Cabinet d'audiologie "Écouter et Vivre"

20/03/2026

Benign Paroxysmal Positional Vertigo (BPPV) is treated by canalith repositioning maneuvers, which move displaced otoconia from the semicircular canal back to the utricle. The maneuver depends on the involved semicircular canal (SSC).

1. Semicircular Canal (most common)

Epley maneuver – most commonly used

Semont (Liberatory) maneuver
These reposition otoconia from the posterior canal to the utricle.

2. (Lateral) Semicircular Canal

Barbecue roll (Lempert) maneuver

Gufoni maneuver
These rotate the head/body to move particles out of the horizontal canal.

3. (Superior) Semicircular Canal

Deep head hanging maneuver (Yacovino maneuver)
This uses head extension to allow debris to exit the anterior canal.

:
Posterior canal → Epley / Semont
Horizontal canal → BBQ roll / Gufoni
Anterior canal → Deep head hanging

19/03/2026

18/03/2026

Classification & Features of Thyroiditis

🔵 1. Hashimoto’s Thyroiditis (Chronic Autoimmune)
-Age: All (peak 30–50)
-S*x ratio: 8–9 : 1
-Cause: Autoimmune
-Function: Hypothyroidism
-TPO antibodies: ↑ High
-ESR: Normal
Pathology:
-Diffuse symmetrical enlargement
-Firm, pale, multilobulated gland

🟢 2. Painless Postpartum Thyroiditis
-Age: Childbearing women
-Cause: Autoimmune
-Function: Hyper → Hypo → Recovery
-TPO: High
-ESR: Normal
Pathology:
-Firm, tan-white gland
-Nodules of varying size

🟢 3. Painless Sporadic Thyroiditis
-Age: All (peak 30–40)
-S*x ratio: 2 : 1
-Cause: Autoimmune
-Function: Hyper ↔ Hypo
TPO: High
ESR: Normal
Pathology: Similar to postpartum type

🔴 4. Painful Subacute Thyroiditis (De Quervain)
-Age: 20–60
-S*x ratio: 5 : 1
-Cause: Likely viral / unknown
-Function: Hyper → Hypo (transient)
-TPO: Low
-ESR: ↑ High (key feature)
Pathology:
-Firm, tender gland
-Granulomatous inflammation

🟠 5. Suppurative Thyroiditis (Bacterial)
-Age: 20–40
-S*x ratio: 1 : 1
-Cause: Infection
-Function: Usually euthyroid
-TPO: Absent
-ESR: ↑ High
Pathology:
-Abscess formation
-Focal/diffuse enlargement

⚫ 6. Riedel’s Thyroiditis (Fibrosing)
-Age: 30–60
-S*x ratio: 3–4 : 1
-Cause: Unknown
-Function: Usually euthyroid
-TPO: Present
-ESR: Normal
Pathology:
-Dense fibrosis replacing thyroid
-Hard “woody”


-Painful thyroid → think De Quervain or infection
-High ESR → De Quervain / Suppurative
-Autoimmune → Hashimoto + painless types (↑ TPO)
-Woody hard thyroid → Riedel’s
-Postpartum + transient hyper/hypo → painless postpartum

18/03/2026

FNAC Findings of Pleomorphic Adenoma (Parotid Gland)

FNAC (Fine Needle Aspiration Cytology) is a test where a thin needle is used to take cells from a lump in the parotid salivary gland to examine under a microscope.
In Pleomorphic Adenoma (the most common benign salivary gland tumor), the FNAC report usually shows three main components.

1. Cells
These are gland cells.
Appearance in FNAC:
Cells arranged in clusters, sheets, or ducts
Uniform (similar looking) cells
Round or oval nucleus
No major abnormal features
This indicates the tumor is benign.

