Table Of ContentENT
ENT
FOURTH EDITION
MELISSA A. SCHOLES, MD
Assistant Professor
Department of Otolaryngology
University of Colorado
Aurora, CO
VIJAY R. RAMAKRISHNAN, MD
Assistant Professor
Department of Otolaryngology
Co-Director, CU Skull Base Program
University of Colorado
Aurora, CO
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ENT SECRETS, FOURTH EDITION ISBN: 978-0-323-29856-8
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Library of Congress Cataloging-in-Publication Data
ENT secrets / [edited by] Melissa A. Scholes, Vijay R. Ramakrishnan.—Fourth edition.
p. ; cm.—(Secrets series)
Includes bibliographical references and index.
ISBN 978-0-323-29856-8 (pbk. : alk. paper)
I. Scholes, Melissa A., editor. II. Ramakrishnan, Vijay R., editor. III. Series: Secrets series.
[DNLM: 1. Otorhinolaryngologic Diseases–Examination Questions. WV 18.2]
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2015009820
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PREFACE
ENT Secrets has been a learning tool used by medical students, residents, and health care providers
since the first edition, published in 1996 by Bruce Jafek and Anne Stark. Dr. Jafek went on to edit two
subsequent editions with the goal of sharing knowledge and insight in the field of otolaryngology. Our
newest edition aims to provide updates on that knowledge as well as introduce new concepts and
technologies in the ever-changing field of otolaryngology. We were fortunate to be residents under
Dr. Jafek, who loved teaching and training students of all types. We want to carry on that tradition with
this latest edition of ENT Secrets. This has been possible with the support of the University of Colorado
Otolaryngology Department faculty, alumni, and residents, and other contributors of this book. We
sincerely thank them.
v
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CONTRIBUTORS
Gregory C. Allen, MD, FACS, FAAP Daniel W. Bowles, MD
Associate Professor Assistant Professor
Departments of Otolaryngology—Head and Neck Department of Medicine
Surgery and Pediatrics University of Colorado School of Medicine
University of Colorado School of Medicine; Aurora, CO
Department of Pediatric Otolaryngology
Allison Brower, AuD, MS
Children’s Hospital Colorado
Department of Audiology
Aurora, CO
University of Colorado Hospital
Jeremiah A. Alt, MD, PhD Aurora, CO
Sinus and Skull Base Surgery Program
Mariah Brown, MD
Division of Otolaryngology
Assistant Professor
University of Utah
Department of Dermatology—Mohs Surgery
Salt Lake City, UT
University of Colorado School of Medicine
Marcelo B. Antunes, MD Aurora, CO
Private Practice
Cristina Cabrera-Muffly, MD, FACS
Northwest Facial Aesthetic Center
Assistant Professor
Marietta, GA
Department of Otolaryngology
Ronald Balkissoon, MD University of Colorado School of Medicine
Division of Pulmonology Aurora, CO
National Jewish Health
Thomas L. Carroll, MD
Denver, CO
Director
Renee Banakis Hartl, MD, AuD Voice Program
Department of Otolaryngology Brigham and Women’s Hospital;
University of Colorado School of Medicine Division of Otolaryngology
Aurora, CO Harvard Medical School
Boston, MA
Henry P. Barham, MD
Department of Otolaryngology—Head and Neck Justin Casey, MD
Surgery Department of Otolaryngology—Head and Neck
University of Colorado Surgery
Aurora, CO University of Colorado Hospital
Aurora, CO
Kenneth T. Bellian, MD, MBA
Assistant Professor Stephen P. Cass, MD
Department of Otolaryngology—Head and Neck Professor
Surgery Department of Otolaryngology
University of Colorado; University of Colorado Denver School of Medicine
Chief of Clinical Operations Aurora, CO
Denver Health Medical Center
Jeffrey Chain, MD
Denver, CO
Private Practice
Carly Bergey, MA, CCC-SLP Comprehensive ENT, Head and Neck Surgery
CCC-SLP- Rehabilitation Denver, CO
National Jewish Health
Denver, CO
