shaped celled in nests with psammoma bodies |
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Term
| How can you avoid post-operative blunting after lateral graft tympanoplasty? |
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Definition
1) Remove anterior canal wall bulge
2) Avoid direct placement of graft over anterior canal bone
3) Place canal packing over graft into anterior sulcus
4) Ensure overlapping of canal skin and graft |
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Term
| What is size criteria for gamma knife for acoustic neuroma? |
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Definition
| Not >3cm (swelling and hydrocephalus can occur with big tumors) |
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Term
| What are the autosomal recessive conditions of hearing loss? |
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Definition
1) Pendred
2) Usher
3) Jervell and Lange-Nielson
Less common and more severe |
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Term
| What are the X-linked causes of congenital hearing loss? |
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Definition
| X-linked stapes gusher, Alport, Otopalatodigital syndrome |
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Term
| What about recruitment can indicate a retrocochlear lesion? |
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Definition
| Absence of recruitment in setting of known SNHL |
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Term
| What is the sunderland nerve injury classification? |
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Definition
Class 1: Neuropraxia (compression)
Class 2: Wallerian degeneration
Class 3: Neurotmesis
Class 4: Violation of perineurium
Class 5: Complete transeciton |
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Term
| Describe childhood hearing evaluations appropriate by age |
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Definition
1) <6 months: BOA
2) 6-30 months: VRA
3) >30 months: CPA |
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