EAR, NOSE AND THROAT (ENT)

EAR
Theear is dividedinto three areas: external, middle and inner ear.

External Ear
The external ear consists of the auricle (pinna) and the external auditory meatus (canal). The
auricle is the outer portion of the ear consisting of elastic cartilage covered by skin. The
external auditory meatus isa canal that extends from the outside to the tympanic membrane.
It is lined with skin containing sebaceous glands, hair and ceruminous glands that secrete a
waxy substance called cerumen (ear wax). Cerumen traps foreign particles and helps to
protect the canal.

Middle Ear
The tympanic membrane is the boundary between the external and middle ear. It consists of
a thin layer of connective tissue. It has a layer of skin on its external surface and a mucous
membrane on its internal surface.

The middle ear resides in a hollow chamber called the tympaniccavity. The cavity is lined
with a mucous membrane. The cavity contains a canal called the Eustachian tube
(pharyngotympanic tube) that connects with the nasopharynx.
Three small bones called auditoryossicles transmit vibrations from the tympanicmembrane to
the oval window of the inner ear. These are the malleus, incus and stapes.
The stapes is attached to the surface of the cochlea at aspot called the oval window. The
cochlea is filled with fluid and has tiny nerve endings called the hairs of Corti covering its interior
surface.
When sound vibrations reach the stapes, the stapes gently presses against the oval window causing
fluid to move in the cochlea.

This in turn stimulates the hairs of Corti, causing nerve impulses to be sent to the brain through
the auditory division (cochlear component) of the vestibulocochlear nerve.
The brain then interprets these impulses as sounds.
The sound waves are transmitted within the ear in two phases: the conductive
phase and the
sensorineural phase
Conductive phase: Sound waves travel through the external and middle ear by conduction.
Sensorineural phase: The sensorineural phase involves the cochlea and the
nerve.
vestibulocochlear
 Semicircular canal

Oval window
Roundwindow Vestib
Incus ulococ
hlear
Auricle Nerve
Malleus

Cochlea

Tympaniccavity
Tympanic
Mernbrane Eustadhian
Bdemal Stapes Tube
Auditory
Meatus

Inner Ear
The inner ear resides within acavity inside of the temporal bone. It consists of the cochlea,
vestibule and semi-circular canals.The cochlea is a spiral shaped structure that connects
tothe anterior portion of the vestibule.
Once the vibrations of the eardrum have been transmitted to the oval window, the sound waves
continue their journey into the inner ear.

The inner ear is amaze of tubes and passages, referred to as the labyrinth. In the labyrinth can
be found the vestibular and the cochlea.

Cochlea
In the cochlea, sound waves are transformed into electrical impulses which are sent on to the
brain. The brain then translates the impulses into sounds that we know and understand.
What is the cochlea and what is the function of the cochlea? The cochlea resembles a snail
shell or a wound-up hose and is filled with a fluid called perilymph and contains two
closely
positioned membranes. These membranes form a type of partition wall in the cochlea.
However, for the fluid to move freely in the cochlea from one side of the partition wallto
theother, the wal hasa little hole in it (the helicotrema). This hole is
necessary, in ensuring
that the vibrations from the oval window are transmitted to all the fluid in
the cochlea.
 moves inside the cochlea, thoUsands of microscopic hair fibres inside the
When ihe fiuid
into motion. There are approximately 24,000 of these hair fibres,
partition wall are put
arranged in four long rows.

Auditory nerve the

all connected to the auditory nerve and, depending on
are
The hair fibres in the cochlea different hair fibres are put into motion.
the cochlear fluid,
nature of the movements in
send electrical signals to the auditory nerve which is
When the hair fibres move, they In the brain the electrical impulses
are
of the brain.
connected to the auditory centre understand. Therefore, these hair fibres
and
translated into sounds which we recognize damaged, then our
hearing ability.Should these hair fibres become
are essential toour
hearing ability will deteriorate.
mechanism
Vestibular- the balance
ring-shaped passages, oriented in three different planes.
three
The vestibular consists of that moves in accordance with the body's
filled with fluid
All three passages are passages also contain thousands of hair fibres
these
movements. In addition to the fluid, little impulses to the brain.
The brain
of the fluid sending
which react to the movement help the body keep its balance.
which are used to
then decodes these impulses

