20 High-Yield ENT Flashcards for NEET PG 2025

Flashcard 1

External Ear

• Incisura terminalis is the site of incision in an endaural surgery.
• This incision is known as a Lempert endaural incision.

Flashcard 2

Middle Ear Cleft

• Function: Ventilation of the middle ear
• Components:
  • Eustachian tube (anterior): Connects the middle ear and the nasopharynx.
  • Middle ear proper
  • Attic
  • Aditus (communication between the attic and the Antrum)
  • Mastoid air cells (posterior)
• Ventilatory pathway of the middle ear/ Middle ear cleft:
  • On inhalation, the air reaches the nose → nasopharynx → eustachian tube → middle ear proper → Attic → Aditus → Antrum → Rest of the mastoid air cells.

Flashcard 3

• Parts included in the bony labyrinth:
  • SCC
  • Elliptical and spherical recess
  • Scala vestibuli and tympani.
• Cochlear duct connected to saccule via Ductus reuniens /cannalis reuniens
• Saccular and utricular ducts combine to form endolymphatic ducts leading to endolymphatic sac
• Vestibular aqueduct: Bony covering around the endolymphatic duct

Auditory Pathway 

Sound from cochlea → to 8th nerve → to brain. This entire pathway is called the Auditory pathway.

Flashcard 4

Order of Auditory Pathway

Mnemonic: ECOLI MA

• E- Eight nerve (8th)
• C- Cochlear Nucleus
• O- Superior olivary complex
• L- Lateral lemniscus
• I- Inferior colliculus
• M- Medial geniculate body
• A- Auditory cortex

Flashcard 5

Rinne Test

• In a normal ear
  • AC > BC → RINNE positive
    • > represents AC is Longer than BC.
    • > represents AC is louder than BC.
• In conductive hearing loss
  • AC < BC → RINNE negative
    • Because the conductive pathway in AC gets affected.
• In SNHL
  • AC > BC → RINNE positive
    • Because the Sensory neural pathway in both AC and BC gets affected.
    • But BC gets affected more than AC.
• False negative Rinne
  • i.e., AC < BC → RINNE negative
  • Seen in U/L severe to profound SNHL.

Flashcard 6

Pure Tone Audiometry 

• Pure tones are produced from the audiometer, with which AC and BC both are tested.
• The intensity of the pure tone is increased or decreased in 5db.
• The chart graph is called an audiogram.
• This confirms the type of hearing loss (Conductive / Sensorineural / Mixed)
• The degree of hearing loss can also be measured accurately.
• The patient is made to sit in a soundproof room.

Flashcard 7

Fistula Test

• A positive fistula test means communication between the middle and inner ear is present.
• A negative fistula test means no communication between the middle ear and the internal ear.
• False positive fistula (Hennebert's test) is seen in case of congenital syphilis.
• A false negative fistula test is seen in patients with a dead labyrinth.

Flashcard 8

Malignant Otitis Externa 

• Seen in patients with uncontrolled diabetes, immunosuppressed
• Caused by: Pseudomonas infection
• Symptoms: Excruciating pain increases on chewing/ jaw movements
• Pseudomonas infection involves the bones: Base of the skull along with facial nerve is involved
• Later, lower cranial nerves (9th,10th,11th) are also involved
• Symptoms due to cranial nerve involvement is also seen
• Locally invasive, aggressive infection

Flashcard 9

Keratosis obturans 

• Ciliary motility disorder in the external auditory canal
• Normally cilia will vibrate pushing all the dead epithelium towards the external auditory canal, in ciliary motility disorder, epithelium gets trapped layer by layer forming a plug of dead desquamated mass- onion skin lamellar arrangement
• Overlying bone gets widened and ballooning of overlying bone is seen
• Rarely, 7th nerve palsy can also occur
• Treatment: Remove the mass after giving keratolytics to soften the mass

Flashcard 10

1. The fungus causing otomycosis most commonly is Aspergillus niger
2. Myringitis bullosa is caused by viral infection/ Haemophilus influenzae. It is a condition where bullous vesicles are seen on the tympanic membrane
3. Malignant otitis externa is caused by Pseudomonas
4. Malignant otitis externa is characterized by excruciating pain which increases on chewing and jaw movement
5. The hallmark of malignant otitis externa includes granulation tissue in the bony cartilaginous junction
6. A patient presenting with painful ear discharge, edema of external auditory canal and facial palsy not responding to antibiotics most likely has malignant otitis externa
7. The drug of choice for rapidly spreading infection of the EAC with bone involvement and granulation tissue is Anti pseudomonas antibiotics:
   1. Piperacillin
   2. Tazobactam
8. Facial nerve palsy is seen in malignant otitis externa/ Ramsay hunt syndrome/ Keratosis obturans
9. Keratosis obturans is characterized by onion ring appearance
10. Chalky white tympanic membrane is seen in tympanosclerosis

