ENT Medicine and Surgery Illustrated Clinical Cases: ENT Medicine and Surgery
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SIMON LLOYD MANOHAR BANCE JAYESH DOSHI ILLUSTRATED CLINICAL CASES ENT Medicine and Surgery Illustrated Clinical Cases: ENT Medicine and Surgery ILLUSTRATED CLINICAL CASES ENT Medicine and Surgery SIMON LLOYD MBBS, BSc (Hons), MPhil, FRCS (ORL-HNS) Consultant Otologist and Skull Base Surgeon Manchester University NHS Foundation Trust; Professor of Otolaryngology, University of Manchester, UK MANOHAR BANCE MBChB, MSc, FRCSC Professor of Otology and Skull Base Surgery University of Cambridge, UK JAYESH DOSHI MBChB (Hons), MMed, PhD, FRCS (ORL-HNS) Consultant ENT Surgeon, Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust; Honorary Senior Clinical Lecturer, University of Birmingham, UK CRC Press Taylor & Francis Group 6000 Broken Sound Parkway NW, Suite 300 Boca Raton, FL 33487-2742 © 2019 by Taylor & Francis Group, LLC CRC Press is an imprint of Taylor & Francis Group, an Informa business No claim to original U.S. Government works Printed on acid-free paper International Standard Book Number-13: 978-1-4822-3041-3 (Hardback) This book contains information obtained from authentic and highly regarded sources. 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Trademark Notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. Library of Congress Cataloging-in-Publication Data Names: Lloyd, Simon (Simon Kinglsey Wickham), author. | Bance, Manohar, author. | Doshi, Jayesh, author. Title: ENT medicine and surgery : illustrated clinical cases / Simon Lloyd, Manohar Bance, Jayesh Doshi. Other titles: Illustrated clinical cases. Description: Boca Raton : CRC Press, [2016] | Series: Illustrated clinical cases Identifiers: LCCN 2016041239| ISBN 9781482230413 (pbk. : alk. paper) | ISBN 9781482230420 (eBook PDF) Subjects: | MESH: Otorhinolaryngologic Diseases | Otorhinolaryngologic Surgical Procedures | Case Reports | Examination Questions Classification: LCC RF56 | NLM WV 18.2 | DDC 617.5/1–dc23 LC record available at https://lccn.loc.gov/2016041239 Visit the Taylor & Francis Web site at http://www.taylorandfrancis.com and the CRC Press Web site at http://www.crcpress.com CONTENTS Preface ix Authors xi Contributors xiii Section 1: Head and neck Case 1 3 Case 2 7 Case 3 11 Case 4 13 Case 5 15 Case 6 17 Case 7 19 Case 8 21 Case 9 23 Case 10 25 Case 11 27 Case 12 29 Case 13 31 Case 14 33 Case 15 37 Case 16 41 Case 17 45 Case 18 47 Case 19 51 Case 20 53 Case 21 55 Case 22 57 Case 23 59 Case 24 61 Section 2: Laryngology Case 25 65 Case 26 67 Case 27 69 v Case 28 73 Case 29 75 Case 30 77 Case 31 79 Section 3: Otology and skull base Case 32 83 Case 33 87 Case 34 89 Case 35 91 Case 36 93 Case 37 95 Case 38 99 Case 39 103 Case 40 105 Case 41 109 Case 42 111 Case 43 115 Case 44 117 Case 45 121 Case 46 123 Case 47 127 Case 48 131 Case 49 137 Section 4: Rhinology and facial plastics Case 50 143 Case 51 145 Case 52 147 Case 53 149 Case 54 151 Case 55 155 Case 56 159 Case 57 161 Case 58 163 Case 59 165 Case 60 169 vi Case 61 173 Case 62 175 Case 63 179 Case 64 181 Case 65 183 Case 66 185 Case 67 189 Case 68 191 Case 69 193 Case 70 195 Case 71 199 Case 72 201 Case 73 203 Case 74 205 Case 75 207 Case 76 209 Case 77 211 Section 5: Paediatrics Case 78 215 Case 79 217 Case 80 219 Case 81 221 Case 82 223 Case 83 225 Case 84 227 Case 85 231 Case 86 233 Case 87 235 Case 88 239 Case 89 241 Case 90 245 Case 91 247 Case 92 249 Case 93 251 Case 94 253 Case 95 255 Case 96 257 Case 97 259 vii Section 6: Miscellaneous Case 98 265 Case 99 267 Case 100 269 Case 101 271 Case 102 275 Index 