2. Case 1:
A 45-year-old female patient presented to the ENT clinic with dry sensation of
the nose and, burning sensation in the mucosa covering the hard palate. The
condition was accompanied by loss of lacrimation. CT scan of the skull revealed
amass measuring (1 cm in diameter) in the pterygopalatine fossa.
A. What is the structure responsible for this condition?
Sphenopalatine ganglion.
B. Enumerate the roots of that structure?
Sensory roots: from the maxillary nerve.
C. a. Parasympathetic root: Greater superficial petrosal nerve.
D. b. Sympathetic root: Deep petrosal nerve.
c. Enumerate the branches of that structure?
Orbital branches: supply the periosteum of orbit:
a. Nasal branches: lateral nasal (short spheno-palatine) and medial nasal (long spheno-
palatine) branches
b. Palatine branches: greater palatine nerve and lesser palatine nerves.
Pharyngeal branches: supply the nasopharynx and the auditory (Eustachian) tube
Case 2:
A 45 diabetic male patient presented to ophthalmology outpatient clinic with
severe headache, high fever and inability to move the right eye.
He gave history of nasal septum abscess drainage one week ago.
A. What is the most probable diagnosis?
Cavernous sinus thrombosis.
B. Explain the cause of this condition?
Spread of infection from the nasal septum to pterygoid venous plexus then to cavernous sinus by
emissary vein passing through the foramen ovale .
3. Case 3:
A 45-year-old man with a complaint of ear pain and difficulty hearing is
diagnosed with tonsillitis. Otoscopic examination reveals fluid in the middle ear
cavity.
1- Hypertrophy of which of the following structures would be most likely to compromise the
drainage of the auditory tube?
a. Lingual tonsil
b. Palatine tonsil
c. Pharyngeal tonsil
d. Superior constrictor muscle
e. Uvula
2- The auditory tube passes through the ........... Gap of the pharynx.
a.1st
b. 2nd
C. 3rd
d. 4th
e. 5th
3- The palatine tonsil is located in:
a. Nasopharynx
b. Oropharynx
c. Laryngopharynx
d. Larynx
e. Esophagus
4. Case 4:
A patient suffered from a pharyngeal tumor and it is closely related to the 4th
gap of the lateral wall of the pharynx.
A. What is the location of the 4th gap?
Below inferior constrictor muscle.
B. Which structures will be mostly affected?
Recurrent laryngeal nerve and inferior laryngeal artery
C. What is the arterial supply of the pharynx?
Ascending pharyngeal artery, pharyngeal branch of maxillary artery and ascending palatine branch of
facial artery
Case5:
A 2-month-old male infant had a small pit at the anterior border of the
sternocleidomastoid muscle with mucus dripping intermittently from the
opening. The pit extended to the tonsillar fossa as a branchial fistula.
A. What is the anomaly of this patient?
Cleft palate.
B. Which pharyngeal pouch is involved in this case?
Failure of fusion between the different segments of the palate.
C. What is the cause of this anomaly?
-Unilateral complete cleft palate.
- Bilateral complete cleft palate.
- Partial cleft palate.
- Cleft uvula.