2. Cells
These are special support cells found in salivary glands.
Appearance:
Can look spindle-shaped, plasmacytoid, or round
Found scattered or in clusters

3. (Mucoid) Stroma
This is the characteristic background material of pleomorphic adenoma.
Appearance:
Gel-like or myxoid material
Looks bluish or fibrillary on staining
Sometimes resembles cartilage-like matrix
This mixed appearance is why it is called “pleomorphic” (many forms).

Classic FNAC Description
A typical report may say:
> “Smears show clusters of epithelial and myoepithelial cells in a chondromyxoid background, suggestive of Pleomorphic Adenoma.”

Diagnostic Triad
Pleomorphic adenoma FNAC shows:
1. Epithelial cells
2. Myoepithelial cells
3. Chondromyxoid stroma

13/03/2026

Gargling in laryngitis
Gargling (often with salt water) is usually recommended for sore throat, but in laryngitis it is often not very helpful and sometimes discouraged.
Because of
1. Gargling does not reach the larynx
-Laryngitis = inflammation of the larynx (voice box), which sits below the throat (pharynx).
-When you gargle, the liquid mainly stays in the mouth and upper throat.
-It rarely reaches the vocal cords, so it cannot directly treat the inflamed larynx.

2. Can trigger coughing or irritation
-Gargling can stimulate the gag or cough reflex.
-Coughing and throat clearing strain the vocal cords, which can worsen laryngitis.

3. Excess throat clearing
-Gargling sometimes makes people clear their throat repeatedly.
-Throat clearing causes additional friction on inflamed vocal cords, delaying healing.

usually suggest:
-Voice rest (most important)
-Warm fluids (tea, soup, water)
-Steam inhalation / humidified air
-Avoid smoking and irritants
-Hydration

Gargling isn’t harmful in most cases, but it doesn’t reach the vocal cords and may provoke coughing, so it’s not very useful for laryngitis.

13/03/2026

CT temporal bone shows:
1, EAC;
2, mastoid air cells;
3, tegmen mastoideum;
4, tegmen tympani;
5, tympanic segment of the facial nerve;
6, labyrinthine segment of facial nerve;
7, petrous apex;
8, basal turn of the cochlea;
9, interscalar septum;
10, middle turn of the cochlea;
11, carotid canal;
12, tendon of the tensor tympani;
13, lateral process of the malleus;
14, lateral malleal ligament;
15, malleus (head).

13/03/2026

13/03/2026

X-ray soft tissue neck lateral viwe

10/03/2026

Burning Mouth Syndrome (BMS)

Burning Mouth Syndrome is a condition characterized by a chronic burning sensation in the oral cavity (tongue, lips, palate, or entire mouth) without any visible clinical lesions or identifiable medical cause.


More common in middle-aged and elderly individuals

Females are affected more frequently, especially after menopause.

(Causes)
1. Primary (Idiopathic) BMS

No identifiable cause

Often related to neuropathic dysfunction of oral sensory nerves

2. Secondary BMS Occurs due to underlying conditions such as:

Nutritional deficiencies (Vitamin B12, iron, folic acid)

Diabetes mellitus

Hormonal changes (menopause)

Xerostomia (dry mouth)

Oral infections (Candida)

Allergic reactions to dental materials or foods

Certain medications

Psychological factors (anxiety, depression)

Features
Burning or scalding sensation in the mouth (especially tongue)

Dry mouth (xerostomia)

Altered taste sensation (bitter or metallic taste)

Pain may increase during the day

No visible oral lesions


Diagnosis is mainly clinical and by exclusion:

Detailed medical and dental history

Oral examination

Blood tests for vitamin deficiencies and diabetes

Tests to rule out oral infections or systemic diseases

/ Treatment
Treatment depends on the underlying cause:

Vitamin and mineral supplementation

Treatment of oral infections

Saliva substitutes for dry mouth

Neuropathic pain medications (e.g., clonazepam, gabapentin)

Psychological counseling or stress management


Symptoms may persist for months or years

Proper diagnosis and management can significantly reduce discomfort