Flashcard 11

Flashcard 12

Complications of ASOM and CSOM

Extracranial	Intracranial
Mastoiditis	Meningitis
Labyrinthitis	Extradural abscess
Facial nerve palsy	Subdural abscess
Petrositis	Brain abscess
Osteomyelitis	Lateral sinus thrombophlebitis
Septicemia	Otitic hydrocephalus

Flashcard 13

Lateral Sinus Thrombophlebitis 

• Infection spreads from middle ear to mastoid sinus
• Posterior border of mastoid has sigmoid sinus
• Infection results in thrombosis of sigmoid sinus
• Leads to intermittent emboli in the bloodstream: Hectic picket fence type of fever with rigor- fever doesn't touch the baseline
• Mastoid emissary veins can also not drain into the sigmoid sinus- edema and bluish discolouration of the mastoid: Griesinger sign
• Cranial circulation cannot drain into the sigmoid sinus- raised ICP- manifests as papilledema- dilatation of optic disc
• Tobey-Ayer's test: Compression of IJV on the healthy side produces a rise in CSF pressure.
• Crowe-Beck test: Pressure of the IJV on the healthy side produces engorgement of the retinal veins.

Flashcard 14

Stapedial Otosclerosis: Tests

Flashcard 15

Glomus tumors

• Benign tumor of the middle ear
• Glomus tumor originates from paraganglionic cells
  • Cells of sympathetic nervous system which secrete catecholamines- epinephrine, norepinephrine, dopamine
  • Usually present across major blood vessels like internal carotid artery, internal jugular vein
  • In the middle ear, floor is related to the internal jugular vein and on the promontory (formed by the basal turn of ganglia), a plexus is formed- tympanic plexus- formed by glossopharyngeal nerve and sympathetic plexus of carotid
  • From these sympathetic plexus and the sympathetic plexus covering the internal jugular vein the tumor arises
  • Glomus juglare: Arising from the sympathetic plexus covering the internal jugular vein
  • Glomus tympanicum: Arising from the tympanic plexus

Flashcard 16

1. First branch of facial nerve is GSPN
2. Nerve involved in hyperacusis is nerve to stapedius
3. Lacrimation is affected when facial nerve is injured above the level of 1st genu
4. Taste is affected when mastoid segment of facial nerve is involved
5. Most common cause of facial nerve palsy: idiopathic> traumatic
6. Iatrogenic facial nerve palsy occurs during mastoidectomy
7. Which segment of facial nerve is affected first in ischemia and edema labyrinthine segment
8. Which segment of facial nerve is affected in iatrogenic trauma vertical/mastoid segment
9. Which fracture of petrous bone is responsible for facial injury transverse fracture
10. Crocodile tears occur due to faulty innervation with chorda tympani nerve

Flashcard 17

• External nose has 2 no. of paired bones and 1 no. of unpaired bones
• External nose has3 no. of paired cartilages and 1 no. of unpaired cartilages
• Other name of pseudostratified columnar epithelium of nose is Schneiderian membrane
• Nasion is Frontal bone with nasal bone in midline
• Rhinion is Nasal bone with upper lateral cartilage in midline
• Limen Nasi is Lower border of upper lateral cartilage
• Turbinate which is not a part of ethmoid bone is Inferior Turbinate
• Sinus draining into hiatus semilunaris is Frontal sinus and Anterior ethmoidal sinus
• Sinus draining into infundibulum is Maxillary sinus
• Sinus draining in superior meatus is Posterior ethmoid sinus
• Sphenoid sinus drains into the sphenoethmoidal recess
• Sinus absent at birth is Frontal sinus
• Sinus whose development coincides with development of secondary dentition is Maxillary sinus
• Earliest sinus to develop and be visible radiologically is Maxillary sinus
• Largest sinus is Maxillary sinus
• Last sinus to develop is Frontal sinus
• Most common sinusitis in children is Ethmoidal sinusitis
• Most common sinusitis in adults is Maxillary sinusitis

Flashcard 18

Antrochoanal polyp

• Polyp that originates from the maxillary antrum and extends posteriorly from the choana
  • Single/ unilateral- Occurs due to infection in the maxillary sinus.
  • Greyish white mass
  • Grows into nasal cavity reaching nasopharynx
  • Seen in young age group
  • Male predominant
  • Organism responsible for infection: Streptococcus pneumoniae

Flashcard 19

Sinusitis and its Complications 

• Inflammation of sinus mucosa
• Can be acute (< 4 weeks) or chronic (>12 weeks)
• Between 4 - 12 weeks- subacute form of sinusitis

One liners

• Most common sinus affected in an adult: Maxillary sinus
• Most common sinus affected in children: Ethmoidal sinus (as it is most developed in children)
• Least common sinus affected: Sphenoid sinus (as it is the posterior most sinus)

Flashcard 20

Pott's Puffy Tumor

• Infection of the frontal sinus can spread to the overlying bone, causing a subperiosteal abscess
• Osteomyelitis of the frontal bone, known as Pott's puffy tumor

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