European Manual of Otorhinolaryngology, Head And Neck Surgery (European Manual of Medicine)

Otology and Neurotology Edited by Salvatore Iurato and Wolfgang Arnold 1.1 Basics 1.1.1 Clinical Anatomy 1.1.1.1 External Ear 1.1.1.2 Middle Ear and Mastoid 1.1.1.3 Inner Ear References Suggested Reading 1.1.2 Physiology 1.1.2.1 Auricle and External Auditory Canal 1.1.2.2 Tympanic Membrane and Ossicular Chain 1.1.2.3 Oval and Round Windows 1.1.2.4 Basilar Membrane and Travelling Waves 1.1.2.5 Inner and Outer Hair Cells 1.1.2.6 Semicircular Canals, Utricle and Saccule Suggested Reading 1.1.3 Ear-related Questions 1.1.3.1 Hearing Loss 1.1.3.2 Earache (Otalgia, Ear Pain) 1.1.3.3 Otorrhoea (Aural Discharge) 1.1.3.4 Tinnitus (Head Noise) 1.1.3.5 Dizziness/Vertigo References 1.1.4 Principles of Clinical Examination 1.1.4.1 Inspection and Palpation 1.1.4.2 Fistula Test 1.1.4.3 Tube Inflation 1.1.4.4 Patulous Eustachian Tube 1.1.5 Technical Diagnostic Procedures 1.1.5.1 Subjective Tests 1.1.5.2 Objective Tests References Suggested Reading 1.1.6 Imaging of the Temporal Bone 1.1.6.1 Conventional Radiography 1.1.6.2 Computed Tomography 1.1.6.3 Magnetic Resonance Imaging Suggested Reading 1.2 Malformations of the Ear 1.2.1 Synonyms 1.2.2 Definition 1.2.3 Epidemiology 1.2.4 Symptoms 1.2.5 Complications 1.2.6 Diagnostic Procedures 1.2.7 Therapeutic Management 1.2.7.1 Malformations of the Outer and Middle Ear 1.2.7.2 Management of Hearing Impairment 1.2.7.3 Management of Aesthetic Deficits 1.2.7.4 Malformations of the Inner Ear 1.2.8 Surgical Principles 1.2.8.1 Cochlear Implantation 1.2.8.2 Bone-Anchored Hearing Aid (Tjёllström Technique) 1.2.8.3 Functional Surgery for Ear Atresia (Jahrsdoerfer Technique) 1.2.8.4 Bone-anchored Epithesis 1.2.8.5 Implantation of Active Middle Ear Prosthesis 1.2.8.6 Reconstructive Surgery of the Auricle (Nagata Technique) Suggested Reading 1.3 Diseases of the Auricle and of the External Auditory Canal 1.3.1 Trauma/Otohaematoma 1.3.1.1 Sharp Trauma, Lacerations and Bite Wounds 1.3.1.2 Blunt Trauma and Auricular Haematoma 1.3.1.3 Frostbite 1.3.1.4 Burning 1.3.2 Infections of the Auricle and of the External Auditory Canal 1.3.2.1 Infections of the Auricle 1.3.2.2 External Otitis 1.3.2.3 Malignant External Otitis Suggested Reading 1.3.3 Obstructions of the External Auditory Canal 1.3.3.1 Impacted Ear Wax (Cerumen) 1.3.3.2 Foreign Bodies 1.3.3.3 Exostoses 1.3.3.4 Osteomas 1.3.3.5 External Fibrous Otitis 1.3.3.6 Keratosis Obturans 1.3.3.7 Postoperative Cholesteatoma of the External Auditory Canal 1.3.3.8 Collapsing Canal Suggested Reading 1.3.4 Tumours of the Auricle and of the External Auditory Canal 1.3.4.1 Tumours of the Auricle 1.3.4.2 Tumours of the External Auditory Canal 1.4 Middle Ear 1.4.1 Traumatic Perforations of the Tympanic Membrane 1.4.1.1 Definition 1.4.1.2 Aetiology 1.4.1.3 Symptoms 1.4.1.4 Diagnostic Procedures 1.4.1.5 Treatment 1.4.1.6 Prognosis 1.4.2 Myringitis 1.4.2.1 Definition 1.4.2.2 Diagnostic Procedures 1.4.2.3 Therapy 1.4.3 Acute Otitis Media 1.4.3.1 Synonyms 1.4.3.2 Definition 1.4.3.3 Aetiology/Epidemiology 1.4.3.4 Symptoms 1.4.3.5 Complications 1.4.3.6 Diagnostic Procedures 1.4.3.7 Additional/Useful Diagnostic Procedures 1.4.3.8 Therapy 1.4.3.9 Differential Diagnosis 1.4.3.10 Surgical Principles 1.4.3.11 Prognosis 1.4.3.12 Special Remarks Suggested Reading 1.4.4 Otitis Media with Effusion 1.4.4.1 Synonyms 1.4.4.2 Definition 1.4.4.3 Aetiology/Epidemiology 1.4.4.4 Pathophysiology 1.4.4.5 Symptoms 1.4.4.6 Complications 1.4.4.7 Diagnostic Procedures 1.4.4.8 Therapy 1.4.4.9 Differential Diagnosis 1.4.4.10 Prognosis Suggested Reading 1.4.5 Acute Mastoiditis 1.4.5.1 Synonym 1.4.5.2 Definition 1.4.5.3 Aetiology/Epidemiology 1.4.5.4 Types/Symptoms 1.4.5.5 Complications 