Myogenic activity (tympanometry)
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Tympanometry is a test that measures myogenic activity by recording the mechanical response of the middle ear muscles to changes in air pressure in the ear canal. It produces a tympanogram that shows compliance levels and can identify three main types - Type A indicating normal function, Type B associated with fluid in the middle ear, and Type C where the peak is at a more negative pressure typically seen in patients with Eustachian tube dysfunction. Abnormal tympanograms can also provide information about conditions affecting the ossicular chain or eardrum mobility. The test cannot be conducted if the eardrum is ruptured.
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- Diagnosis involves otoscopy, pneumatic otoscopy, and tympanometry which can classify effusions. Type B
Gastro oesophageal reflux & aspiration
This document defines and discusses gastro-oesophageal reflux, aspiration, their causes, symptoms, diagnostic tests and treatments. It notes that reflux is common in infants and usually physiological, but can become pathological if harming the child. Aspiration risks include impaired swallowing coordination or laryngeal protection. Diagnostic tests are videofluoroscopy and fibreoptic evaluation of swallowing. Treatments include positioning, thickened feeds, acid suppression, and sometimes surgery to control severe reflux or reduce saliva production for aspiration.
Fungi( all fungal sinusitis & candidiasis)
1) Mycotic diseases of the paranasal sinuses range from indolent infections in healthy individuals to lethal infections in immunocompromised people.
2) Fungal sinusitis is classified into invasive, noninvasive, and allergic types based on histopathology and clinical presentation. Invasive types can spread to nearby structures like the orbit and brain.
3) Diagnosis involves imaging like CT scans to assess bone destruction, biopsy and culture of tissue to confirm infection and identify the fungal species. Treatment depends on the type but may include antifungal drugs, surgery, and improving immune function.
Diseases of the tonsil
The tonsils are lymphoid tissue located in the throat that help the immune system. Acute tonsillitis is usually caused by viruses or bacteria like Streptococcus and is typically self-limiting. Treatment focuses on pain relief and hydration. Antibiotics may help if symptoms persist after 2-3 days. Complications are rare but include peritonsillar abscesses, which are treated with antibiotics and needle aspiration. The tonsils can also present lymphomas or cancers.
Chronic otitis media in childhood
This document discusses chronic otitis media, including the histology and pathogenesis. It notes that chronic inflammation is characterized by both tissue destruction and attempts at healing. Repeated infections from the nasopharynx or external ear canal can prevent resolution of otitis media. Persistent bacterial biofilms and chronic perforations of the tympanic membrane also contribute. Chronic retraction of the pars tensa portion of the eardrum can lead to atrophy and complications like cholesteatoma formation over time if not addressed. Early intervention may be warranted for more advanced retractions to prevent future problems.
Branchial arch fistulae, thyroglossal duct anomalies& lymphangioma
This document discusses the embryology and presentation of several congenital anomalies of the head and neck region, including branchial arch fistulae, thyroglossal duct anomalies, preauricular sinuses, and lymphangioma. It describes how these structures develop from the branchial arches and pouches during embryogenesis. Common locations and presentations of each anomaly are provided, along with diagnostic evaluation and treatment approaches. Surgical excision is often needed but can be challenging due to the relationship of these structures to nearby nerves and vessels.
Antimicrobial therapy
The document discusses the use of antimicrobial therapy and various classes of antibiotics. It provides details on the mechanisms of action, spectra of activity, indications for use, and side effects of different classes of antibiotics including beta-lactams (penicillins, cephalosporins, carbapenems), glycopeptides, quinolones, sulfonamides/trimethoprim, metronidazole, tetracyclines, chloramphenicol, macrolides, aminoglycosides, streptogramins, and oxazolidinones. It also discusses Clostridium difficile infection as a common gastrointestinal side effect caused by antibiotic use.
Acute otitis media in children
Acute otitis media (AOM) is an inflammation of the middle ear caused by bacterial or viral infection. It is common in young children and causes symptoms like ear pain, fever, and hearing loss. While most cases clear up without treatment, antibiotics are usually prescribed to reduce symptoms and risk of complications. For recurrent cases, management involves identifying and addressing risk factors, medical or surgical prophylaxis including ventilation tubes, and vaccination when available. AOM poses a significant burden as it is one of the most frequent reasons children receive antibiotics.
Physiology of swallowing
Swallowing involves three phases - oral, pharyngeal, and esophageal. In the oral phase, food is mixed with saliva and moved to the back of the throat by the tongue. The soft palate then elevates to protect the nasal airway. In the pharyngeal phase, the larynx and pharynx elevate to allow food to pass while protecting the airway, and a series of muscle contractions propel the food over the epiglottis and into the esophagus. In the esophageal phase, the upper esophageal sphincter relaxes to allow the food to pass into the esophagus for peristalsis down to the stomach.
More from Shekhar Krishna Debnath (20)
Branchial arch fistulae, thyroglossal duct anomalies& lymphangioma
Branchial arch fistulae, thyroglossal duct anomalies& lymphangioma
Myogenic activity (tympanometry)
- 1. Myogenic activity(Tympanometry) Myogenic activity can be recorded as electrical activity of the muscles(electromyography) or as the mechanical manifestation of their contraction(force,pressure,acceleration,displacement).In fact conventional behavioural audiometry on the myogenic activity.acoustic reflex, tympanometry,post-auricular myogenic response, body motion sensing all are example. Tympanograms typically show complaiance (the inverse of stiffness) as the measured aspect of impedance,there are three main types : Type A,which shows a clear peak of compliance between 0 & -100mm of water,associated with normal function. Type B where no peak in the compliance is noted ,typically associated with fluid in the middle ear cavity. Type C resembling type A but peaking at a pressure negative than -100mm of water ,most commonly found in patients ETD. A variant of type A with abnormally low compliances (high impedance) is found in patient with fixation of the ossicular chain such as ossicular chain. Conversely an abnormally high compliance (low impedance ) type A tympanogram is typical in patient with disruption of the ossicular chain, rendering the ear drum abnormally mobile & compliant. When the TM is ruptured tympanometry cannot be conducted.& ear canal volumne indicated by tympanometer & measured ,is larger than 2.5cc as compared to 1cc in adult or slightly less in children. The middle ear is an air filled space approximately high 15mm, wide 2-4mm, 1 to 2cm3 in volume.