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CONTRIBUTORS vii
Kenny H. Chan, MD Marcia Eustaquio, MD
Department of Otolaryngology Assistant Professor
University of Colorado School of Medicine; Department of Otolaryngology—Head and Neck
Department of Pediatric Otolaryngology Surgery
Children’s Hospital Colorado Denver Health Medical Center
Aurora, CO University of Colorado Denver
Denver, CO
Henry H. Chen, MD, MBA
Department of Otolaryngology Vincent Eusterman, MD, DDS
Facial Plastic and Reconstructive Surgery Associate Professor
Cedars-Sinai Medical Center University of Colorado School of Medicine;
Los Angeles, CA Director
Otolaryngology—Head and Neck Surgery
Tendy Chiang, MD
Denver Health Medical Center
Department of Otolaryngology—Head and Neck
Denver, CO
Surgery
The Ohio State University College of Medicine; Geoffrey R. Ferril, MD
Department of Pediatric Otolaryngology—Head Resident Physician
and Neck Surgery Department of Otolaryngology—Head and Neck
Nationwide Children’s Hospital Surgery
Columbus, OH Facial Plastic and Reconstructive Surgery
University of Colorado School of Medicine
Matthew S. Clary, MD
Aurora, CO
Department of Otolaryngology
University of Colorado School of Medicine Lindsay K. Finkas, MD
Aurora, CO National Jewish Health;
Department of Allergy/Immunology
Stacy Claycomb, AuD
University of Colorado Denver
University of Colorado Hospital
Denver, CO
Aurora, CO
Carol A. Foster, MD
Alexander Connelly, MD
Departments of Otolaryngology, Audiology, and
University of Colorado School of Medicine
Rehabilitative Medicine
Aurora, CO
University of Colorado Denver School of Medicine
Mark S. Courey, MD Aurora, CO
Department of Otolaryngology—Head and Neck
Norman R. Friedman, MD
Surgery
Department of Otolaryngology
Division of Laryngology
University of Colorado School of Medicine;
University of California, San Francisco
Department of Pediatric Otolaryngology
San Francisco, CA
Children’s Hospital Colorado
Brett W. Davies, MD, MS Aurora, CO
Oculoplastic and Orbital Surgery
Sandra Abbott Gabbard, PhD
San Antonio Military Medical Center/Wilford Hall
Associate Professor
San Antonio, TX
Department of Pediatrics
Allison M. Dobbie, MD Department of Speech, Language, Hearing
Department of Otolaryngology Sciences
University of Colorado School of Medicine; University of Colorado;
Department of Pediatric Otolaryngology President/CEO
Children’s Hospital Colorado Marion Downs Center
Aurora, CO Denver, CO
Vikram D. Durairaj, MD, FACS Anne E. Getz, MD
Oculoplastic and Orbital Surgery Department of Otolaryngology—Head and Neck
Director Surgery
ASOPRS Fellowship University of Colorado
Texas Oculoplastic Consultants Denver, CO
Austin, TX
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viii CONTRIBUTORS
Sarah A. Gitomer, MD Todd T. Kingdom, MD
Baylor College of Medicine Professor and Vice Chair
Bobby R. Alford Department of Otolaryngology— Department of Otolaryngology—Head and Neck
Head and Neck Surgery Surgery
Houston, TX University of Colorado School of Medicine
Aurora, CO
John C. Goddard, MD
Associate Ted H. Leem, MD, MS
House Ear Clinic; Department of Otolaryngology
Clinical Instructor University of Colorado School of Medicine
University of Southern California Aurora, CO
Los Angeles, CA
J. Eric Lupo, MD, MS
Julie A. Goddard, MD, FACS Clinical Fellow
Department of Otolaryngology—Head and Neck House Ear Clinic
Surgery Los Angeles, CA
University of California, Irvine
Jon Mallen-St. Clair, MD, PhD
Orange, CA
Department of Otolaryngology—Head and Neck
Elizabeth A. Gould, BA Surgery
Department of Otolaryngology University of California, Los Angeles
University of Colorado Los Angeles, CA
Aurora, CO
Scott Mann, MD
Leah J. Hauser, MD Assistant Professor
Department of Otolaryngology—Head and Neck Department of Otolaryngology
Surgery University of Colorado Denver School of Medicine
University of Colorado Aurora, CO
Aurora, CO
Jameson K. Mattingly, MD