1.4.5.6 Diagnostic Procedures 1.4.5.7 Therapy 1.4.5.8 Differential Diagnosis 1.4.5.9 Prognosis 1.4.5.10 Surgical Principles Suggested Reading 1.4.6 Chronic Otitis Media (Without Cholesteatoma) 1.4.6.1 Definition 1.4.6.2 Aetiology/Epidemiology 1.4.6.3 Symptoms 1.4.6.4 Complications 1.4.6.5 Diagnostic Procedures 1.4.6.6 Additional/Useful Diagnostic Procedures 1.4.6.7 Therapy 1.4.6.8 Surgery 1.4.6.9 Differential Diagnosis Suggested Reading 1.4.7 Cholesteatoma of the Middle Ear 1.4.7.1 Synonyms 1.4.7.2 Definition 1.4.7.3 Aetiology/Epidemiology 1.4.7.4 Symptoms 1.4.7.5 Complications 1.4.7.6 Diagnostic Procedures 1.4.7.7 Special Forms 1.4.7.8 Differential Diagnosis 1.4.7.9 Therapy 1.4.7.10 Prognosis References Suggested Reading 1.4.8 Intratemporal and Intracranial Complications of Otitis Media 1.4.8.1 Definition 1.4.8.2 Aetiology/Epidemiology 1.4.8.3 Pathways 1.4.8.4 Complications 1.4.8.5 Symptoms 1.4.8.6 Diagnosis of Established Specific Complications 1.4.8.7 Treatment of Specific Complications References Suggested Reading 1.5 Middle Ear/Inner Ear 1.5.1 Barotrauma 1.5.1.1 Synonyms 1.5.1.2 Definition 1.5.1.3 Symptoms 1.5.1.4 Complications 1.5.1.5 Diagnostic Procedures 1.5.1.6 Therapy 1.5.1.7 Differential Diagnosis 1.5.1.8 Prognosis 1.5.1.9 Suggestions 1.5.2 Otosclerosis 1.5.2.1 Synonym 1.5.2.2 Definition 1.5.2.3 Aetiology/Epidemiology 1.5.2.4 Incidence 1.5.2.5 Symptoms 1.5.2.6 Complications 1.5.2.7 Diagnostic Procedures 1.5.2.8 Additional/Useful Diagnostic Procedures 1.5.2.9 Therapy 1.5.2.10 Differential Diagnosis 1.5.2.11 Surgical Principles 1.5.2.12 Prognosis Suggested Reading 1.5.3 Traumatisms of the Temporal Bone 1.5.3.1 Definition 1.5.3.2 Aetiology/Epidemiology 1.5.3.3 Symptoms 1.5.3.4 Complications 1.5.3.5 Diagnostic Procedures 1.5.3.6 Additional/Useful Diagnostic Procedures 1.5.3.7 Therapy 1.5.3.8 Differential Diagnosis 1.5.3.9 Prognosis 1.5.3.10 Surgical Principles Suggested Reading 1.5.4 Tumours 1.5.4.1 Squamous Cell Carcinoma of the Temporal Bone Suggested Reading 1.5.4.2 Vestibular Schwannoma References Suggested Reading 1.5.4.3 Paragangliomas of the Temporal Bone Suggested Reading 1.5.5 Petrous Bone Cholesteatoma 1.5.5.1 Synonyms 1.5.5.2 Definition 1.5.5.3 Aetiology/Epidemiology 1.5.5.4 Types (Sanna’s Classification) 1.5.5.5 Symptoms 1.5.5.6 Complications 1.5.5.7 Diagnostic Procedures 1.5.5.8 Surgical Treatment 1.5.5.9 Differential Diagnosis 1.5.5.10 Prognosis Suggested Reading 1.5.6 Petrous Apex Cholesterol Granuloma 1.5.6.1 Synonym 1.5.6.2 Definition 1.5.6.3 Aetiology/Epidemiology 1.5.6.4 Symptoms 1.5.6.5 Diagnosis 1.5.6.6 Therapy 1.5.6.7 Differential Diagnosis 1.5.6.8 Prognosis Suggested Reading 1.6 Inner Ear 1.6.1 Zoster Oticus 1.6.1.1 Synonyms 1.6.1.2 Definition 1.6.1.3 Aetiology/Epidemiology 1.6.1.4 Symptoms 1.6.1.5 Complications 1.6.1.6 Diagnostic Procedures 1.6.1.7 Therapy 1.6.1.8 Differential Diagnosis 1.6.1.9 Prognosis Suggested Reading 1.6.2 Labyrinthitis 1.6.2.1 Synonym 1.6.2.2 Definition 1.6.2.3 Viral Labyrinthitis 1.6.2.4 Bacterial or Purulent Labyrinthitis 1.6.2.5 Haematogenic Labyrinthitis 1.6.2.6 Diagnostic Procedures 1.6.2.7 Therapy 1.6.2.8 Prognosis Suggested Reading 1.6.3 Contusio Labyrinthi 1.6.3.1 Synonym 1.6.3.2 Definition 1.6.3.3 Symptoms 1.6.3.4 Complications 1.6.3.5 Diagnostic Procedures 1.6.3.6 Therapy 1.6.3.7 Prognosis References Suggested Reading 1.6.4 Otoliquorrhoea/Otorhinoliquorrhoea 1.6.4.1 Definition 1.6.4.2 Aetiology/Epidemiology 1.6.4.3 Symptoms 1.6.4.4 Complications 1.6.4.5 Diagnostic Procedures 1.6.4.6 Therapy 1.6.4.7 Differential Diagnosis Suggested Reading 1.6.5 Sudden Sensorineural Hearing Loss (Including Perilymphatic Fistula) 1.6.5.1 Synonyms 1.6.5.2 Definition 1.6.5.3 Epidemiology 1.6.5.4 Aetiology/Classification 1.6.5.5 Symptoms 1.6.5.6 Complications 