Complications of ventilation tubes: - Dr. Nassem Talaat

C) Nasal manifestation: 1- Nasal obstruction: usually unilateral.
2-MP discharge.
3-Mild epistaxis.
4-Nasal tone of voice.
On exam. Ant. rhinoscopy : may reveal a nasal mass
Post rhinoscopy or endoscopy: fungating mass, ulcerative lesion, or
submucosal swelling
D) Neurological manifestation :
1- Vidian nerve affection. 2-Cranial nerves: any can be affected.
3- Sympathetic chain. 4-Increased ICT.
NB the Diagnostic Trotters triad: Unilateral conductive deafness
Investigations:
1- CT
Unilateral facial pain
Immobile soft palate
2-Biopsy: endoscopic or direct if repeatedly negative: blind curettage
3- Tympanomtry 4- Metastatic work up
Treatment:
- Radio therapy is treatment of choice (recently chemoradiotherapy).
- Role of surgery: Biopsy.
RND, if persistent after 1ry control.
Salvage surgery of recurrent or residual disease is of limited
role due to complex anatomy.
NB: Other malignant tumors of NPX: Lymphoma, chordoma, & craniopharyngioma
Congenital anomalies of the pharynx: Cleft palate
Def: Failure of fusion of 2 halves forming the palate
Types: Depends upon: depth & length
1- Overt cleft: Bifid uvula, cleft soft palate, complete cleft (soft& hard), bipartite
cleft (complete + unilateral gum cleft), tripartite cleft (complete + bilateral gum
cleft).
2-Submucos cleft: deficient palatal muscles with intact mucosa.
Clinical picture: Nasal regurge, rhinolalia aperta