Otolaryngology

(Otolaryngology Head and Neck Surgery)

Yucheng Yang Ph.D. Prof.

Department of Otolaryngology
The First Affiliated Hospital
Chongqing Medical University
2020
 Formative Assessment Program

Composition of Final Score:

Formative assessment accounted for 20 %
Final examination results accounted for 80 %.
In - class examination： 30×20%

A web-based homework: 30×20%

Class attendance: 40×20%

 Content

• Overview

• Applied Anatomy of the Nose

• Acute Rhinitis

• Allergic Rhinitis
 Overview

Definition
Otolaryngology (otolaryngology head and neck surgery)

• the study on anatomy, physiology and diseases of

organs:
ear, nose, pharynx, throat, trachea, esophagus, neck
• and their functions:
audition, balance, olfactory sensation, breathing ,
swallowing , pronunciation and language
 Overview

Characteristics of Otolaryngology
ENT/ear, nose, pharynx, throat, trachea, esophagus, neck

• Anatomy: connected
• Physiology: correlated
• Pathology: influenced
• Examination: commonality
• Treatment: assisted
 Overview

Special examination equipment

ear speculum frontal mirror

 Overview

Special diagnosis desk

Overview
 Overview

Learning focus

• Important diseases:
otitis media, rhinitis and sinusitis, pharyngitis
and tonsillitis, laryngitis , hearing loss

• Three critical diseases ：

laryngeal obstruction
foreign body in the trachea
otogenic complications
 Overview

Development
• Otology：ear surgery and otoneurosurgery,
ossicular reconstruction, cochlear implantation
• Nasology：nasal endoscopic skull base surgery,
related operations of nose and eyes
• Pharyngology and laryngology：obstructive sleep apnea-
hypopnea syndrome(OSAHS）
• Head and Neck Surgery ：tumor resection ,lymphadenectomy,
repair and reconstruct
 Overview

Endoscopic sinus surgery with navigational aids

American GE company InstaTrak ENTrak 3500

electromagnetic imaging navigation system
 Applied Anatomy of the Nose
• the first part of the upper respiratory tract
• located in the centre of face
• composed of three parts
 Applied Anatomy of the Nose

• external nose
A. Nasal vestibule

B. Nasal cavity proper

• nasal cavities
C. The Mucous Membrane

D. Vessels
• paranasal sinuses
 Applied Anatomy of the Nose

Nasal cavity
• The nasal cavities are situated on either side of the
median plane

• They open in front through the nares, and

communicate behind through the choana with the
nasopharynx.
 Nasal cavity

• The nasal cavity in each side is divided into

two parts:
A. nasal vestibule
B. nasal cavity proper

Nasal cavity proper

Limen nasi

Nasal vestibule
 Nasal cavity

A. Nasal vestibule
Nasal vestibule is the anterior and inferior part
of nasal cavity.
B. Nasal cavity proper
The nasal cavity proper is separated from the
vestibule anteriorly by limen nasi ,the most narrow
portion of nasal cavity, and opening posteriorly
through the choana to nasal pharynx.
Nasal cavity proper

Limen nasi Choana

Nasal vestibule
 Nasal cavity proper

View of nose on CT scan

anterior rhinoscopy
 Nasal cavity proper

Nasal cavity proper

 Nasal cavity proper

Each nasal cavity proper has :

a. a lateral wall
b. a medial wall
c. a roof
d. a floor
 Nasal cavity proper

a. Lateral Wall:
On the lateral wall there are the superior,
middle, and inferior nasal concha or turbinate,
and below and lateral to each concha is the
corresponding nasal passage or meatus.

Superior turbinate
Middle turbinate
Superior
Middle
meatus
meatus

Lateral wall

Inferior turbinate
Inferior
meatus
 Nasal cavity proper

Fig.3 Lateral Wall of the nasal cavity proper

 Nasal cavity proper

b. Medial Wall:
The medial wall or septum is a
partition of bone and cartilage between
two nasal cavities.

Nasal septum
 Nasal cavity proper

c. The roof:
The roof of the nasal cavity proper is
narrow from side to side, except at its posterior
part, and may be divided, from behind forward,
into sphenoidal, ethmoidal, and frontonasal
parts, after the bones which form it.
 Nasal cavity proper

d. The floor:
The floor is concave from side to side and
almost horizontal antero-posteriorly; its anterior
three-fourths are formed by the palatine
process of the maxilla, its posterior fourth by the
horizontal process of the palatine bone.
 Nasal cavity proper

C. The Mucous Membrane

The nasal mucous membrane lines

the nasal cavities proper, and is
intimately adherent to the periosteum or
perichondrium.
 Nasal cavity

D. Vessels
a. Arteries:
• internal carotid artery (ICA)
anterior ethmoidal branch
ophthalmic artery

posterior ethmoidal branch

• external carotid artery (ECA) sphenopalatine branch

 Vessels

Blood supply of the

nasal septum
 Vessels

b. Kieselbach’s plexus(Little’s area):

In the anterior part of the septum,
anastomosis of the external carotid artery (ECA)
and internal carotid artery (ICA) branches form
Kieselbach’s plexus at Little’s area, which is the
most common site for epistaxis.