HEGAZY SURGERY

1. MCQsMCQs for the DOHNSfor the DOHNS
Mr S AhluwaliaMr S Ahluwalia

2. 1. Recurrent Laryngeal Nerve1. Recurrent Laryngeal Nerve
•• A.) Has only motor fibresA.) Has only motor fibres
•• B.) Supplies all of the muscles of theB.) Supplies all of the muscles of the
larynxlarynx
•• C.) Lies in theC.) Lies in the tracheotracheo oesophageal grooveoesophageal groove
on the Lefton the Left
•• D.) Hooks under the aortic arch on theD.) Hooks under the aortic arch on the
rightright
•• E.) is intimately associated with theE.) is intimately associated with the
superior thyroid arterysuperior thyroid artery

3. Recurrent Laryngeal NerveRecurrent Laryngeal Nerve
AnswersAnswers
•• A.) FalseA.) False
•• B.) FalseB.) False
•• C.) TrueC.) True
•• D.) FalseD.) False
•• E.) FalseE.) False

4. Recurrent Laryngeal NerveRecurrent Laryngeal Nerve
DiscussionDiscussion
•• LeftLeft –– under aortic arch (L 6under aortic arch (L 6thth
arch artery)arch artery)
•• RightRight –– underunder subclaviansubclavian artery ( 4artery ( 4thth
archarch
artery)artery)
•• Originates fromOriginates from VagusVagus XX
•• Motor to all intrinsic laryngeal musclesMotor to all intrinsic laryngeal muscles
exceptexcept cricothyroidcricothyroid (ext(ext larynglaryng n. from supn. from sup
larynglaryng branch ofbranch of vagusvagus))
•• Sensory toSensory to subglotticsubglottic mucosa and pharynxmucosa and pharynx

5. 2. Otology2. Otology
•• A.) TheA.) The scalascala media and tympani containmedia and tympani contain
perilymphperilymph whilst thewhilst the scalascala vestibulivestibuli containscontains
endolymphendolymph
•• B.)B.) ChordaChorda tympani supplies taste to thetympani supplies taste to the
posterior 2/3 of the tongueposterior 2/3 of the tongue
•• C.) Tendon of theC.) Tendon of the stapediusstapedius muscle emergesmuscle emerges
from the base of the pyramidfrom the base of the pyramid
•• D.) Tympanic membrane is approx 1cm inD.) Tympanic membrane is approx 1cm in
diameterdiameter

6. Otology AnswersOtology Answers
•• A.) FalseA.) False
•• B.) FalseB.) False
•• C.) FalseC.) False
•• D.) TrueD.) True

7. Otology discussionOtology discussion
•• TheThe scalascala media containsmedia contains endolymphendolymph (K/(K/nana))
•• TheThe scalscal vestibulivestibuli containscontains perilymphperilymph (k/NA)(k/NA)
•• TheThe scalascala tympani containstympani contains perilymphperilymph and isand is
continuous with thecontinuous with the vestibulivestibuli at the apex.at the apex.
•• TheThe chordachorda tympani and facial nerve passtympani and facial nerve pass
through the middle earthrough the middle ear
•• Taste anterior 2/3 tongueTaste anterior 2/3 tongue

8. 3. Thyroid and3. Thyroid and ParathyroidsParathyroids
•• A.) The thyroid may be supplied by the thyroidA.) The thyroid may be supplied by the thyroid
imaima arteryartery
•• B.) The superiorB.) The superior parathyroidsparathyroids are derived formare derived form
the 3the 3rdrd pouchpouch
•• C.) The thyroid is enclosed byC.) The thyroid is enclosed by platysmaplatysma
•• D.) The recurrent laryngeal nerve is intimatelyD.) The recurrent laryngeal nerve is intimately
related to the inferior thyroid arteryrelated to the inferior thyroid artery
•• E.) The thyroid isE.) The thyroid is embryologicallyembryologically related to therelated to the
foramenforamen caecumcaecum

9. Thyroid andThyroid and ParathyroidsParathyroids
AnswersAnswers
•• A.) TrueA.) True
•• B.) FalseB.) False
•• C.) FalseC.) False
•• D.) TrueD.) True
•• E.) TrueE.) True

