Discover and read the best of Twitter Threads about #ENT

Most recents (19)

What is the most likely diagnosis in this 30 y/o w/ history of discitis/osteomyelitis presenting w/ fevers, chills, and neck pain? 🧠
#ent #Neurosurgery #Neurology #medtwitter #MedEd @The_ASSR #NeuroTwitter ImageImageImageImage
Answer: Longus Colli Calcific Tendinitis

▶️Etiology: inflammatory reaction in response to deposition of calcium hydroxyapatite crystals (just like in the rotator cuff)

▶️This case is a bit tricky as the history is somewhat misleading (though it often is in radiology)
Imaging:

▶️Sagittal STIR shows marked retropharyngeal/prevertebral edema (yellow arrow) and focal hypointensity from the hydroxyapatite crystals (green arrow)

▶️Axial T2 again shows the marked edema ImageImage
Read 9 tweets
Child with a history of dental caries presents with a firm mass at the angle of the mandible. What is the most likely diagnosis? 🤔 🧠

#neurotwitter #ent #peds #Neurology #neurosurgery @ASHNRSociety @The_ASPNR #MedTwitter ImageImageImageImage
Answer: Sclerosing osteomyelitis of Garré

▶️Biopsy showed a reactive and reparative osseous process and bone culture grew oral flora (though cultures are usually negative)
▶️SOG is thought to be due to a low grade infection possibly 2/2 dental disease. However, there should be no signs of acute infection (suppuration, bony sequestration or draining tracts)
Read 7 tweets
Case of emphysematous epiglottitis in an adult

Epiglottitis is an emergency as it can potentially cause airway compromise especially in children who have smaller airways #neurotwitter #ent #peds #Neurosurgery #MedTwitter #MedEd @ASHNRSociety ImageImage
▶️In children the diagnosis can be confirmed with upright plain film. CT requires placing the patient supine which may exacerbate inspiratory strider

▶️In adults, the diagnosis may not be suspected clinically so patients may end up with a CT scan as in this case
▶️Bacterial infection typically 2/2 H. Influenza in unvaccinated children

▶️In adults, possible pathogens include Strep, Staph, and H. influ
Read 4 tweets
Interesting case of complicated acute bacterial rhinosinusitis in this child with no PMH presenting w/ HA, fever & L sided weakness

#NeuroTwitter #ent #radres #neurosurgery @TheASNR @ASHNRSociety @PhilipRChapman1 #radres #futureradres ImageImageImageImage
CT shows opacification of the frontal and anterior ethmoid sinuses without evidence of cortical dehiscence

💡 In peds, infection can spread through vascular channels w/o destroying the bone ImageImage
MR shows abnormal signal filling the sinuses with associated restricted diffusion 2/2 purulent material

Post contrast we see areas of relative hypoenhancement in comparison to the normal mucosa on the contralateral side ImageImageImage
Read 9 tweets
Dacryocystitis in this patient with painful swelling in the region of the right medial canthus

Etiology: obstruction of the nasolacrimal duct leads to proximal dilatation and superimposed infection of the nasolacrimal duct sac

#ophthalmology #ent #radres @ASHNRSociety ImageImage
May be congenital or acquired

Congenital: imperforate membrane, incomplete canalization, or atresia leads to tears and mucus accumulation causing a dacryocystocele, if infected/inflamed, use the term dacryocystitis

Adults: acquired from any cause of obstruction
Imaging: often obtained to evaluate for orbital cellulitis

Look for a well defined cystic lesion at the medial canthus with continuity with the nasolacrimal duct

When reporting, discuss the extent of the lesion, laterality, and if there are signs of infection 🧠
Read 3 tweets
1/To be or not 2b?? That is the question!

Do you have questions about how to remember cervical lymph node anatomy & levels?

Here’s a #tweetorial to show you how--#Superbowl weekend edition!
#medtwitter #meded #neurorad #HNrad #FOAMed #FOAMrad #radres #radtwitter #ENT #radiology
2/Google cervical lymph node anatomy & you always get this anatomic picture w/the head flung back like a model posing.

But unless you live in LA, your patients don’t look like this & understanding anatomy from this image is difficult
3/First, you need to know how lymph node drainage works in the neck.