1.6.5.7 Diagnosis 1.6.5.8 Therapy 1.6.5.9 Differential Diagnosis 1.6.5.10 Prognosis Suggested Reading 1.6.6 Ménière’s Disease 1.6.6.1 Synonyms 1.6.6.2 Definition 1.6.6.3 Aetiology/Epidemiology 1.6.6.4 Symptoms 1.6.6.5 Diagnostic Procedures 1.6.6.6 Additional/Useful Diagnostic Procedures 1.6.6.7 Differential Diagnosis 1.6.6.8 Therapy References Suggested Reading 1.6.7 Autoimmune Inner Ear Disease 1.6.7.1 Synonyms 1.6.7.2 Aetiology/Epidemiology 1.6.7.3 Symptoms 1.6.7.4 Diagnostic Procedure 1.6.7.5 Differential Diagnosis 1.6.7.6 Therapy 1.6.7.7 Prognosis Suggested Reading 1.6.8 Tinnitus 1.6.8.1 Synonym 1.6.8.2 Definition/Symptoms 1.6.8.3 Epidemiology 1.6.8.4 Aetiology 1.6.8.5 Diagnostic Procedures 1.6.8.6 Therapy 1.6.8.7 Prognosis Suggested Reading 1.6.9 Noise-induced Hearing Loss 1.6.9.1 Explosions 1.6.9.2 Impulsive Noise Trauma 1.6.9.3 Acute Acoustic Trauma 1.6.9.4 Occupational Hearing Loss Suggested Reading 1.6.10 Ototoxicity 1.6.10.1 Definition 1.6.10.2 Aetiology/Epidemiology 1.6.10.3 Symptoms 1.6.10.4 Audiometric Monitoring of Risk Patients on Ototoxic Drug Therapy 1.6.10.5 Prevention 1.6.10.6 Rehabilitation 1.6.10.7 Potential Ototoxicity of Topical Otic Preparations Suggested Reading 1.6.11 Presbyacusis 1.6.11.1 Synonym 1.6.11.2 Definition 1.6.11.3 Aetiopathology 1.6.11.4 Aetiology/Epidemiology 1.6.11.5 Symptoms 1.6.11.6 Complications 1.6.11.7 Diagnostic Procedures 1.6.11.8 Additional/Useful Diagnostic Procedures 1.6.11.9 Therapy 1.6.11.10 Differential Diagnosis 1.6.11.11 Prognosis 1.6.11.12 Special Remarks Suggested Reading 1.6.12 Hearing Impairment in Childhood 1.6.12.1 Synonym 1.6.12.2 Definition 1.6.12.3 Aetiology/Epidemiology 1.6.12.4 Symptoms 1.6.12.5 Complications 1.6.12.6 Diagnostic Procedures 1.6.12.7 Therapy 1.6.12.8 Differential Diagnosis 1.6.12.9 Prognosis 1.6.12.10 Surgical Procedure: Cochlear Implantation Suggested Reading 1.6.13 Hearing Aids 1.6.13.1 Definition and Components 1.6.13.2 Classification 1.6.13.3 Recommendations Suggested Reading 1.6.14 Vestibular Neuritis 1.6.14.1 Synonyms 1.6.14.2 Definition 1.6.14.3 Aetiology/Epidemiology 1.6.14.4 Symptoms 1.6.14.5 Complications 1.6.14.6 Diagnostic Procedures 1.6.14.7 Additional Useful Diagnostic Procedures 1.6.14.8 Therapy 1.6.14.9 Differential Diagnosis 1.6.14.10 Prognosis Suggested Reading 1.6.15 Benign Paroxysmal Positioning Vertigo 1.6.15.1 Synonym 1.6.15.2 Definition 1.6.15.3 Aetiology/Epidemiology 1.6.15.4 Symptoms 1.6.15.5 Complications 1.6.15.6 Diagnostic Procedures 1.6.15.7 Additional Useful Diagnostic Procedures 1.6.15.8 Therapy 1.6.15.9 Differential Diagnosis 1.6.15.10 Prognosis References Suggested Reading 1.6.16 Motion Sickness 1.6.16.1 Synonyms 1.6.16.2 Definition 1.6.16.3 Aetiology/Epidemiology 1.6.16.4 Symptoms 1.6.16.5 Complications 1.6.16.6 Diagnosis 1.6.16.7 Therapy 1.6.16.8 Differential Diagnosis 1.6.16.9 Prognosis Suggested Reading 1.7 Facial Nerve 1.7.1 Idiopathic Facial Palsy 1.7.1.1 Synonyms 1.7.1.2 Definition 1.7.1.3 Aetiology/Epidemiology 1.7.1.4 Symptoms 1.7.1.5 Complications 1.7.1.6 Diagnostic Evaluation 1.7.1.7 Therapy 1.7.1.8 Differential Diagnosis 1.7.1.9 Prognosis Suggested Reading 1.7.2 Traumatic Facial Palsy 1.7.2.1 Definition 1.7.2.2 Aetiology/Epidemiology 1.7.2.3 Symptoms 1.7.2.4 Complications 1.7.2.5 Diagnostic Procedures 1.7.2.6 Additional/Useful Diagnostic Procedures 1.7.2.7 Therapy 1.7.2.8 Differential Diagnosis 1.7.2.9 Prognosis 1.7.2.10 Surgical Principles: Double Approach to the Intratemporal Facial Nerve Suggested Reading 1.7.3 Facial Nerve Schwannoma 1.7.3.1 Synonyms 1.7.3.2 Definition 1.7.3.3 Aetiology/Epidemiology 1.7.3.4 Symptoms 1.7.3.5 Complications 1.7.3.6 Diagnosis 1.7.3.7 Therapy 1.7.3.8 Differential Diagnosis 1.7.3.9 Prognosis Suggested Reading Diseases of the Nose and