Core Concepts and Principles Flashcards

Primary acquired cholesteatoma most commonly starts in which location?

Answer: Pars flaccida (Prussak's space)

Retraction of the pars flaccida into Prussak's space is the classic origin of primary acquired cholesteatoma.

Ludwig angina most commonly comes from which source of infection?

Answer: Mandibular second or third molar

The roots of the lower molars sit below the mylohyoid line, so infection spreads into the submandibular space.

Which semicircular canal is most commonly involved in benign paroxysmal positional vertigo?

Answer: Posterior

Gravity makes otoconia settle mostly in the posterior canal, which is diagnosed with Dix-Hallpike and treated with the Epley maneuver.

An adolescent male with recurrent unilateral epistaxis and nasal obstruction most likely has which lesion?

Answer: Juvenile nasopharyngeal angiofibroma

JNA is a vascular tumor of adolescent males that arises near the sphenopalatine foramen, so biopsy is avoided.

What is the main pathophysiologic feature of Ménière's disease?

Answer: Endolymphatic hydrops

Ménière's disease is associated with endolymphatic hydrops, which causes episodic vertigo, fluctuating low-frequency SNHL, tinnitus, and aural fullness.

A midline neck mass that rises with tongue protrusion is best treated with which procedure?

Answer: Sistrunk procedure

The Sistrunk procedure removes the thyroglossal duct cyst together with the central hyoid body, which lowers the recurrence rate.

A new adult patient has unilateral serous otitis media. Which diagnosis must be ruled out?

Answer: Nasopharyngeal carcinoma

A nasopharyngeal mass can block the Eustachian tube, so the nasopharynx needs to be examined in adults with unilateral effusion.