A 45-year-old patient presents with conductive hearing loss, facial pain in temporoparietal and the lower jaw area, and immobile soft palate on the right side. The probable diagnosis is:
Correct Answer: Trotter's syndrome
Description: Trotter's syndrome or triad which is due to nasopharyngeal carcinoma consists of:(i). Conductive hearing loss due to eustachian tube obstruction.(ii). Ipsilateral immobility of palate.(iii). Neuralgic pain in distribution of mandibular division (V3 ) due to spread of growth laterally through sinus of Morgagni to involve (V3 ). Costen syndrome consists of ear pain, blocked ear and tinnitus. It is due to abnormality of TM joint caused by defective bite.Sluder's neuralgia is due to neuralgia of sphenopalatine ganglion (V2 ) causing pain in the lower half of face but there is, in addition, congestion of nose, watering of eyes and rhinorrhoea.Wallenberg's syndrome due to thrombosis of posterior-inferior cerebellar artery leading to ischaemia of lateral pail of medulla. It causes:Vertigo- Vestibular nucleusAnaesthesia of ipsilateral side of face- Nucleus and descending tract of CN VParalysis of palate, pharynx and larynx- Nucleus ambiguousHorner's syndrome- Preganglionic sympathetic fibresContra lateral anaesthesia of the body- Crossed lateral spinothalamic tract
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ENT
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