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Inhoudsopgave3.1 Aandoeningen van de oorschelp..............................................................................................................................7
3.1.1 Congenitale afwijkingen.....................................................................................................................................7
3.1.2 Traumata............................................................................................................................................................7
3.1.3 Ontstekingen......................................................................................................................................................8
3.1.4 Tumoren.............................................................................................................................................................8
3.2 Aandoeningen uitwendige gehoorgang.....................................................................................................................9
3.2.1 Congenitale afwijkingen...................................................................................................................................10
3.2.2 Oorstop (oorsmeerprop)..................................................................................................................................10
3.2.3 Corpus alienum (= vreemd voorwerp)..............................................................................................................10
3.2.4 Ontstekingen....................................................................................................................................................10
3.2.5 Degeneratie en metabole aandoeningen.........................................................................................................12
3.2.6 Aandoeningen met onbekende oorzaak...........................................................................................................12
3.2.7 Tumoren...........................................................................................................................................................12
3.3 Aandoeningen uitwendige oor op kinderleeftijd.....................................................................................................12
3.3.1 Afstaande oren of flaporen...............................................................................................................................12
3.3.2 Congenitale atresie en microtie van het oor....................................................................................................13
4.1. Congenitale/aangeboren afwijkingen.....................................................................................................................14
4.2. Ontstekingen + complicaties..................................................................................................................................14
4.2.1 Myringitis (ontsteking trommelvlies)................................................................................................................14
4.2.2 Otitis media......................................................................................................................................................14
4.2.3 Acute otitis media (AOM).................................................................................................................................15
4.2.4 Otitis media met effusie (OME)........................................................................................................................16
4.2.5 Chronische otitis media....................................................................................................................................18
4.2.6 Chronische otitis media met cholesteatoom....................................................................................................18
4.2.7 Resttoestanden na otitis media........................................................................................................................19
4.3 Trauma.................................................................................................................................................................... 19
4.3.1 Penetrerend trauma.........................................................................................................................................19
4.3.2 Schedelbasistrauma..........................................................................................................................................19
4.4 Otosclerose..............................................................................................................................................................20
4.4.1 Klinisch beeld....................................................................................................................................................20
4.4.2 Onderzoek........................................................................................................................................................20
4.4.3 Behandeling......................................................................................................................................................21
4.5 Reconstructieve middenooroperaties.....................................................................................................................21
4.5.1 Middenoorbeluchting (trommelvliesbuisjes)....................................................................................................21
4.5.2 Herstel van trommelvlies (myringoplastiek, tympanoplastiek)........................................................................21
4.5.3 Ketenreconstructie...........................................................................................................................................21
4.5.4 Stapeschirurgie (stapedotomie, stapedectomie)..............................................................................................21
,4.6. Tumoren van middenoor en mastoid (niet in detail kennen).................................................................................21
5.1 Inleiding................................................................................................................................................................... 22
5.2 Erfelijk gehoorverlies...............................................................................................................................................22
5.2.1 Niet-syndromaal erfelijk verlies: DFN...............................................................................................................23
5.2.2 Syndromaal erfelijk verlies................................................................................................................................23
5.2.3 Chromosomale afwijkingen met gehoorverlies................................................................................................25
5.3 Congenitaal niet-erfelijk perceptief verlies..............................................................................................................25
5.4 Verworven perceptief gehoorverlies.......................................................................................................................26
5.5 Tinnitus.................................................................................................................................................................... 29
5.6 Niet-organische vormen van gehoorverlies.............................................................................................................30
7.1 Inleiding................................................................................................................................................................... 31
7.2 Anamnese................................................................................................................................................................31
7.1.1 Vestibulaire klachten........................................................................................................................................31
7.3 Neuro-otologisch onderzoek...................................................................................................................................32
7.4 Differentiaaldiagnose..............................................................................................................................................32
7.5 Continue rotatoire vertigo.......................................................................................................................................33
7.5.1 Neuritis vestibularis..........................................................................................................................................33
7.5.2 Hersenstam CVA...............................................................................................................................................34
7.6 Eenzijdige, spontaan wisselende disfunctie.............................................................................................................35
7.6.1 Ziekte van Menière (MD)..................................................................................................................................35
7.6.2 Vestibulaire migraine........................................................................................................................................39
7.7 Paroxismale positionele vertigo...............................................................................................................................39
7.7.1 Benigne paroxismale positioneringsduizeligheid (BPPD/BPPV)........................................................................39
7.7.2 Vestibulair Paroxisme.......................................................................................................................................42
7.8 Frequente aanvallen van duizeligheid of instabiliteit..............................................................................................42
7.8.1 Binnenoorfistels................................................................................................................................................42
7.8.2 Superiot Semicirculair Canal Dehiscence (SSCD)...............................................................................................44
7.9 Posturale instabiliteit zonder neuro-symptomen....................................................................................................45
7.9.1 Bilaterale Vestibulopathie (BV).........................................................................................................................45
7.9.2 Persisterende Posturale Perceptuele Duizeligheid (PPPD)...............................................................................46
7.10 Eenzijdig langzaam progressieve uitval.................................................................................................................47
10.1. Vestibulair schwannoom..................................................................................................................................47
7.11 Behandelingen.......................................................................................................................................................48
7.11.1 Causale behandeling.......................................................................................................................................48
7.11.2 Symptomatische behandeling........................................................................................................................48
7.12 Motion Sickness.....................................................................................................................................................49
8.1 Inleiding................................................................................................................................................................... 50
8.2 Klinische anatomie..................................................................................................................................................50
8.2.1 Verloop.............................................................................................................................................................50
, 8.2.2 Aftakkingen.......................................................................................................................................................51
