Crowe-Beck test is positive in
Correct Answer: Lateral sinus thrombophlebitis
Description: Ans. c (Lateral sinus thrombophlebitis) (Ref. PL Dhingra ENT 2nd ed., 89)LATERAL SINUS THROMBOPHLEBITIS (SIGMOID SINUS THROMBOSIS)# A lateral sinus thrombosis may occur with an infected cholesteatoma.Clinical Features# Characteristic high spiking fever with rigors and a "picket-fence" pattern; Headache; anaemia and emaciation# Signs and test:- Pappilloedema- Griesinger's sign: Pain, redness, and swelling of tip of mastoid due to involvement of the mastoid emissary veins.- Tobey-Ayer test- Lillie-Crowe-Beck test: is used to diagnose unilateral lateral sinus occlusion (Digital compression of the opposite internal jugular vein causes retinal veins to dilate, as the major venous outflow tracts on both sides now blocked).- Tendreness along jugular vein# CECT: Empty delta sign: CT sign of dural venous sinus thrombosis / superior sagittal sinus, where contrast outlines a triangular filling defect (clot).# MR venogram is the best investigation (IOC) for diagnosis# Rx: It is treated like a lateral sinus thrombosis in association with acute coalescent mastoiditis. If the cholesteatoma is extensive, a CWD mastoidectomy should be performed.OTITIC HYDROCEPHALUS# It is defined as T intracranial pressure secondary to acute or chronic middle ear infection without evidence of meningitis or subdural or brain abscess.# It characteristicallx presents as headache and lethargy in a patient with an ear infection.# MRI easily identifies sigmoid sinus thrombosis with total occlusion.# Papilledema is almost always present; however, papilledema is not always an adequate predictor of - intracranial pressure.# Treatment of otitic hydrocephalus requires:- mastoidectomy appropriate for the disease,- exposure of all diseased dura to normal dura, and- removal of excess extradural granulation tissue.Also Know:ABLE test of fowlerTo test + recruitment as in meneier's diseaseBing test and Chamini moss testTuning fork test to detect hearing lossCrowe Beck testLateral sinus thrombosisTobey Ayer (Queckenstedt's) testLateral sinus thrombosisDoerfier Stewart test, Erhard's test, Gault's testTo detect malingering.
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