Laryngomalacia literally means ‘abnormal softening of the larynx’
It is a congenital condition in the supraglottic part of the larynx is abnormally flaccid
It is the most common congenital lesion of the larynx and is the most common cause of congenital stridor
During inspiration, the epiglottis folds upon itself and is sucked into the larynx
This causes stridor and sometimes cyanosis
The severity is more when the child is crying and is relieved by placing the child in prone position
It appears at or soon after birth and usually disappears by 2 years of age
Diagnosis is …

Bill’s bar is a vertical crest that divides the superior compartment of the internal acoustic meatus into anterior and posterior compartments
The anterior compartment contains the facial nerve and the nervus intermedius
The posterior compartment contains the superior vestibular nerve (which supplies utricle, superior and lateral semicircular canals)

Cerebellopontine angle is the anatomical space between the cerebellum and the pons
Various tumours occur in this region. They are:

Acoustic neuroma – most common
Meningioma
Cholesteatoma
Arachnoid cyst
Schwannoma of cranial nerves
Aneurysms
Glomus tumour
Metastasis

It results in cerebellopontine angle syndrome with features arising due to the compression of cranial nerves by the tumour

Otomicroscopic view of central perforation of tympanic membrane in a patient presenting with ear discharge and hearing loss
(click on image for an enlarged view)

Central perforation of tympanic membrane is that which is not involving the annulus and is bounded on all sides by the remnant of the tympanic membrane.
It can be caused by suppurative otitis media or trauma
It is associated with less complications as compared to marginal type of perforation and has greater chance of spontaneous healing
Central perforation can be closed once the infection subsides by using grafts (eg: cadeveric …

Waldeyer’s lymphatic ring is a collection of lymphoid tissue present in the neck (Waldeyer’s outer ring) and pharynx (Waldeyer’s inner ring /  Waldeyer’s tonsillar ring)
It plays an important role in protection against pathogens
It was named after the nineteenth century German anatomist Heinrich Wilhelm Gottfried von Waldeyer-Hartz.

Waldeyer’s inner ring

It is located in the nasopharynx and oropharynx
The components are:

Adenoids (nasopharyngeal tonsil)
Tubal tonsil
Palatine tonsil
Lingual tonsil

It helps protect the body against inhaled and ingested pathogens

Waldeyer’s outer ring

It is composed of various lymph nodes in the neck
The component lymph nodes are:

Occipital
Post auricular
Pre auricular
Parotid
Facial (superficial – upper, …

Killian’s dehiscence is a potential triangular gap between the oblique fibers of thyropharyngeus and the transverse fibers of cricopharyngeus (Thyropharyngeus and cricopharyngeus are 2 parts of the inferior constrictor of pharynx)
It is named after German ENT surgeon – Gustav Killian
It is through this gap that the herniation of pharyngeal mucosa occurs in case of pharyngeal pouch (Zenker’s diverticulum)
It is also called ‘gateway of tears’ as it is a common site for perforation during oesophagoscopy

Synonyms:

Laimer triangle
Laimer-Haeckermann area
Laimer-Killian triangle

Rhinospoidiosis is a granulomatous disease of the nose caused by Rhinosporidium seeberi
R. seeberi was initially thought to be a fungus, but now it is now considered to be an aquatic protistan
Rhinosporidiosis is found in India (southern states mostly), Pakistan and Sri Lanka

Etiology

There are various theories explaining the etiology of rhinosporidiosis

Demellow’s theory of infection – Infection arises from swimming in water bodies frequented by animals
Karunarathnae’s theory of auto inoculation - The spread of lesions to skin and conjunctiva occur as a result of auto inoculation
Hematogenous spread
Lymphatic spread

Clinical features

Symptoms

epistaxis
nasal stuffiness

Signs

Leafy, polypoidal, pink to pruple mass in …

Atrophic rhinitis is a chronic inflammatory disease of the nasal cavity that is characterised by atrophy of turbinates and nasal mucosa with foul smelling crusts
It can be primary or secondary

Primary Atrophic Rhinitis

Etiology (can be remembered with the mnemonic ‘HERNIA’)

Heriditary factors
Endocrine

Atrophic rhinitis is mostly seen in females, starts around puberty and decreases after puberty.
Hence a hormonal etiology is suggested

Racial – more in whites and yellow races
Nutritional

Atrophic rhinitis is more seen in the developing nations
It is rarely seen in people belonging to higher socioeconomic status
Hence deficiency of vitamins and nutrients is believed …

The premalignant lesions of oral cavity are:

Leukoplakia
Erythroplakia
Submucous fibrosis
Hyperplastic candidiasis
Discoid lupus erythematosis
Oral lichen planus
Epidermolysis bullosa
Dyskeratosis congenital
Palatal lesions of reverse cigarette smoking

Antrochoanal polyp Click on image for an enlarged view

Antrochoanal polyp arises from the maxillary sinus.
It usually grows posteriorly towards the nasopharynx

The reasons for growing posteriorly are as follows:

Mucociliary flow is directed posteriorly
Accessory ostium, through which the antrochoanal polyp comes out is located more posterior in the nasal cavity
Effect of gravity when lying down
Inspiratory airflow is stronger compared to expiratory flow
Broetz anatomical variation theory
Bernoulli effect

Image credits:
Antrochoanal polyp – Otolaryngology Houston
Antrochoanal polyp – endoscopic view – Otolaryngology Houston
Antrochoanal polyp CT scan – Radiopaedia. Original image can be viewed here