Nodes drain like rivers—smaller streams drain into larger rivers.

In the neck, there are outer circle nodes (peripheral) & inner circle nodes—both drain into the large river of the deep cervical nodes
Read 17 tweets
Sort of like ABSITE studying itself, our high yield #absite graphics series this year had some highs and some lows. What better way to reminisce than putting them all in one place... 🧵(1/n)
We kicked it off with the ruler of tricky anatomy, the #thyroid (2/n) Image
Found its close friend and confidante and remembered our dual criteria for the #parathyroids (3/n) Image
Read 18 tweets
70 y.o. female w/ forehead swelling that grew over 2 years and caused progressive proptosis and loss of vision (Will provide Reference, patient consented). Etiology may surprise you. #neurosurgery #ent ImageImage
Mass effect on brain but contents similar attenuation on CT to brain parenchyma
Hint: Slow growth, bony structures w/ thinning and no destruction, no enhancement, homogenous nature, and no vascularity.
Read 4 tweets
Welcome everyone to our 2nd Pediatric on Squares Board Review Course
We are starting today until the coming 8 days
Hope it’ll be helpful and enjoyable course
✏️ Note that you still can join and register on the course with accessibility to all recorded session until 27th of August ImageImage
Day 1
1st session: Pulmonology Review
By Dr. Bassem Kurdi @Bassemkurdi

#Pediatric #Pulmonology #MCQ ImageImage
Day 1
2nd session: Keys to Answer MCQs
3rd session: Neonatology review
By: Prof. Abdulrahman Alnemari @aalnemri
#Pediatric #Neonatology #NICU #MCQ ImageImage
Read 23 tweets
Pterygopalatine fossa🧵- inspired by ?s from med students in neuroanatomy lab & a resident w/ case of perineural tumor spread on same day! #meded #FOAMrad #medtwitter #medstudents #radiology #neurorad #HNrad #radres #neurology #ENT #temporalbone #neurosurgery #neuroanatomy
1/22
The PTERYGOPALATINE FOSSA (PPF) is a space deep in the face/skull base, bordered anteriorly by the maxilla (max sinus), posteriorly by the pterygoid base of the sphenoid, and medially by the perpendicular plate of the palatine bone. 2/22
It’s best to think of the PPF as a crossroads/intersection. Think about the roads that lead to and from it, and the cast of characters that pass through.

Some like to simplify/visualize the PPF as a cube or inverted pyramid.

3/22
Read 22 tweets
I'll be adding short important points which would hopefully help in remembering certain concepts during #PLAB preparation, to this thread🧵every now and then as I take them out from my scattered notes. Feel free to comment your tips and tricks which would help others, as well 👇
Please don't take any of these as medical advice 😂🙏. Real life stuff is much more nuanced. These are just clinchers for the sake of the exam.
#PLAB
1. Drug contraindications...
-Avoid BAN drugs in Asthma (Beta blockers, aspirin, NSAIDS) &
-DAMN drugs in diarrhoea (Diuretics, ACEIs, Metformin, NSAIDs)
#PLAB
Read 60 tweets
Every speciality who is on (or wants to be) the ‘Mucor’ team- how many are willing to admit a patient with Mucor under their care and manage (even after surgical debridement). How many were admitting before and will admit after the pandemic? (1/n)#Mucormycosis #COVID19India
Some hypothetical consultations in the emergency before and after the pandemic:

#ENT : We will operate and transfer back

#Ophthalmology : Call us during the Surgey, we will coordinate with ENT in the OT, if needed

#Neurology : Continue Amphotericin (2/n)
#Endocrinology : Send us a consultation after admission under primary, we will control sugars

#Neurosurgery :No active neurosurgical intervention required

#Nephrology :We will do renal modification of Amphotericin

#Medicine/ #Infectiousdisease Admit under any of the above
Read 4 tweets
Accountability

Flowers, I will go see she said.

Headed to Esplanade (cuz this photo alone would check a box but would actually be cheating - the power of “optics” or manufactured data whose lives & careers are Twitter).

Question everything you see
See like a #pediatrician Image
I shall see from a new perspective she said - I will cross on the other side.

