Proof puncture is done through ?
Ans. is 'c' i.e., Inferior meatus Proof functure (Antral puncture) This procedure involves puncturing the medial wall of maxillary sinus in the region of inferior meatus and irrigating the sinus. Indications 1. Chronic and subacute maxillary sinusitis with dual purpose of : Confirming the diagnosis and Washing out the pus 2. To collect the specimen of the antral contents for culture and sensitivity, or cytological examination to exclude early malignancy. Contraindications Children less than 12 years of age. Acute maxillary sinusitis as it may lead to osteomyelitis Fracture of maxilla as fluid may pass through fracture line. Diabetes hearing it. The examiner then says that he is going to repeat the test, but puts a non-vibrating fork on the mastoid while at the same time bringing a vibrating fork close to the auricle. If the patient is malingering, he will hear the tuning fork through air conduction, but think that it is being heard through the bone. If he is really deaf he will not hear the fork. 3. Lomard's test This depends upon the fact that to the normal man the sound of his own voice is necessary for the proper regulation of its tone and loudness. The Barany noise apparatus is adjusted to the patient's sound ear and its machinery staed in order to accustom him to its grating noise. He is given a book, and told to read aloud in his normal voice and not to stop reading when the instrument is set in action. As soon as the noise begins, a man whose opposite ear is profoundly deaf will at once raise his voice and, if his deafness is absolute, may literally shout. The malingerer, on the other hand, claiming a one-sided deafness which is not real will continue to read in an even tone or in a tone only slightly elevated. 4. Acoustic reflex (stapedial reflex threshold) If stapedial reflex is present, it rules out NOHL because stapedial reflex is not in voluntary control. 5. Electric response audiometry (ERA) or coical evoked response audiometry It is very useful in NOHL and can establish hearing acuity of the person to within 5-10 dB of actual thresholds. 6. Other tests Gault test, Erhard's test, delayed speech feedback.
Superior meatus
Middle meatus
Inferior meatus
Sphenoethmoidal recess