10. Thyroid andThyroid and ParathyroidsParathyroids
DiscussionDiscussion
•• The thyroid is supplied by the superior,The thyroid is supplied by the superior,
inferior thyroid andinferior thyroid and thryoidthryoid imaima arteries.arteries.
•• Drained via the sup, middle &Drained via the sup, middle & infinf thyroidthyroid
veinsveins
•• Enclosed byEnclosed by pretrachealpretracheal fasciafascia
•• SuperiorSuperior parathyroidsparathyroids derived from the 4derived from the 4thth
arch and inferior from the 3arch and inferior from the 3rdrd
archarch
•• Thyroid descends from the foramenThyroid descends from the foramen
caecumcaecum

11. 4. Nose and Sinuses4. Nose and Sinuses
•• A.) The nose is supplied exclusively by theA.) The nose is supplied exclusively by the
ICAICA
•• B.) The septum is composed of triangularB.) The septum is composed of triangular
cartilage and bonecartilage and bone
•• C.) The anteriorC.) The anterior ethmoidethmoid artery is aartery is a
branch of the ECAbranch of the ECA
•• D.) The nasal valve is situated at theD.) The nasal valve is situated at the
middlemiddle meatusmeatus

12. Nose and Sinuses AnswersNose and Sinuses Answers
•• A.) FalseA.) False
•• B.) FalseB.) False
•• C.) FalseC.) False
•• D.) FalseD.) False

13. Nose and SinusesNose and Sinuses
DiscussionDiscussion
•• SeptumSeptum –– quadrilateral cartilage,quadrilateral cartilage, vomervomer,,
perpendicular plate of theperpendicular plate of the ethmoidethmoid &&
maxillary crestmaxillary crest
•• ECAECA –– Internal maxillaryInternal maxillary –– SPA & greaterSPA & greater
palatine arterypalatine artery
•• ICAICA –– ophthalmic arteryophthalmic artery –– anterior &anterior &
posteriorposterior ethmoidalethmoidal arteryartery
•• Nasal valve is ant to the antNasal valve is ant to the ant infinf turbinateturbinate

14. Nasal SeptumNasal Septum

15. 5. Facial Nerve5. Facial Nerve
•• A.) Terminal branches include TemporalA.) Terminal branches include Temporal
andand ZygomaticZygomatic
•• B.) Is a purely motor nerveB.) Is a purely motor nerve
•• C.) Emerges from theC.) Emerges from the stylomastoidstylomastoid
foramenforamen
•• D.) Synapses at theD.) Synapses at the geniculategeniculate ganglionganglion
•• E.) Traverses the Internal AcousticE.) Traverses the Internal Acoustic MeatusMeatus
with thewith the VestibulocochlearVestibulocochlear nervenerve

16. Facial NerveFacial Nerve
AnswersAnswers
•• A.) TrueA.) True
•• B.) FalseB.) False
•• C.) TrueC.) True
•• D.) TrueD.) True
•• E.) TrueE.) True

17. Facial nerveFacial nerve
DiscussionDiscussion
•• Motor and sensoryMotor and sensory
•• InfratemporalInfratemporal && ExtratemporalExtratemporal portionsportions
•• StylomastoidStylomastoid foramen and divides into T,foramen and divides into T,
Z, B, M, C nerves within parotid glandZ, B, M, C nerves within parotid gland
•• Facial expression,Facial expression, lacrimationlacrimation, salivation, salivation
•• Taste sensation anterior 2/3 of tongueTaste sensation anterior 2/3 of tongue

18. 6. Muscles of the Larynx6. Muscles of the Larynx
•• A.) Cricothyroid tenses the vocal foldsA.) Cricothyroid tenses the vocal folds
•• B.) LateralB.) Lateral cricoarytenoidcricoarytenoid abducts the vocal foldsabducts the vocal folds
•• C.) PosteriorC.) Posterior cricoarytenoidcricoarytenoid abducts the vocalabducts the vocal
foldsfolds
•• D.)D.) ThyroarytenoidThyroarytenoid is supplied by the recurrentis supplied by the recurrent
laryngeal nervelaryngeal nerve
•• E.) Cricothyroid is supplied by the externalE.) Cricothyroid is supplied by the external
laryngeal nervelaryngeal nerve

19. Muscles of LarynxMuscles of Larynx
AnswersAnswers
•• A.) TrueA.) True
•• B.) FalseB.) False
•• C.) TrueC.) True
•• D.) TrueD.) True
•• E.) TrueE.) True