(Actually, I wanted to be on the other side but would have to walk a block to cross so, fine, I’ll cross on this side. Bah humbug). Image
I shall admire the barely born green hope unfurling into the crisp Spring air, fragile yet #resilient, she said

(Yay #Science and @museumofscience #BostonStrong #Boston ... and yes, and requisite monuments to male anatomy and war as well) Image
Read 25 tweets
Neuroanatomy TOTD #15🧵
The inner ear #tweetorial--it packs a large functional punch for its small size-strap in!
#meded #FOAMed #FOAMrad #medtwitter #medstudents #radiology #neurorad #HNrad #radres #neurology #ENT #temporalbone #neurosurgery #neuroanatomy #neuroanatomyTOTD
1/24
To evaluate the t-bone, best to compartmentalize--external/middle/inner ear (IE). See previous #tweetorial of the ME. The IE is difficult as most structures are obliquely oriented (at different obliquities!)-and can be hard to see on standard views. 2/24
IE communicates with ME via oval&round windows (which allow for transmission&dissipation of sonic vibrations). IE houses sensory organs for hearing/balance/sensing motion. The cochlear&vestibular nerves (CNVIII) transmit signals to the brain via the int auditory canal (IAC). 3/24
Read 25 tweets
Neuroanatomy TOTD #14🧵
Got some requests to do one of the trickiest areas of human anatomy, the #temporalbone. So many named structures! #meded #FOAMed #FOAMrad #medtwitter #medstudents #radiology #neurorad #radres #neurosurgery #neuroanatomy #ENT #otolaryngology

1/21 Image
Whether learning t-bone anatomy as a medical student or evaluating a CT of the t-bone as a radres, it’s best to compartmentalize into external, middle, and inner ear. This thread🧵is on the middle ear: Inner ear to follow, some day:)

2/21 Image
The external ear extends from the external meatus to the TM. The TM should be thin and *almost* imperceptible on CT. Thickened and retracted TM suggests prior pathology (usually otitis media) and scarring.

3/21 Image
Read 22 tweets
1/
OK! Here goes nothing. My first ever #tweetorial on the Coordinated Interview Release process for #Match2021.

This will be broken up into five parts:
1) What
2) Why
3) Who
4) How
5) Alternatives

#MedEd #MedStudentTwitter
Formatting inspired by the great @DrStevenTChen.
2/
Starting with WHAT. What is a coordinated interview release?

A coordinated interview release 📨 is when numerous residency programs (ideally all programs*) agree to send out their interview invites on the same pre-determined day (or time frame) to applicants.
2.5/
*It's important to note that programs are constrained by factors out of their control – especially this year with #COVID19 & the coordinated release process being new for most specialties. Those who could not participate this year should in no way be viewed negatively.🆗!!
Read 18 tweets
Warning : Images with Blood / Images with Mutilated Face Ahead. Viewer Discretion Adviced

Last Week, this person has sustained a injury face due to crackers.

This was how he was bought to the #RGGGH (Rajiv Gandhi Government General Hospital)

1/5
This was the 3D Reconstruction of the CT Scan

A Team of OroFacialMaxillo Surgeons from Madras Dental College and Plastic Surgeons from Madras Medical College (the Duty Assistant Plastic Surgeon did MCh parallel to me and we have worked in Trauma Ward Together a lot) and the
3
Read 5 tweets
1. Last night after eating a fav dish, had a #TangoOfDeath w/#CircleOfHellHeartburn. The kind where despite knowing u’re 2 healthy 2 b having 1 🤞🏻, u still vaguely hope that u’re having a heart attack so the 🔥PAIN🔥 will end. Sweating, bent over chewing antacids like tic tacs.
2. Finally fell asleep in a fetal position & woke up & thought— #DeathPeppers... w/a little work, there’s a #SyFy movie waiting to be born. 🤪 😈 So here goes:
Millennial chef Whilhemina Pepper decides to open a CaliTexMexChinese fusion restaurant Called “Chill Will’s”.
3. She has developed her own special to-be-branded peppers that will be used. Unbeknownst to her, the manager she hires is an unknown 3rd cousin twice removed who is— BENT ON REVENGE! (And just happens to be a plant geneticist.😉) Evil cousin gets access ro the peppers and...
Read 15 tweets

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