Herman Jenkins, MD Department of Otolaryngology
Department of Otolaryngology University of Colorado School of Medicine;
University of Colorado School of Medicine Department of Pediatric Otolaryngology
Aurora, CO Children’s Hospital Colorado
Aurora, CO
Kristina L. Johnston, MA, CCC-SLP
CCC-SLP-Rehabilitation Brook K. McConnell, MD
National Jewish Health Department of Otolaryngology
Denver, CO University of Colorado School of Medicine;
Department of Pediatric Otolaryngology
Sana D. Karam, MD, PhD
Children’s Hospital Colorado
Department of Radiation Oncology
Aurora, CO
University of Denver Colorado
Aurora, CO Jessica D. McDermott, MD
Fellow
Rohit K. Katial, MD, FAAAAI, FACP
Division of Medical Oncology
Professor of Medicine
University of Colorado School of Medicine
Program Director, Allergy/Immunology
Aurora, CO
Director
Weinberg Clinical Research Unit Benjamin Milam, MD
Denver, CO Resident Physician
Department of Otolaryngology—Head and Neck
Peggy E. Kelley, MD
Surgery
Department of Otolaryngology
University of Colorado
University of Colorado School of Medicine;
Aurora, CO
Department of Pediatric Otolaryngology
Children’s Hospital Colorado David M. Mirsky, MD
Aurora, CO Pediatric Neuroradiologist
Children’s Hospital Colorado;
Assistant Professor of Radiology
University of Colorado
Aurora, CO
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CONTRIBUTORS ix
Paul Montero, MD Kavitha K. Prabaker, MD
Division of Gastrointestinal, Tumor, and Endocrine Instructor
Surgery Department of Internal Medicine
University of Colorado Hospital Division of Infectious Diseases
Aurora, CO University of Colorado School of Medicine
Aurora, CO
Pamela A. Mudd, MD
Assistant Professor Jeremy D. Prager, MD
Pediatric Otolaryngology Department of Otolaryngology
Children’s National Medical Center University of Colorado School of Medicine;
Washington, DC Department of Pediatric Otolaryngology
Children’s Hospital Colorado
Vignesh Narayanan, MD
Aurora, CO
Division of Medical Oncology
University of Colorado School of Medicine Craig Quattlebaum, MD
Denver, CO Resident Physician
University of Colorado
Stephen S. Newton, MD
Aurora, CO
Assistant Professor of Otolaryngology
University of Colorado; Jeevan B. Ramakrishnan, MD
Pediatric Otolaryngologist Raleigh-Capitol Ear, Nose, and Throat, P.A.
Children’s Hospital of Colorado Raleigh, NC
Colorado Springs, CO
Brianne Barnett Roby, MD
Sarah J. Novis, MD Department of Pediatric ENT and Facial Plastic
Department of Otolaryngology—Head and Neck Surgery
Surgery Children’s Hospitals and Clinics of Minnesota
University of Michigan St. Paul, MN;
Ann Arbor, MI Associate Professor
Department of Otolarynology
Matthew Old, MD, FACS
University of Minnesota
Assistant Professor
Minneapolis, MN
Department of Otolaryngology—Head and Neck
Surgery Victor I. Scapa, MD
The James Cancer Hospital and Solove Research Department of Otolaryngology—Head and Neck
Institute Surgery
Wexner Medical Center at The Ohio State Group Health Permanente
University Seattle, WA
Columbus, OH
Ameer T. Shah, MD
Richard R. Orlandi, MD Department of Otolaryngology—Head and Neck
Sinus and Skull Base Surgery Program Surgery
Division of Otolaryngology Tufts Medical Center
University of Utah Boston, MA
Salt Lake City, UT
Kaylee Skidmore, MA, CCC-SLP
Anju K. Patel, MD Speech Language Pathologist
Otolaryngology Resident Department of Rehabilitation
Department of Otolaryngology—Head and Neck University of Colorado Hospital
Surgery Aurora, CO
Tufts Medical Center
Franki Lambert Smith, MD
Boston, MA
Clinical Associate
Erik Peltz, DO Dermatology
Division of Trauma and Acute Care Surgery Mayo Clinic Health System-Franciscan Healthcare
University of Colorado Hospital La Crosse, WI
Aurora, CO
Daniel A. Pollyea, MD, MS
Division of Hematology
University of Colorado School of Medicine
Denver, CO
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