8.3 Gevolgen facialis uitval (belangrijk!)........................................................................................................................51
8.4 Anamnese................................................................................................................................................................52
8.5 KNO-onderzoek.......................................................................................................................................................52
8.5.1 Onderzoek facialisfunctie.................................................................................................................................52
8.5.2 Aanvullend onderzoek......................................................................................................................................52
8.5.3 Niet-invasieve therapie bij iedere facialis parese.............................................................................................53
8.6 Oorzaken................................................................................................................................................................. 53
8.7 Chirurgische behandeling........................................................................................................................................55
8.7.3 Reconstructie in acute fase...............................................................................................................................55
8.7.4 Reconstructie in chronische fase......................................................................................................................55
8.7.5 Statische technieken.........................................................................................................................................56
8.7.6 Adjuvante behandeling.....................................................................................................................................57
12.1 Aangeboren afwijkingen........................................................................................................................................58
12.2 Septumdeformaties...............................................................................................................................................58
12.3 Uitwendige neusdeformaties................................................................................................................................58
12.4 Ontstekingen vestibuli nasi....................................................................................................................................59
12.5 Rinitis – classificaties.............................................................................................................................................59
12.6 Infectieuze rinitis...................................................................................................................................................60
12.7 Allergische rinitis...................................................................................................................................................60
12.8 Niet-allergische, niet-infectieuze rinitis.................................................................................................................61
12.9 Atrofische rinitis en ozaena...................................................................................................................................62
12.10 Nasaal liquorlek...................................................................................................................................................62
12.11 Corpus alienum....................................................................................................................................................62
12.12 Tumoren..............................................................................................................................................................62
12.13 Reukstoornissen..................................................................................................................................................62
12.14 Traumatische neusafwijkingen............................................................................................................................63
12.15 Neusbloeding (epistaxis)......................................................................................................................................64
13.1 Rinosinusitis...........................................................................................................................................................65
13.2 Retentiecysten en mukokèles................................................................................................................................67
13.3 Ontwikkelingsstoornissen......................................................................................................................................67
13.4 Benigne tumoren...................................................................................................................................................67
13.5 Maligne tumoren...................................................................................................................................................68
13.6 Auto-immuun tumorachtige processen.................................................................................................................68
13.7 Traumata en fracturen..........................................................................................................................................68
16.1 Inleiding.................................................................................................................................................................69
16.2 Afwijkingen van het gebit......................................................................................................................................69
16.2.1 Doorbraakstoornissen....................................................................................................................................69
16.2.2 Cariës en de mogelijke gevolgen:...................................................................................................................69
, 16.3 Aandoeningen van het tandvlees..........................................................................................................................69
16.3.1 Gingivitis en parodontitis................................................................................................................................69
16.2.2 Zwellingen van het tandvlees.........................................................................................................................70
16.3 Afwijkingen van het mondslijmvlies......................................................................................................................70
16.3.1 Ulceraties........................................................................................................................................................70
16.3.2 Witte afwijkingen:...........................................................................................................................................71
16.3.3 Rode afwijkingen............................................................................................................................................72
16.3.4 Pigmentaties...................................................................................................................................................72
16.3.5 Zwellingen......................................................................................................................................................72
16.4 Enkele tongaandoeningen.....................................................................................................................................74
16.4.1 Beslagen tong en haartong.............................................................................................................................74
16.4.2 Fissuurtong (lingua fissurata)..........................................................................................................................74
16.4.3 ‘Harige’ leukoplakie bij HIV – infectie/ aids....................................................................................................74
16.4.4 Landkaarttong (lingua geographica)...............................................................................................................74
16.4.5 Glossitis rhomboidea mediana.......................................................................................................................74
16.4.6 Glossodynie....................................................................................................................................................75
17.1 Onderzoeksmethoden...........................................................................................................................................76
17.1.1 Klinisch onderzoek..........................................................................................................................................76
17.1.2 Beeldvormende diagnostiek...........................................................................................................................77
17.2 Aandoeningen van de nasofarynx.........................................................................................................................77
17.2.1 Congenitale afwijkingen:................................................................................................................................77
17.2.2 Ontstekingen..................................................................................................................................................77
17.2.3 Benigne tumoren............................................................................................................................................78
17.3 Aandoeningen van de orofarynx...........................................................................................................................78
17.3.1 Congenitale afwijkingen:................................................................................................................................78
17.3.2 Ontstekingen..................................................................................................................................................79
17.3.3 Benigne tumoren............................................................................................................................................81
17.4 Aandoeningen van de hypofarynx.........................................................................................................................81
17.4.1 Verbrandingen en etsingen............................................................................................................................81
17.4.2 Globus.............................................................................................................................................................81
18.1 Onderzoeksmethoden...........................................................................................................................................83
18.1.1 Inspectie & palpatie........................................................................................................................................83
18.1.2 Indirecte laryngoscopie..................................................................................................................................83
18.1.3 Inspectie met optieken...................................................................................................................................83
18.1.4 Stroboscopie...................................................................................................................................................83
18.1.5 Directe (mirco)laryngoscopie..........................................................................................................................83
18.1.6 Tracheobronchoscopie...................................................................................................................................83
18.1.7 Beeldvormende diagnostiek...........................................................................................................................83
18.1.8 Beoordeling en onderzoek van de stem.........................................................................................................83
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