Type A- Normal tympanogram

Type As- Compliance lower, seen in fixation of ossicles eg:Otosclerosis,malleus fixation

Type Ad- High compliance,Seen in ossicular discontinuity and lax tympanic membrane

Type B- Flat dome shaped graph.No change in compliance.Seen in middle ear fluid/thick tympanic membrane.

Type C- Maximum compliance with negative pressure in excess of 100mmHg.Seen in retracted tympanic membrane and minimal fluid in middle ear.

1. Conductive deafness(Eustachian tube blockade)
2. Ipsilateral temperoparietal neuralgia(Vth N)
3. Palatal palsy(Xth N)

Superior and middle concha/turbinate- Part of ethmoid bone

Inferior Concha is a seperate bone.

Openings in meatus

Superior meatus- Posterior ethmoid sinus

Middle meatus- Frontal sinus,Anterior and middle Ethmoid sinus,Hiatus semilunaris recieves maxillary sinus

Inferior meatus- Nasolacrimal Duct(INDia)

Spheno ethmoidal recess- Sphenoid sinus

Tip: It is usual that the middlemen benefit the most, while the producers and retailers are least benefitted.

Thyroglossal cyst

90% Thyroglossal cysts lie in the midline

Commonest site for thyroglossal cyst-Subhyoid.

Atypical thyroglossal cysts are usually found on left side.

Thyroglossal cyst is the commonest congenital neck swelling.

Commonest cause of recurrence is the failure to remove body of hyoid.

Treatment of papillary Ca of thyroglossal cyst-Sistrunks+Post op TSH suppression+Eltroxin

Sistrunks Operation

Surgery for thyroglossal cyst

Structures removed are

1. Thyroglossal cyst
2. Body of hyoid bone
3. Core of tongue tissue pointing towards foramen caecum

Branchial cyst

Upper 1/3rd of neck on anterior border of sternocleidomastoid muscle.

Remnant of 2nd pharyngeal pouch(branchial cleft)

Cystic transformation of LN

Lined by stratified squamous epithelium.

Lymphoid tissue is seen on the walls.

Cystic Hygroma

Earliest congenital neck swelling

Posterior triangle of neck

Brilliantly transilluminant

Due to sequestration of jugular lymphsac

TOC: Surgery

Injection of sclerosants like OK-432,tertracycline,bleomycin are other modalities.