20. Muscles of LarynxMuscles of Larynx
DiscussionDiscussion
•• TensorTensor –– CricothyroidCricothyroid –– External LaryngealExternal Laryngeal
NerveNerve
•• RelaxorRelaxor –– ThyroarytenoidThyroarytenoid –– RLNRLN
•• AdductorAdductor –– LateralLateral CricoarytenoidCricoarytenoid –– RLNRLN
-- TransverseTransverse ArytenoidArytenoid -- RLNRLN
•• AbductorAbductor –– PosteriorPosterior CricoarytenoidCricoarytenoid -- RLNRLN

21. 7. The tonsil7. The tonsil
•• A.)A.) PalatoglossusPalatoglossus lies anterior to the tonsillies anterior to the tonsil
•• B.) The tonsil is supplied by the tonsillarB.) The tonsil is supplied by the tonsillar
artery, a branch of the pharyngeal arteryartery, a branch of the pharyngeal artery
•• C.) The ECA lies 2.5cm behind and lateralC.) The ECA lies 2.5cm behind and lateral
to the tonsilto the tonsil
•• D.) Lymph drains to the upper deepD.) Lymph drains to the upper deep
cervical &cervical & jugulodigastricjugulodigastric lymph nodeslymph nodes

22. Tonsil AnswersTonsil Answers
•• A.) TrueA.) True
•• B.) FalseB.) False
•• C.) FalseC.) False
•• D.) TrueD.) True

23. Tonsil DiscussionTonsil Discussion
•• The tonsil lies between theThe tonsil lies between the palatoglossuspalatoglossus
andand palatopharyngeuspalatopharyngeus, superiorly the, superiorly the
palate and inferiorly the tongue.palate and inferiorly the tongue.
•• Supplied by the tonsillar artery via theSupplied by the tonsillar artery via the
facial artery.facial artery.
•• The ICA lies 2.5cm behind & lateral to theThe ICA lies 2.5cm behind & lateral to the
tonsiltonsil

24. Insulin Diabetic Patient undergoingInsulin Diabetic Patient undergoing
total thyroidectomy, shouldtotal thyroidectomy, should
a.a. Be admitted 1 hour before surgeryBe admitted 1 hour before surgery
FalseFalse
b.b. Receive preReceive pre--operative insulinoperative insulin
FalseFalse
c.c. Receive intravenous normal saline preoperativelyReceive intravenous normal saline preoperatively
FalseFalse
d.d. Receive a glucose, insulin and potassium infusionReceive a glucose, insulin and potassium infusion
preoperativelypreoperatively
TrueTrue
e.e. Should receive intravenous insulinShould receive intravenous insulin intraoperativelyintraoperatively
FalseFalse

25. IDDM surgical patientsIDDM surgical patients
•• All patients must be admitted before any period ofAll patients must be admitted before any period of
starvationstarvation
•• Normal insulin dose regimes usually includeNormal insulin dose regimes usually include
intermediate/long acting insulin, therefore stop allintermediate/long acting insulin, therefore stop all
normal dosesnormal doses
•• Maintain hourly blood glucose readings between 6Maintain hourly blood glucose readings between 6--1212
mmolmmol/L using a dextrose, insulin and potassium sliding/L using a dextrose, insulin and potassium sliding
scale infusionscale infusion
•• Run patientRun patient’’ss ‘‘hyperglycaemichyperglycaemic’’ during surgeryduring surgery
•• Keep on sliding scale until back to normal diet, and thenKeep on sliding scale until back to normal diet, and then
watch BMs closely whilst on normalwatch BMs closely whilst on normal s/cs/c insulin regimeinsulin regime

26. Total serumTotal serum thyroxinethyroxine is reduced byis reduced by
a.a. Oral contraceptive pillsOral contraceptive pills
FalseFalse
b.b. PregnancyPregnancy
FalseFalse
c.c. NephroticNephrotic SyndromeSyndrome
TrueTrue
d.d. PropanololPropanolol
FalseFalse

27. Total serumTotal serum thyroxinethyroxine
•• ThyroxineThyroxine (T4) is present in serum as free T4 and bound(T4) is present in serum as free T4 and bound
T4. The bound form predominates and is bound toT4. The bound form predominates and is bound to
thyroglobulinthyroglobulin (TBG),(TBG), prealbuminprealbumin and albuminand albumin
•• This bound form of T4 serves as a reservoir, henceThis bound form of T4 serves as a reservoir, hence
buffers against wild fluctuations of free/active T4buffers against wild fluctuations of free/active T4
•• In pregnancy, TBG rises, reducing free T4 whichIn pregnancy, TBG rises, reducing free T4 which
stimulates TSH production, and therefore T4 production.stimulates TSH production, and therefore T4 production.
Total T4 therefore rises, although free T4 does notTotal T4 therefore rises, although free T4 does not
•• InIn NephroticNephrotic syndrome, TBG and albumin is lost. Free T4syndrome, TBG and albumin is lost. Free T4
consequently rises, inhibiting TSH production and T4consequently rises, inhibiting TSH production and T4
synthesis. Total T4 therefore fallssynthesis. Total T4 therefore falls