Paranasal Sinuses Edited by Manuel Bernal-Sprekelsen 2.1 Anatomy of the Nasal Cavity and Paranasal Sinuses 2.1.1 Introduction 2.1.2 Ethmoid Bone 2.1.3 Frontal Bone 2.1.4 Maxilla 2.1.5 Palatine Bone 2.1.6 Inferior Turbinate 2.1.7 Lacrimal Bone 2.1.8 Sphenoid Bone 2.1.9 Vomer 2.1.10 Conclusion References 2.2 Physiology of the Nose 2.2.1 Airflow Dynamics 2.2.2 Air Conditioning 2.2.3 Olfaction Suggested Reading 2.3 Examination of the Nasal Cavity and Paranasal Sinuses 2.3.1 Examination of the Nasal Cavity 2.3.1.1 Anterior Rhinoscopy 2.3.1.2 Posterior Rhinoscopy 2.3.1.3 Nasal Endoscopy 2.3.1.4 Nasopharyngoscopy 2.3.2 Examination of the Paranasal Sinuses 2.3.2.1 Transmeatal Puncture 2.4 Functional Investigations of the Nose 2.4.1 Introduction 2.4.2 Rhinomanometry 2.4.3 Acoustic Rhinometry 2.4.4 Exploration of Mucociliary Function 2.4.5 Cellular Exploration: Nasal Cytology 2.4.6 Olfactory Exploration 2.4.7 Conclusion Suggested Reading 2.5 Imaging of the Nasal Cavity and Paranasal Sinuses: Anatomy and Anatomic Variations 2.5.1 Anatomy 2.5.1.1 Frontal Cells 2.5.2 Anatomic Variations and Congenital Abnormalities 2.5.2.1 Variations of the Middle Turbinate 2.5.2.2 Uncinate Process Variations 2.5.2.3 Infraorbital Ethmoid Cells (Haller’s Cells) 2.5.2.4 Onodi Cells 2.5.2.5 Ethmoid Bulla Variations 2.5.2.6 Medial Deviation or Dehiscence of the Lamina Papyracea 2.5.2.7 Aerated Crista Galli 2.5.2.8 Cephalocele 2.5.2.9 Posterior Nasal Septal Air Cell References 2.6 Diseases of the Outer and Inner Nose 2.6.1 Erysipela 2.6.2 Furuncle/Carbuncle 2.6.3 Atrophic Rhinitis 2.6.4 Midline Granuloma 2.6.5 Wegener’s Granulomatosis 2.6.6 Nasal Fractures 2.6.7 Deviated Nasal Septum 2.6.8 Septal Haematoma 2.6.9 Nasal Deformity Suggested Reading 2.7 Epistaxis 2.7.1 Nose: Pertinent Vascular Anatomy 2.7.2 Epistaxis 2.7.2.1 Aetiology/Epidemiology 2.7.2.2 Symptoms 2.7.2.3 Complications 2.7.2.4 Diagnostic Procedures 2.7.2.5 Therapy 2.7.2.6 Differential Diagnosis 2.7.2.7 Prognosis 2.7.2.8 Surgical Principles 2.7.3 Special Remarks 2.7.3.1 Surface Anaesthesia of the Nasal Mucosa Suggested Reading 2.8 Congenital Malformation: Choanal Atresia 2.8.1 Rhinopharynx 2.8.1.1 Basics 2.8.1.2 Choanal Atresia 2.8.1.3 Special Remarks 2.9 Nasal Obstruction 2.9.1 Introduction 2.9.2 Aetiology/Epidemiology 2.9.3 Diagnostic Procedures 2.9.3.1 Recommended European Standard 2.9.3.2 Additional/Useful Diagnostic Procedures 2.9.3.3 Therapy 2.10 Nonallergic Rhinitis and Primary Ciliary Dyskinesia 2.10.1 Introduction 2.10.2 Diagnosis 2.10.3 Epidemiology 2.10.4 Occupational Rhinitis 2.10.5 Drug-induced Rhinitis 2.10.6 Rhinitis and Pregnancy 2.10.7 Rhinitis Associated with Physical and Chemical Factors 2.10.8 Food-induced Rhinitis 2.10.9 Atrophic Rhinitis 2.10.10 Nonallergic Rhinitis Eosinophilic Syndrome 2.10.11 Vasomotor/Idiopathic Rhinitis 2.10.12 Other Possible Causes of Nonallergic, Noninfectious Rhinitis 2.10.12.1 Emotions 2.10.12.2 Gastroesophageal Reflux 2.10.12.3 Metabolic Conditions 2.10.13 Primary Ciliary Dyskinesia 2.10.13.1 Introduction 2.10.13.2 Diagnosis 2.10.13.3 Treatment References 2.11 Allergic Rhinitis 2.11.1 Introduction 2.11.2 Definition and Classification 2.11.3 Aetiology and Triggers 2.11.3.1 Allergens 2.11.3.2 Pollutants 2.11.3.3 Aspirin and Non-Steroidal Anti-Inflammatory Drugs 2.11.4 Mechanisms of Action 2.11.5 Comorbidities 2.11.5.1 Asthma 2.11.5.2 Other Comorbidities 2.11.6 Diagnosis 2.11.6.1 Clinical History 2.11.6.2 Nasal Examination 2.11.6.3 Diagnostic Tests 2.11.7 Management and Treatment 2.11.7.1 Allergen Avoidance 2.11.7.2 Pharmacological Treatment 2.11.7.3 Specific Immunotherapy 2.11.7.4 Selection of Medications 2.11.7.5 Treatment of Concomitant Rhinitis and Asthma 2.11.7.6 Treatment of Conjunctivitis 2.11.8 Special Considerations 