Section: 
From practice
From practiceRare diseases in practice of otorhinolaryngologist of outpatient clinic. Some aspects of diagnostics
A. S. Kiselev (1), A. A. Vavilova (2), (3)
(1) Kirov Military medical academy, Saint Petersburg, 194044, Russia, (2) Nikiforov Russian Center of Emergency and Radiation Medicine, EMERCOM of Russia, Saint Petersburg, 194044, Russia, (3) Medical company „AVA-PETER", Saint Petersburg, 191014, Russia
UDK: УДК 616.21-039.42
DOI: https://doi.org/10.18692/1810-4800-2022-4-113-122
ABSTRACT
The article is a review of the diagnostic features of some rare ENT diseases, which the author would like to focus on based on his own clinical experience to help the outpatient otorhinolaryngologist. Among such diseases are neuroma of the VIII cranial nerve and tumors of the nasopharynx. It is emphasized that the first symptoms in the form of hearing loss in these diseases can help guide the doctor’s thoughts in the right direction in order to transfer the patient to a specialized institution in a timely manner. The importance of Weber’s test in the diagnosis of these diseases is noted. So, with neuroma of the VIII nerve, the symptom of N. S. Blagoveshchenskaya (lack of lateralization toward the better ear in case of unilateral hearing loss according to the type of sound perception) makes it possible to suspect an acoustic neuroma. And with a tumor of the nasopharynx, a unilateral hearing loss according to the type of sound conduction, resulting from compression of the auditory tube by the tumor, may be the first symptom of the disease. The article discusses the diagnostic aspects of other rare ENT diseases: destructing adenoma of the nasal septum, granulating external otitis, benign tumors of the sweat glands of the auricle and external auditory canal, lateral branchial cysts of the neck. In addition to the listed diseases, the author, also sharing his own clinical observations, dwells on a rather rare complication of latent sphenoiditis – paresis of the abducens (VI) nerve. Another clinical example devoted to anosmia describes a rare mechanism of its development – traumatic, when falling back and hitting the surface with the back of the head. This mechanism can be explained by the detachment of olfactory fibers in the region of the cribriform plate of the ethmoid bone, which occurs due to the inertial displacement of the brain structures during a backward fall.
Publication date:
18.08.2022
Keywords:
neuroma, acoustic, early diagnosis, nasopharyngeal tumor, destructive nasal septum adenoma, granulating otitis externa, benign tumors of the auricle, lateral branchial (congenital) cysts of the neck, latent sinusitis, sphenoiditis, optochiasmal arachnoiditis, abducens (VI) nerve, t For citation:
Kiselev A. S., Vavilova A. A. Rare diseases in practice of otorhinolaryngologist of outpatient clinic. Some aspects of diagnostics. Rossiiskaya otorinolaringologiya. 2022;21(4):113-122. https://doi.org/10.18692/1810-4800-2022-4-113-122