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1、耳鼻咽喉科学,Otorhinolaryngology,Introduction 一.The tasks of Oto-Rhino-Laryngology (ORL) Study：ORL and esophagus, trachea and bronchi-anatomy、physiology and diseases 1、The function & features of organs in ORL Special function：audition、olfaction、sense of taste、balance Physiologic function：respiratory funct
2、ion，phonatory function and deglutitory function，immune defensive function. Ordinary diseases：otitis media, rhinitis and sinusitis, pharyngitis and tonsillitis, laryngitis, deafness.,Emergency cases：foreign body, traumatism, hematorrhea, laryngeal obstruction Tumor：carcinoma of nasopharynx, carcinoma
3、 of larynx, carcinoma of rhinosinus, carcinoma of middle ear. 2、Relationship with other organs Noseorbit, anterior cranial fossa, sellar area, oral cavity Earmiddle and posterior skull base, clivus, rhinopharynx Pharynx and larynxoral cavity, rhinopharynx, trachea and bronchi, esophagus, obstructive
4、 sleep apnea syndrom(OSA) Infective focusrheumatic fever, arthritis, cardiac disorder, nephritis,3、Development of otorhinolaryngology： CT, MRI, microscope, endoscope, navigation system, head neck surgery, otoneurosurgery, skull base surgery, rhinoneurosurgery. 二、The educational aims of otorhinolaryn
5、gology Aims：Methods of examination for ORL，diagnosis, treatment, and prevention of the diseases in ORL.,Anatomy of the nose External nose,Anatomy of the nose External nose Frame Skin Vein nerve,nasal cavity and sinuses,Nasal vestibule， nasal fossa proper；,nasal cavity and sinuses,nasal fossa proper；
6、 6 walls 1, medial wall, 2,superior wall 3,inferior wall 4, anterior wall 5,posterior wall 6,lateral wall,nasal cavity and sinuses,lateral wall of the nose 3 turbinates: inferior, middle, superior, 3 meatus : inferior, middle, superior,inferior turbinate & inferior meatus middle turbinate & middle m
7、eatus superior turbinate & superior meatus,uncinate process，ethmoid bulla， semilunar hiatus,concha bullosa, uncinate process,frontal sinus,ethmoid sinus maxillary sinus,sphenoid sinus choanae or posterior nares,Blood supply： Ophthalmic arteryanterior & posterior ethmoidal arteries Internal maxillary
8、 arterysphenopalatine artery、infraorbital artery、greater palatine artery Littles areanasopalatine、anterior ethmoidal、posterior ethmoidal、superior labial & greater palatine artery,Nerve supply of the nasal cavity：olfactory nerve，sensory nerve，and sympathetic nerve, parasympathetic nerve.,第六章 鼻及颅面外伤 第
9、一节 Fracture of nasal bone Symptoms & Sign：pain, epistaxis, nasal deformity or deviation, bruising. Diagnosis：X-ray in lateral view. Doubt for septal hematomapuncture Treatment：hemostasia, cleaning & suturing wound, restoring alignment Deal with septal hematoma & abscess,第二节 鼻窦外伤 Fracture of frontal
10、bone Pathology：often combine with fracture of naso-fronto- ethmoido-orbital complex. Front wall, front & back wall, base fracture (frontonasal fracture). Stringy, sunken and smashed fracture Symptoms & Sign：epistaxis, edema or sunken front. Diagnosis：frontal palpation, X-ray, CT scans,front wall fra
11、cture front & back wall fracture (sunken fracture凹陷型) (smashed fracture 粉碎型),Treatment：according to the situation 1、 stringy fracture 2、 sunken fracture 3、 smashed fracture 4、 front & back wall fracture 5、base fracture (frontonasal fracture): restore the function of frontal sinus. Principle：to isola
12、te the communication between frontal sinus and cranial cavity, to prevent rhinogenic complications, to keep the frontal part from deformation.,Fracture of ethmoidal bone Pathology：often combine with fracture of naso-fronto- ethmoido-orbital complex. Symptoms & Sign： edema of eyelid or nasal root, an
13、 increase in the intercanthal distance. sunken front ，vision disorder, Diagnosis：X-ray film, CT scan Treatment： vision disorderdepression of optic canal Nosebleednasal pack or arterial ligation (ligation of ethmoidal artery),Fracture of naso-fronto- ethmoido-orbital complex,第三节 颅面骨骨折 一、 Blow-out and
14、 blow-in fracture Blow-out fracture： Symptoms & Sign： Swelling and bruising involving all eyelids, lid and infraorbital emphysema. diplopia，restricted movement of the eyes； vision disorder. Diagnosis： Clinical manifestation, X-ray, CT scans Treatment：Reduction within 710d post-wound. Operation appro
15、ach: via infraorbit, via maxillary sinus and external ethmoidectomy.,击出性骨折 (眶底暴折) blow-out fracture,Blow-in fracture： Relatively rare. Symptoms & Sign：protruding eye, swelling eyelids and zygoma, palpation: infraorbital “stairs”. Diagnosis：Clinical manifestation, X-ray, CT scans Treatment： Reduction
16、 within 710d post-wound. Midface fracture Le Fort , Le Fort , Le Fort ,第五节 Cerebrospinal fluid rhinorrhea (CSF) Etiology： Traumatic, Iatrogenic, and external trauma. Intracranial or extracranial surgery. Cribriform plate Sphinoid, frontoethmoidal complex. Nontraumatic, spontaneous (or primary), direct erosion or increased intracranial pressure (tumors, congenital or acquired hydrocephalus, or infections.,Diagnosis：history, laborator