2.11.8.1 Pregnancy 2.11.8.2 Paediatric Aspects 2.11.8.3 Ageing 2.11.9 Key Recommendations [4] References 2.12 Acute Sinusitis 2.12.1 Introduction 2.12.2 Aetiology/Epidemiology 2.12.3 Symptoms 2.12.4 Diagnostic Procedures 2.12.4.1 Recommended European Standard 2.12.4.2 Additional/Useful Diagnostic Procedures 2.12.5 Differential Diagnosis 2.12.6 Microbiology 2.12.7 Complications 2.12.8 Therapy 2.12.8.1 Medical Treatment 2.12.8.2 Surgical Treatment 2.12.9 Prognosis 2.12.10 Special Remarks References 2.13 Chronic Rhinosinusitis: Definition, Diagnostics and Physiopathology 2.13.1 Introduction 2.13.2 Clinical Findings 2.13.3 Diagnosis 2.13.4 Classification 2.13.5 Physiopathology 2.13.6. Therapeutic Principles References 2.14 Nasal Polyposis 2.14.1 Introduction 2.14.2 Origin of Polyps 2.14.3 Classification Systems 2.14.4 Treatment 2.14.5 Recurrence 2.14.6 Surgery 2.14.7 Postoperative Care 2.14.8 Nasal Polyposis in Children 2.14.9 Conclusion Reading Recommendations 2.15 Specific Sinusitis 2.15.1 Specific Sinusitis (Fungal Rhinosinusitis) 2.15.1.1 Fungus balls 2.15.1.2 Allergic Fungal Rhinosinusitis 2.15.1.3 Invasive Fungal Rhinosinusitis References 2.16 Complications of Sinusitis 2.16.1 Introduction 2.16.2 Diagnostic Procedures 2.16.3 Clinical Classification 2.16.3.1 Local Complication: Osteomyelitis 2.16.3.2 Orbital Complications 2.16.3.3 Intracranial Complications 2.16.4 Treatment 2.16.4.1 Medical Treatment 2.16.4.2 Surgical Treatment References 2.17 Principles of Functional Endoscopic Sinus Surgery 2.17.1 Introduction 2.17.2 Equipment 2.17.3 Patient Preparation 2.17.4 Surgical Procedures 2.17.4.1 Uncinectomy 2.17.4.2 Maxillary Antrostomy 2.17.4.3 Anterior Ethmoidectomy 2.17.4.4 Posterior Ethmoidectomy 2.17.4.5 Sphenoidotomy 2.17.4.6 Frontal Sinus Surgery 2.17.5 Postoperative Care Suggested Reading 2.18 Endoscopic Dacryocystorhinostomy: from Diagnosis to Surgery 2.18.1 Introduction 2.18.2 Diagnosis 2.18.3 Surgery 2.18.4 Postoperative Care 2.18.5 Results 2.18.6 Discussion 2.18.7 Conclusion References 2.19 Trauma of the Paranasal Sinuses and Orbit 2.19.1 Fractures of Frontal Sinus, Midface, Nose-Orbital-Ethmoid, Zygomatic Bone and Orbital Floor 2.19.2 Frontal Sinus Trauma 2.19.3 Midface Fracture 2.19.4 Naso-Orbital-Ethmoid Fracture 2.19.5 Zygomatic-Maxillary Complex Fracture 2.19.6 Fractures of the Orbital Floor Suggested Reading 2.20 Endoscopic Repair of Anterior Skull Base Defects 2.20.1 Introduction 2.20.2 Diagnosis 2.20.3 Surgical Technique 2.20.4 Postoperative Handling 2.20.5 Results 2.20.6 Discussion 2.20.7 Conclusion References 2.21 Smell Disorders 2.21.1 Introduction 2.21.2 Defining Smell Disorders 2.21.3 Evaluation and Diagnostic Methods 2.21.3.1 History 2.21.3.2 Physical Examination 2.21.3.3 Laboratory Tests 2.21.3.4 Imaging Techniques 2.21.3.5 Olfactory Testing 2.21.3.6 Other Studies 2.21.4 Aetiology 2.21.5 Treatment References 2.22 Benign Sinonasal Neoplasms 2.22.1 Introduction 2.22.2 Fibrous Dysplasia 2.22.3 Endoscopic Pituitary Gland Surgery 2.22.4 Inverted Papillomas 2.22.5 Juvenile Nasopharyngeal Angiofibroma Reading Recommendations 2.23 Malignant Tumours of the Paranasal Sinuses and the Anterior Skull Base 2.23.1 Introduction 2.23.2 Symptoms 2.23.3 Diagnosis 2.23.4 Classification and Staging 2.23.5 Therapy 2.23.5.1 Treatment Considerations 2.23.5.2 Surgical Therapy 2.23.5.3 Radiotherapy 2.23.5.4 Chemotherapy 2.23.5.5 Outcome 2.23.5.6 Conclusion References 2.24 Headache and Facial Ache 2.24.1 Basics 2.24.2 Secondary Headaches Attributed to Sinonasal Disorders 2.24.2.1 Definitions 2.24.2.2 Aetiology/Epidemiology 2.24.2.3 Symptoms 2.24.2.4 Complications 2.24.2.5 Diagnostic Procedures 2.24.2.6 Therapy 2.24.2.7 Surgical Treatment 2.24.2.8 Differential Diagnosis 2.24.2.9 Prognosis 