NOSE
in the middle of the face of humans. Anorgan of
feature located
Nose is the most prominent
tract, it is actively involved in inhalation.
the upper respiratory
are to filter the atmospheric air before passing it further
of nose
The most important functions
the respiratory system and to provide the sense of smell.
into
through the nostrils is led to the nasal cavity, which further
entering
At the time of breathing, air
pharynx, trachea, bronchi, and finaly, to the lungs.
passes to the
the type of nose depends upon the bone and cartilage the nasal
The external feature of a nose or cavity.
separates the nostrils, which in turn, continue with the nasal
Septum
the nose region contain the sinuses. Anatomically, sinuses
The bones of the face around
that are lined by mucous membrane (like the nasal cavity),and they
are hollowaircavities based on
paranasal sinuses. There are four subgroups of sinus, classified
are also known as ethmoid, and
bones to which the sinuses are present. They are frontal, maxillary,
the
Among these four sinuses, ethmoid sinus is located around the area of nose
sphenoid sinus.
sinuses cause sinus problems.
bridge. An abnormality in any of these paranasal
 nside the Nose and Throat

Frontat
Sinus

Nasal
Cavity
Nostril
Hard Paiate
Soft Palate
Tongue
Throat
(pharynx)

Voice Box
{laryrx)
Vocal
Fotd

THROAT
The throat, or pharynx, is divided into three
parts. The nasopharynx (1) is located behind
the nose. The oropharynx is behind the
mouth (2). And
section of the throat, is in front of the esophagus (4); this the laryngopharynx (3), or lower
is where the larynx, or voice box,
and the vocal cords are housed (5). The
often- infected tonsils (6) and adenoids (7) are
found in the naso- and oropharynx. Afew
and other infections that cause sore common problems can affect the throat: strep
a few. throats, hoarseness, laryngitis, and tonsillitis are just

3
 DISEASES OF ENT
Allergic Rhinitis
Allergic rhinitis is an inflammation of the nasal passages, usually associated with
watery nasal
discharge and itching of the nose and eyes. Also called as Hay fever.

Laryngitis
Laryngitis is an inflammation of the mucous membrane lining the larynx (voice box), which
is in the upper part of the respiratory tract. It causes hoarseness,and possiblyatemporary
loss of speech.
Otitis Externa

External otitisor "swimmer's ear" is an infection of the skin covering the outer ear and ear canal.
Acute external otitis is commonly a bacterial infection caused by streptococcus,
staphylococcus,or pseudomonastypes of bacteria. The swimmer's ear infection is usually
caused by excessive water exposure. When water collects in the ear canal (frequently
trapped bywax), the skin will become soggy and serve as an inviting culture media for
bacteria.

Otitis Media

Otitis mediais inflammation of the middle ear. "Otitis" means inflammation of the ear, and"media"
means middle.

This inflammation often begins with infections that cause sore throats, colds or other
respiratory problems, and spreads to the middle ear. These can be caused by viruses or
bacteria, and can be acute or chronic

Tinnitus
Tinnitus is aringing, buzzing or other type of noise that seems to originate in the ear or head.

Sinusitis
Sinusitis refers to inflammation of the sinuses that occurs with a viral, bacterial, or fungal infection.
Tonsillitis
Tonsillitis is inflammation (swelling) of the tonsils
Mastoiditis - Inflammation of the mastoid process, most commonly due to a bacterial infection.
Vertigo -The hallucinatory sensation of spinning, whirling, or dizziness that is associated with
difficulty in maintaining balance.
 that develops on
Acoustic Neuroma -An acoustic neuroma is a noncancerous growth
vestibulocochlear nerve, it connects the inner
the eighth cranial nerve. Also known as the
is involved in transmitting sound;
ear with the brain and has two different parts. One part
to the brain.
the other helps send balance information from the inner ear
potentially serious sleep
Obstructive Sleep Apnea - Obstructive sleep apnea is a
sleep. This type of apnea
disorder. It causes breathing to repeatedly stop and start during
block your airway during sleep.
OCcurs when your throat muscles intermittentlyrelax and
Anoticeable sign of obstructive sleep apnea is snoring.