ENT Rhinology and Sinonasal Disorders 3

Question 1

What is the recommended timing for surgical repair of a nasal bone fracture to avoid soft-tissue edema obscuring the reduction?

Accepted Answer

Within 3–5 days before significant edema develops, or after 10–14 days when edema resolves

Answer

Immediate surgery within 2 hours

Answer

Only after 3 weeks when healing is complete

Answer

Surgical repair is never indicated; only closed reduction is used

Question 2

Anosmia following an upper respiratory infection is most commonly attributed to which mechanism?

Accepted Answer

Sensorineural loss from direct viral injury to olfactory receptor neurons

Answer

Permanent destruction of the olfactory bulb

Answer

Conductive loss due to nasal mucosal inflammation blocking odorant access to the olfactory epithelium

Answer

Central lesion in the orbitofrontal cortex

Question 3

Choanal atresia presenting in a neonate is considered a surgical emergency when it is:

Accepted Answer

Bilateral, because neonates are obligate nasal breathers

Answer

Unilateral and bony in composition

Answer

Associated with CHARGE syndrome

Answer

Detected incidentally on prenatal ultrasound

Question 4

Nasal saline irrigation benefits patients with CRS primarily through which mechanism?

Accepted Answer

Mechanically clearing mucus, allergens, and inflammatory mediators from the nasal cavity

Answer

Delivering antibiotics directly to the sinuses

Answer

Reducing mucosal vascular permeability

Answer

Activating innate immune defenses via toll-like receptors

Question 5

The Lund-Mackay scoring system is used in rhinology for which purpose?

Accepted Answer

Quantifying degree of sinonasal opacification on CT scans

Answer

Grading severity of nasal polyps on endoscopy

Answer

Assessing olfactory function pre-operatively

Answer

Staging sinonasal malignancies

Question 6

Empty nose syndrome (ENS) most commonly results from which surgical procedure?

Accepted Answer

Aggressive inferior turbinectomy

Answer

Functional endoscopic sinus surgery (FESS)

Answer

Septoplasty

Answer

Caldwell-Luc procedure

Question 7

A nasal septal abscess requires urgent surgical drainage because the most dangerous complication if left untreated is:

Accepted Answer

Saddle-nose deformity from cartilage necrosis leading to intracranial extension

Answer

Permanent anosmia

Answer

Chronic rhinosinusitis

Answer

Epistaxis