2.24.2.10 Surgical Principles References Diseases of the Nasopharynx Edited by Uwe Ganzer and Andreas Arnold 3.1 Basics 3.1.1 Clinical Anatomy 3.1.2 Principles of Clinical Examination 3.2 Adenoiditis 3.2.1 Synonyms 3.2.2 Definition 3.2.3 Aetiology/Epidemiology 3.2.4 Symptoms 3.2.5 Complications 3.2.6 Diagnostic Procedures 3.2.6.1 Recommended European Standard 3.2.6.2 Additional Useful Diagnostic Procedures 3.2.7 Therapy: Conservative Treatment 3.2.8 Prognosis 3.3 Adenoids 3.3.1 Synonyms 3.3.2 Definition 3.3.3 Spectrum of Causative Organisms 3.3.4 Aetiology/Epidemiology 3.3.5 Symptoms 3.3.6 Complications 3.3.7 Diagnostic Procedures 3.3.7.1 Recommended European Standard 3.3.7.2 Additional Useful Diagnostic Procedures 3.3.8 Therapy 3.3.8.1 Conservative Treatment 3.3.8.2 Surgical Treatment 3.3.9 Additional Useful Surgical Procedure 3.3.10 Differential Diagnosis 3.3.11 Prognosis 3.3.12 Principles of Surgery 3.3.13 Special Remarks 3.4 Tumours of the Nasopharynx 3.4.1 Benign Tumours 3.4.1.2 Juvenile Angiofibroma 3.4.2 Malignant Tumours 3.4.2.1 General Remarks 3.4.2.2 Nasopharyngeal Carcinoma Suggested Reading Diseases of the Salivary Glands Edited by Patrick J. Bradley 4.1 Salivary Gland Anatomy 4.1.1 Introduction 4.1.2 Parotid Glands 4.1.2.1 Embryology 4.1.2.2 Anatomy 4.1.2.3 Contents of Parotid Glands 4.1.2.4 Nerve Supply to the Parotid Glands 4.1.3 Parapharyngeal Space 4.1.3.1 Boundaries 4.1.3.2 Spaces or Compartments 4.1.4 Submandibular Glands 4.1.4.1 Embryology 4.1.4.2 Anatomy 4.1.5 Sublingual Glands 4.1.5.1 Anatomy 4.1.5.2 Blood Supply, Nerve Innervation and Lymphatic Drainage 4.1.6 Minor Salivary Glands Suggested Reading 4.2 Saliva, Salivation and Functional Testing 4.2.1 Saliva 4.2.1.1 Composition of Saliva 4.2.1.2 Functions of Saliva 4.2.1.3 Salivary Output and Abnormal Functions 4.2.2 Functional Testing of Salivary Glands 4.2.3 Management Options for Symptomatic Hyposecretion Suggested Reading 4.3 Clinical Examination and Limited Investigations of Salivary Gland Diseases 4.3.1 Clinical Presentation and Evaluation 4.3.2 Physical Examination 4.3.3 Limited Investigation 4.3.3.1 Diagnostic Imaging Suggested Reading 4.4 Trauma to the Salivary Glands and their Management 4.4.1 Definition 4.4.2 Aetiology/Epidemiology 4.4.3 Symptoms 4.4.4 Diagnostic Procedures 4.4.5 Therapy 4.4.5.1 General Aspects 4.4.5.2 Conservative Treatment 4.4.5.3 Surgical Treatment 4.4.5.4 Prognosis 4.4.5.5 Surgical Principles Additional Reading 4.5 Inflammatory and Non-Inflammatory Affections of the Salivary Glands 4.5.1 Introduction 4.5.2 Viral 4.5.2.1 Mumps 4.5.2.2 Others 4.5.3 Acute Bacterial 4.5.3.1 Clinical Course 4.5.3.2 Type of Bacteria 4.5.3.3 Cat Scratch Disease 4.5.3.4 Actinomycosis 4.5.4 Recurrent Bacterial or Chronic Parotitis 4.5.4.1 Recurrent Parotitis in Children 4.5.5 Obstructive Ductal Pathologies: Stones, Strictures, and Tumours 4.5.5.1 Anatomy of the Ductal System 4.5.5.2 Stones 4.5.5.3 Strictures 4.5.5.4 Dilatations 4.5.5.5 Tumours 4.5.5.6 Radiological Assessment of Salivary Duct Obstruction 4.5.5.7 Indications and Contraindications of Sialendoscopy 4.5.5.8 Tools for Sialendoscopy 4.5.5.9 Importance of Restricted Marsupialization 4.5.5.10 Anaesthesia 4.5.5.11 Complications 4.5.5.12 Interventional Sialendoscopy 4.5.5.13 Limitations of Sialendoscopy and Alternative Techniques 4.5.5.14 Other Treatment Options 4.5.5.15 Training for Sialendoscopy 4.5.6 Cystic Diseases 4.5.6.1 Hydatid Disease 4.5.6.2 Ranulas 4.5.6.3 HIV Pseudocysts 4.5.7 Granulomatous Diseases 4.5.7.1 Mycobacteria 4.5.7.2 Sarcoidosis Additional Reading 4.6 Sjögrens Syndrome and Sialosis 4.6.1 Other Salivary Disorders 4.6.1.1 Sjögren’s Syndrome 4.6.1.2 Sialosis Suggested Reading 4.7 Salivary Glands: Benign Tumours 4.7.1 Definition of the Disease 