28. The following areThe following are absorbableabsorbable suturessutures
a.a. Cat gutCat gut
TrueTrue
b.b. SilkSilk
FalseFalse
c.c. Polyamide (Nylon)Polyamide (Nylon)
FalseFalse
d.d. PolyglactinPolyglactin ((VicrylVicryl))
TrueTrue
e.e. PolyglyconatePolyglyconate ((MaxonMaxon))
FalseFalse

29. SuturesSutures
AbsorbableAbsorbable NonNon--absorbableabsorbable
Cat gutCat gut
PolydioxanonePolydioxanone (PDS)(PDS)
PolyglactinPolyglactin ((VicrylVicryl))
VicrylVicryl RapideRapide,, MonocrylMonocryl etcetc
Polyamide (Nylon)Polyamide (Nylon)
Polypropylene (Polypropylene (ProleneProlene))
PolytetrafluoroethylenePolytetrafluoroethylene
(PTFE or(PTFE or GoretexGoretex))
SilkSilk

30. Surgery on the submandibular glandSurgery on the submandibular gland
a.a. An incision on the lower border of the mandible is safeAn incision on the lower border of the mandible is safe
FalseFalse
b.b. The submandibular gland is seen to wrap around theThe submandibular gland is seen to wrap around the
posterior border ofposterior border of mylohyoidmylohyoid
TrueTrue
c.c. The facial artery and vein are divided as they courseThe facial artery and vein are divided as they course
through the deep part of the glandthrough the deep part of the gland
FalseFalse
d.d. The hypoglossal nerve is seen to loop under theThe hypoglossal nerve is seen to loop under the
submandibular ductsubmandibular duct
FalseFalse
e.e. Damage to the lingual nerve will cause loss ofDamage to the lingual nerve will cause loss of
sensation to the posterior third of the tonguesensation to the posterior third of the tongue
FalseFalse

31. Submandibular gland surgerySubmandibular gland surgery
•• Incision is usually two finger breaths below mandible toIncision is usually two finger breaths below mandible to
avoid marginalavoid marginal mandibularmandibular nervenerve
•• Gland has deep and superficial parts that wrap aroundGland has deep and superficial parts that wrap around
posterior border ofposterior border of mylohyoidmylohyoid
•• Facial vessels are divided andFacial vessels are divided and ligatedligated superficial to thesuperficial to the
gland. Artery hooks over the top of gland, and may begland. Artery hooks over the top of gland, and may be
encountered several times!encountered several times!
•• Lingual nerve and not hypoglossalLingual nerve and not hypoglossal ‘‘double crossesdouble crosses’’ thethe
duct. Passing under the duct, from lateral to medial,duct. Passing under the duct, from lateral to medial,
then running forwards onthen running forwards on hyoglossushyoglossus at a level aboveat a level above
the ductthe duct
•• Lingual nerve supplies the anterior two thirds of theLingual nerve supplies the anterior two thirds of the
tonguetongue

32. A 11 month old child presenting with aA 11 month old child presenting with a
midline cystic swelling just below themidline cystic swelling just below the
midlinemidline
a.a. Ultrasound is helpful in the diagnosisUltrasound is helpful in the diagnosis
TrueTrue
b.b. Technetium scanning aids diagnosisTechnetium scanning aids diagnosis
TrueTrue
c.c. Typically has an associated lingual thyroidTypically has an associated lingual thyroid
FalseFalse
d.d. Often resolves spontaneouslyOften resolves spontaneously
FalseFalse
e.e. Often recurs if excision does not remove the body ofOften recurs if excision does not remove the body of
the hyoidthe hyoid
TrueTrue

33. OtosclerosisOtosclerosis
a.a. Patients often require surgery in both earsPatients often require surgery in both ears
TrueTrue
b.b. OtoscopyOtoscopy is normalis normal
TrueTrue
c.c. May be associated with a white forelock andMay be associated with a white forelock and
heterochromiaheterochromia
FalseFalse
d.d. Causes conductive hearing lossCauses conductive hearing loss
TrueTrue
e.e. May be associated with blue scleraMay be associated with blue sclera
TrueTrue