279 viii PREFACE The ability to make an accurate diagnosis is the most important skill a clinician can possess. The key attributes in developing this skill are experience, knowledge and condence. These are only acquired over time but the process can be facilitated through shared experiences. This book is made up of a series of case studies covering all aspects otolaryngology from basic issues in otolaryngology to more challenging clinical cases. The aim of the book is to build a clinically relevant knowledge base for the reader through discussion of the clinical principles that each case elucidates. It is aimed at practicing otolaryngologists, trainees and general practitioners who wish to develop their diagnostic skills in otolaryngology for the benet of their patients. It also provides a useful aid for those undertaking post-graduate exams and facilitates continuing professional development. We hope that this book will highlight important points in otolaryngology and provide an enjoyable means for clinicians to enhance their diagnostic skills in otolaryngology. ix AUTHORS Simon Lloyd, MBBS, BSc (Hons), MPhil, FRCS (ORL-HNS), is a professor of otol- ogy and skull base surgery at University of Manchester and consultant otolaryngologist at Manchester NHS Foundation Trust and Salford Royal NHS Foundation Trust in Manchester, United Kingdom. Manohar Bance, MBChB, MSc, FRCSC, is a professor of otology and skull base surgery at University of Cambridge, United Kingdom. Jayesh Doshi, MBChB (Hons), MMed, PhD, FRCS (ORL-HNS), is a consultant ENT surgeon at the Heart of England Foundation Trust, Birmingham, United Kingdom, and honor- ary senior clinical lecturer at University of Birmingham, United Kingdom. xi CONTRIBUTORS The authors wish to thank the following for Kay Seymour, MA (Cantab), MB, their invaluable contributions to the case stud- BChir, FRCS (ORL-HNS) ies in this book: Barts Health, Royal London Hospital London, United Kingdom Osama Al Hamarneh, MBBS, MD, FRCS (ORL-HNS) We would also like to thank the following Jordan Teaching Hospital and Medical Center people who helped to illustrate the cases: Amman, Jordan Shahzada Ahmed, BSc (Hons), DLO, Thomas Beech, MBChB, MSc, FRCS FRCS (ORL-HNS), PhD (ORL-HNS) University Hospitals Birmingham NHS Trust University Hospital Birmingham Birmingham, United Kingdom Birmingham, United Kingdom Shahram Anari, MD, MSc, FRCS Rebecca Field, MBChB, FRACS (ORL-HNS) (ORL-HNS) Birmingham Heartlands Hospital Christchurch Hospital Birmingham, United Kingdom Christchurch, New Zealand Steve Colley, MBChB, FRCR Edward Flook, FRCS Ed (ORL-NHS) Queen Elizabeth Hospital Birmingham Glan Clwyd Hospital Birmingham, United Kingdom North Wales, United Kingdom Ann Louise McDermott, FDSRCS, Amanda McSorley, MBChB (Hons), BSc FRCS (ORL-HNS), PhD (Hons), MRCS, DOHNS Birmingham Children’s Hospital North West Deanery Birmingham, United Kingdom Manchester, United Kingdom Nicola Pargeter, BSc, MSc, RCSLT, Reg Abhijit Ricky Pal, MB, BChir, MA HCPC (Cantab), MD, FRCS (ORL-HNS) Birmingham Heartlands Hospital Oxford University Hospitals NHS Birmingham, United Kingdom Foundation Trust Oxford, United Kingdom Christopher Thomson, FRACS Christchurch Hospital Glen J. Watson, FRCS (ORL-HNS), Christchurch, New Zealand DOHNS, MBBCh Royal Hallamshire Hospital Tim J. Woolford, MD, FRCS Sheeld, United Kingdom (ORL-HNS) Manchester Royal Inrmary Susannah Penney, MBChB, DOHNS, Manchester, United Kingdom FRCS (ORL-HNS) Manchester Royal Inrmary Manchester, United Kingdom xiii Section 1 HEAD AND NECK CASE 1 QUESTIONS 1 A 39-year-old male presents with a 2-month history of right throat pain.