4.7.2 Epidemiology/Aetiology 4.7.3 Symptoms 4.7.3.1 Pleomorphic Adenoma 4.7.3.2 Submandibular Gland 4.7.3.3 Sub-lingual Gland 4.7.3.4 Minor Salivary Glands 4.7.4 Diagnosis 4.7.5 Additional/Useful Diagnostic Procedures 4.7.6 Therapy 4.7.6.1 Surgery 4.7.7 Differential Diagnosis 4.7.8 Prognosis 4.7.9 Follow-Up Additional Reading 4.8 Primary and Secondary Malignant Salivary Gland Neoplasms 4.8.1 Definition 4.8.1.1 Primary Neoplasm 4.8.1.2 Secondary Neoplasm 4.8.2 Aetiology/Epidemiology 4.8.2.1 Primary Neoplasm 4.8.2.2 Secondary Neoplasm 4.8.3 Symptoms 4.8.3.1 Parotid Glands 4.8.3.2 Submandibular Glands 4.8.3.3 Minor Salivary Glands 4.8.4 Diagnostic Procedures 4.8.5 Therapy 4.8.5.1 General Aspects 4.8.5.2 Conservative Treatment 4.8.5.3 Surgical Treatment 4.8.6 Differential Diagnosis 4.8.7 Prognosis 4.8.8 Surgical Principles 4.8.8.1 Lateral Parotidectomy 4.8.8.2 Subtotal and Total Parotidectomy 4.8.8.3 Facial Nerve Reconstruction 4.8.8.4 Submandibulectomy 4.8.8.5 Resection of Minor Salivary Gland Cancer 4.8.8.6 Neck Dissection 4.8.9 Special Remarks 4.8.9.1 Treatment of Frey’s Syndrome (Gustatory Sweating) 4.8.9.2 Treatment of Synkinesis Due to Facial Nerve Reconstruction Additional Reading 4.9 Salivary Gland Surgery: Principles 4.9.1 Indications for Surgery 4.9.2 Biopsy Procedures 4.9.3 Excisional Salivary Gland Surgery 4.9.3.1 Parotid Gland Surgery 4.9.3.2 Submandibular Gland Surgery 4.9.3.3 Surgery of the Sublingual Gland 4.9.3.4 Minor Salivary Gland Surgery 4.9.4 Complications Associated with Salivary Gland Surgery 4.9.5 Avoidance of or Minimising Complications after Salivary Gland Surgery Suggested Reading Diseases of the Oral Cavity, Oropharynx, Hypopharynx, Cervical Esophagus Edited by Viktor Bonkowsky 5.1 Oral Cavity 5.1.1 Basics 5.1.1.1 Embryology 5.1.1.2 Anatomy 5.1.1.3 Physiology 5.1.2 Clinical Tests 5.1.2.1 Inspection and Palpation 5.1.2.2 Taste Testing 5.1.2.3 Ultrasonography 5.1.2.4 Radiology 5.1.3 Congenital Disorders 5.1.3.1 Congenital Epulis 5.1.3.2 Torus Palatinus and Mandibularis 5.1.3.3 Ankyloglossia 5.1.3.4 Lingual Thyroid 5.1.3.5 Hypoplastic Mandible 5.1.4 Infectious and Inflammatory Disorders 5.1.4.1 Tongue Anomalies 5.1.4.2 Bacterial Infections 5.1.4.3 Fungal Infections 5.1.4.4 Viral Infections 5.1.5 Autoimmune Diseases 5.1.5.1 Behçet’s Syndrome 5.1.5.2 Pemphigus vulgaris 5.1.5.3 Lichen Ruber Planus 5.1.5.4 Systemic Lupus Erythematosus 5.1.5.5 Sjögren’s Syndrome 5.1.5.6 Wegener’s Granulomatosis 5.1.5.7 Lymphomatoid Granulomatosis 5.1.5.8 Necrotizing Sialometaplasia 5.1.5.9 Melkersson–Rosenthal Syndrome 5.1.6 Neoplasms of the Oral Cavity 5.1.6.1 Benign Neoplasms 5.1.6.2 Malignant Neoplasms of the Oral Cavity and the Lips 5.1.6.3 Nonsquamous Carcinomas of the Oral Cavity 5.1.6.4 Melanoma Reference Suggested Reading 5.2 Oropharynx and Hypopharynx 5.2.1 Anatomy of the Oropharynx 5.2.1.1 The Palate 5.2.1.2 The Tonsils 5.2.1.3 Tongue Base 5.2.2 Anatomy of the Hypopharynx 5.2.3 Physiology 5.2.4 Acute Bacterial Infections 5.2.4.1 Acute Streptococcal Pharyngotonsillitis 5.2.4.2 Lingual Tonsillar Infection 5.2.4.3 Lingual Cysts 5.2.4.4 Vincent’s Angina 5.2.4.5 Diphtheria 5.2.4.6 Syphilis 5.2.5 Complications of Oropharyngeal Infections 5.2.5.1 Nonsuppurative Complications 5.2.5.2 Suppurative Complications 5.2.6 Chronic Bacterial Infections 5.2.6.1 Chronic Tonsillitis 5.2.6.2 Chronic Pharyngitis 5.2.7 Acute Viral Infections of the Oropharynx 5.2.7.1 Acute Pharyngitis 5.2.7.2 Infectious Mononucleosis 5.2.7.3 Herpangina 5.2.8 Tonsillectomy 5.2.8.1 Indications 5.7.8.2 Surgical Technique 5.2.8.3 Key Points 5.2.8.4 Complications 5.2.9 Neoplasms of the Oropharynx and Hypopharynx 5.2.9.1 Epidemiology 5.2.9.2 TNM Classification 5.2.9.3 Symptoms 5.2.9.4 Diagnosis 5.2.9.5 Staging 5.2.9.6 Treatment