34. OtosclerosisOtosclerosis
•• Only 15% ofOnly 15% of otosclerosisotosclerosis is truly unilateralis truly unilateral
•• TheThe ‘‘flamingo flushflamingo flush’’ oror SchwartzeSchwartze sign is very uncommonsign is very uncommon
•• Unilateral SNHL, white forelock, eye lid deformity withUnilateral SNHL, white forelock, eye lid deformity with
heterochromiaheterochromia describesdescribes WaardenburgWaardenburg’’ss syndrome (ADsyndrome (AD
syndrome)syndrome)
•• Conductive loss occurs.Conductive loss occurs. CarhartCarhart’’ss notch is a rise in BCnotch is a rise in BC
thresholds at 2kHz due to stapes inertiathresholds at 2kHz due to stapes inertia
•• There is an association withThere is an association with OsteogenesisOsteogenesis ImperfectaImperfecta

35. JuvenileJuvenile angiofibromaangiofibroma
a.a. Patients have often had repeated episodes of epistaxisPatients have often had repeated episodes of epistaxis
TrueTrue
b.b. It is a tumour of young boys with a mean age of 14 atIt is a tumour of young boys with a mean age of 14 at
presentationpresentation
TrueTrue
c.c. Bone erosion of the greater wing of the sphenoid doesBone erosion of the greater wing of the sphenoid does
not occurnot occur
FalseFalse
d.d. External beam radiotherapy is firstExternal beam radiotherapy is first--line treatmentline treatment
FalseFalse

36. JuvenileJuvenile angiofibromaangiofibroma
•• Tumour of young boys who suffer severe bouts ofTumour of young boys who suffer severe bouts of
epistaxis,epistaxis, hyponasalhyponasal speech and otalgiaspeech and otalgia
•• Starts in the sphenopalatine foramen, invades theStarts in the sphenopalatine foramen, invades the
pterygopalatinepterygopalatine fossa, and then thefossa, and then the infratemporalinfratemporal fossafossa
to eventually erode the anterior face of the greater wingto eventually erode the anterior face of the greater wing
of the sphenoidof the sphenoid
•• Surgery with preSurgery with pre--operativeoperative embolisationembolisation gives bestgives best
resultsresults
•• Never biopsy the tumour!Never biopsy the tumour!

37. TracheostomyTracheostomy
a.a. Fenestration is made through the first tracheal ringFenestration is made through the first tracheal ring
FalseFalse
b.b. Can lead to trachealCan lead to tracheal stenosisstenosis
TrueTrue
c.c. Recurrent laryngeal nerves must be identified andRecurrent laryngeal nerves must be identified and
displaceddisplaced
FalseFalse
d.d. Increases anatomical dead spaceIncreases anatomical dead space
FalseFalse
e.e. Improves the efficiency of coughing and thereforeImproves the efficiency of coughing and therefore
improves bronchial toiletimproves bronchial toilet
FalseFalse

38. TracheostomyTracheostomy
•• Fenestration is usually made between the 2Fenestration is usually made between the 2ndnd and 3and 3rdrd
ringsrings
•• Large circumferential fenestrations may lead toLarge circumferential fenestrations may lead to stenosisstenosis
followingfollowing decannulationdecannulation
•• Recurrent laryngeal nerves are not usually identifiedRecurrent laryngeal nerves are not usually identified
•• Anatomical dead space is reduced. Air no longer passesAnatomical dead space is reduced. Air no longer passes
through the nose,through the nose, nasonaso and oropharynx andand oropharynx and supraglottissupraglottis
•• Reduces the efficiency of coughing but allows bronchialReduces the efficiency of coughing but allows bronchial
toilet in those who have lost ability to coughtoilet in those who have lost ability to cough

39. Vocal cord nodulesVocal cord nodules
a.a. May become malignantMay become malignant
FalseFalse
b.b. Respond favourably to speech therapy in most patientsRespond favourably to speech therapy in most patients
TrueTrue
c.c. Are always bilateralAre always bilateral
FalseFalse
d.d. Are related to the consumption of dark spiritsAre related to the consumption of dark spirits
FalseFalse
e.e. Should be removed by microsurgical techniques toShould be removed by microsurgical techniques to
exclude an early squamous cell carcinomaexclude an early squamous cell carcinoma
FalseFalse

40. Glossopharyngeal nerveGlossopharyngeal nerve
a.a. Is the nerve of the 2Is the nerve of the 2ndnd branchial archbranchial arch
FalseFalse
b.b. Is motor to the intrinsic lingual musclesIs motor to the intrinsic lingual muscles
FalseFalse
c.c. Is motor to some extrinsic lingual musclesIs motor to some extrinsic lingual muscles
FalseFalse
d.d. Supplies sensation to the middle ear mucousSupplies sensation to the middle ear mucous
membranemembrane
TrueTrue
e.e. Is deep to the tonsillar fossaIs deep to the tonsillar fossa
TrueTrue

41. Glossopharyngeal nerveGlossopharyngeal nerve
•• Is the nerve of the 3Is the nerve of the 3rdrd branchial archbranchial arch
•• Glossopharyngeal nerve is motor to only one muscle, theGlossopharyngeal nerve is motor to only one muscle, the
stylopharyngeusstylopharyngeus
•• SensorySensory innervationinnervation includes carotid body, taste toincludes carotid body, taste to
posterior third of tongue,posterior third of tongue, secretomotorsecretomotor fibres to thefibres to the
parotid glandparotid gland
•• May be section through a tonsillectomy approach forMay be section through a tonsillectomy approach for
glossopharyngeal neuralgiaglossopharyngeal neuralgia

42. The following structures are removed in theThe following structures are removed in the
operation of a radical neck dissectionoperation of a radical neck dissection
a.a. TrapeziusTrapezius
FalseFalse
b.b. External carotid arteryExternal carotid artery
FalseFalse
c.c. SternothyroidSternothyroid musclemuscle
FalseFalse
d.d. Submandibular glandSubmandibular gland
TrueTrue
e.e. OmoOmo--hyoid musclehyoid muscle
TrueTrue
Other structures includeOther structures include accesoryaccesory nerve,nerve,
sternocleidomastoidsternocleidomastoid muscle and IJVmuscle and IJV

43. Match the following patients with the mostMatch the following patients with the most
appropriate form of imagingappropriate form of imaging
•• CTCT
•• MRIMRI
•• Soft tissue neck XSoft tissue neck X--rayray
•• Ultrasound with fine needleUltrasound with fine needle
aspiration cytologyaspiration cytology
•• A dominant nodule in theA dominant nodule in the
left thyroid lobeleft thyroid lobe
•• SuddenSudden sensorineuralsensorineural
hearing losshearing loss
•• Suspected fishbone in theSuspected fishbone in the
hypopharynxhypopharynx
•• Patient with nasal polypsPatient with nasal polyps
not resolving with medicalnot resolving with medical
treatmenttreatment

44. The following are 10 year survival rates forThe following are 10 year survival rates for
localised thyroid cancer following treatmentlocalised thyroid cancer following treatment
•• Less than 1%Less than 1%
•• Less than 10%Less than 10%
•• Between 50Between 50--80%80%
•• Better than 80%Better than 80%
•• Sporadic (nonSporadic (non--hereditary)hereditary)
MedullaryMedullary Thyroid CarcinomaThyroid Carcinoma
•• AnaplasticAnaplastic thyroid carcinomathyroid carcinoma
•• Papillary thyroid carcinomaPapillary thyroid carcinoma
•• Follicular thyroid carcinomaFollicular thyroid carcinoma

45. Matching the following cases with theMatching the following cases with the
named syndromesnamed syndromes
•• KartagenerKartagener’’ss
•• YoungYoung’’ss
•• Cystic FibrosisCystic Fibrosis
•• OslerOsler--WeberWeber--RenduRendu
syndromesyndrome
•• Patient has obstructivePatient has obstructive azoospermiaazoospermia,,
sinusitis andsinusitis and bronchiectasisbronchiectasis.. CiliaryCiliary
motility is normalmotility is normal
•• Patient withPatient with situssitus inversusinversus, sinusitis, sinusitis
andand bronchiectasisbronchiectasis. Cilia are found to. Cilia are found to
be immotile on electron microscopybe immotile on electron microscopy
•• Patient has chronicPatient has chronic bronchopulmonarybronchopulmonary
infection,infection, malabsorptionmalabsorption and highand high
sodium content in sweatsodium content in sweat
•• Patient has recurrent nose bleedsPatient has recurrent nose bleeds