Reference Suggested Reading 5.3 Oesophagus 5.3.1 Clinical Anatomy 5.3.2 Physiology 5.3.3 Clinical Tests 5.3.3.1 Imaging Techniques 5.3.3.2 Invasive Diagnostic Tests 5.3.4 Congenital Anomalies 5.3.4.1 Oesophageal Atresia 5.3.4.2 Dysphagia Lusoria 5.3.5 Functional Disorders 5.3.5.1 Primary Motility Disorders 5.3.5.2 Secondary Motility Disorders 5.3.6 Pharyngooesophageal Diverticula (Zenker Diverticulum) 5.3.6.1 Symptoms 5.3.6.2 Diagnosis 5.3.6.3 Therapy 5.3.7 Infectious and Inflammatory Disorders 5.3.7.1 Infectious Oesophagitis 5.3.7.2 Noninfectious Oesophagitis 5.3.8 Trauma 5.3.8.1 Caustic Ingestion 5.3.8.2 Oesophageal Perforation 5.3.9 Foreign Bodies 5.3.10 Neoplasms 5.3.10.1 Benign Neoplasms 5.3.10.2 Malignant Neoplasms References Suggested Reading 5.4 Nasopharynx 5.4.1 Evaluation of the Adenoids 5.4.2 Adenoidectomy 5.4.2.1 Indications 5.4.2.2 Surgical Principles 5.4.2.3 Complications Diseases of the Larynx Edited by Patrick J. Bradley 6.1 Anatomy and Physiology of the Larynx and Hypopharynx 6.1.1 Anatomy of the Larynx 6.1.1.1 Generalities 6.1.1.2 Embryology 6.1.1.3 Supraglottis 6.1.1.4 Glottis 6.1.1.5 Subglottis 6.1.1.6 Skeletal Framework 6.1.1.7 Laryngeal Joints 6.1.1.8 Soft Tissues 6.1.1.9 Vascular Supply 6.1.1.10 Lymphatic Drainage 6.1.1.11 Nerve Supply 6.1.1.12 Histology 6.1.2 Anatomy of the Hypopharynx 6.1.2.1 Generalities 6.1.2.2 Soft Tissues 6.1.2.3 Vascular Supply 6.1.2.4 Lymphatic Drainage 6.1.2.5 Nerve Supply 6.1.3 Physiology of the Larynx and Hypopharynx Suggested Reading 6.2 Office Examination 6.2.1 Office Examination and Laryngoscopy 6.2.1.1 Definition 6.2.1.2 Examination 6.2.1.3 Laryngoscopy 6.2.2 Laryngeal Electromyography 6.2.2.1 Definition 6.2.2.2 Technique 6.2.2.3 Clinical Applications Suggested Reading 6.3 Inflammatory Diseases and Lasers 6.3.1 Inflammatory Diseases 6.3.1.1 Definition 6.3.1.2 Aetiology 6.3.2 Specific Lesions 6.3.2.1 Reinke’s Oedema 6.3.2.2 Hypertrophic Laryngitis 6.3.3 Which Laser Should Be Used? Suggested Reading 6.4 Mucosal Disease of the Glottis 6.4.1 Glottic Symptoms 6.4.2 Vocal Cord Structure 6.4.3 Vocal Nodules 6.4.4 Vocal Polyps 6.4.5 Reinke’s Oedema 6.4.6 Vocal Cord Cysts Suggested Reading 6.5 Benign Neoplasms and Other Tumours of the Larynx 6.5.1 Introduction 6.5.2 Classification 6.5.3 Papillomas 6.5.3.1 General Considerations 6.5.3.2 Indications 6.5.3.3 Specific Assessment 6.5.3.4 Surgical Techniques 6.5.3.5 Adjuvant Therapy 6.5.3.6 Specific Recommendations 6.5.4 Haemangioma 6.5.5 Haemangiopericytoma 6.5.6 Leiomyoma 6.5.7 Rhabdomyoma 6.5.8 Lipoma 6.5.9 Neurofibromas and Neurilemmomas or Benign Schwannomas 6.5.10 Salivary Gland Tumours 6.5.11 Oncocytoma 6.5.12 Necrotising Sialometaplasia 6.5.13 Paraganglioma 6.5.14 Granular Cell Tumours 6.5.15 Giant Cell Tumours 6.5.16 Chondroma 6.5.17 Non-neoplastic Laryngeal Tumours 6.5.17.1 Hamartomas 6.5.17.2 Pseudotumours or Pseudoneoplastic Lesions 6.5.18 Summary References Suggested Reading 6.6 Laryngeal Cancer 6.6.1 Definition 6.6.2 Aetiology/Epidemiology 6.6.3 Symptoms 6.6.4 Diagnosis 6.6.4.1 Physical Examination 6.6.4.2 Direct Pharyngolaryngoscopy 6.6.4.3 Diagnostic Imaging 6.6.5 Therapy 6.6.5.1 Surgery 6.6.5.2 Radiotherapeutic Treatment 6.6.5.3 Medical Treatment 6.6.5.4 Larynx Preservation 6.6.6 Prognosis References 6.7 Trauma to the Laryngeal and Tracheal 6.7.1 Definition 6.7.2 Aetiology/Epidemiology 6.7.3 Symptoms 6.7.4 Complications 6.7.5 Diagnosis 6.7.5.1 Recommended European Standard Diagnostic Steps 6.7.5.2 Additional/Useful Diagnostic Procedures 6.7.6 Therapy 6.7.6.1 Conservative Treatment 6.7.6.2 Surgical Treatment 6.7.7 Differential Diagnosis 6.7.8 Prognosis Additional Reading 6.8 Laryngeal and Tracheal Stenosis in Children and Adults 6.8.1 Supraglottic Laryngeal Stenosis 6.8.1.1 Definition 6.