Otolaryngology ENT (MBBS: Course Outline

Practical skills

1. Use of the otoscope to examine the external auditory meatus and tympanic membrane.
2. Basic examination of the nose.
3. Examination of the oropharynx, nasopharynx and laryngopharynx.
4. Examination of the neck.
5. Management of nosebleed and oral bleeding.
6. Instill nose and ear drops/medication.
7. Take swab from ear, nose and throat.
8. Tuning fork tests
9. Dry mopping of eyes

EAR

1. Basic anatomy and physiology of the ear.
2. Common ear symptoms and their relationship with ear diseases e.g. otalgia, otorrhea, hearing loss, tinnitus, vertigo/dizziness.

External Ear:

1. Congenital abnormalities, Pre-auricular sinus, Trauma topinna/hematoma, Perichondritis of the auricle, Atresia : Congenital and Acquired Wax ear, Keratosis obturans, Foreign bodies in the ear, Otitis externa, : Furunculosis, Otomycosis, Malignant Otitis Externa.
2. Benign tumours of the external ear Osteoma/ exostosis, Malignant Tumours of the external ear: Squamous cell carcinoma, Basal cell carcinoma

MIDDLE EAR:

1. Perforation of tympanic membrane
2. Eustachian tube dysfunction
3. Acute Suppurative otitis media
4. Serous otitis media
5. Chronic Suppurative otitis media
6. CSOM without cholesteatoma
7. CSOM with Cholesteatoma
8. Complications of otitis media
9. Extra-cranial complications
10. Intra-cranial complications
11. Conductive deafness; differential diagnosis
12. Otosclerosis

INNER EAR:

1. Sensorineural hearing loss be able to differentiate between different causes
2. Meniers disease, Ototoxicity, Assessment of a deaf child
3. Vertigo: differential diagnosis

Tinnitus

1. Facial nerve paralysis: Differential diagnosis of and its treatment.
2. Temporal bone fractures
3. The principles of Myringotomy/grommet insertion, tympanoplasty and mastoidectomy
   • Clinical Skills:
4. Examination of the ear including the pinna, ear canal and otoscopy. Demonstrate examination under microscopy (EUM).
5. Facial nerve examination
6. Testing hearing with tuning fork (Rinne‟s test, Weber test, ABC test) and audiometry.
7. Assessment of Vestibular System: Nystagmus, Fistula test, Romberg‟s test and Caloric test
8. Presentation and management of common ear disease e.g. otitis externa, otitis media, glue ear, chronic suppurative otitis media with or without cholesteatoma, vertigo, otosclerosis and Meniere‟s disease, and facial palsy.
9. Identifying postoperative problems following ear surgery i.e. sensorineural hearing loss, facial nerve palsy, and vestibular dysfunction.

· Investigations:

1. Radiology Plain, CT scan, MRI
2. Audiological:. Pure tone audiometery / impedance audiometery,

NOSE

1. Anatomy and physiology of the nose.
2. History of the Symptoms: Nasal obstruction, Rhinorrhea, Sneezing,Epistaxis, Postnasal drip, Headache and facial pain. Rhinolalia, Disturbances of smell, Snoring, Nasal Deformity.

Clinical examination

1. Examination of the nose including an assessment of the appearance, the septum, the turbinates, and the mucosa.
2. External nose, internal nose, postnasal space examination, rigid/ flexible endoscopy of nose and postnasal space.
3. Know the principles of management of a fractured nose and the timing of intervention.
4. To understand the principles of common nasal operations including septal surgery, functional endoscopic sinus surgery, and rhinoplasty.
5. Investigations: Plain radiology, CT Scan,Congenital Malformations of nose and paransal sinuses.

Choanal atresia.

1. Nasal and Facial Trauma: Fracture Nasal Bones, Le Fort fractures
2. (introduction only), Blow-out fracture of Orbit
3. Rhinorrhea / Rhinitis
4. Allergic (Seasonal, Perennial, Occupational
5. Infective; Acute, Chronic
6. Others; Idiopathic, NARES (non-allergic rhinitis with eosinophilia -Drug-induced, Vasomotor, Atrophic), Nasal granulomas
7. CSF Rhinorrhea: diagnosis and basic management
8. Epistaxis
9. Sinusitis
10. Acute Sinusitis, Chronic Sinusitis, Complications of Sinusitis
11. Fungal rhinosinusitis
12. Septal Conditions
13. Deviated nasal septum (DNS), Septal Haematoma, Septal Abscess,
14. Septal Perforation
15. Foreign bodies of nose
16. Rhinolith, Maggots

Polyps

1. Ethmoidal Polypi, Antrochoanal polypus, Bleeding polypus
2. Tumours Nose and Paranasal Sinuses
3. External nose:
4. Nasal Dermoid
5. Basal Cell carcinoma and
6. Squamous cell carcinoma
7. Sinu-nasal tumours:
8. Benign: Inverted papilloma, Osteoma, Hemangioma,
9. Malignant: Squamous cell carcinoma, Adenocarcinoma, Staging of sinu-nasal tumours
10. Nasopharynx
11. Nasopharyngeal angiofibroma, Nasopharyngeal carcinoma and lymphoma
12. Headache and facial pain
13. Proptosis related to ENT Disorders
14. Introduction to Endoscopic Sinus Surgery
15. HEAD AND NECK – benign and malignant conditions
16. The basic anatomy and physiology of the oral cavity, salivary glands, pharynx, larynx, oesophagus, and their lymph node drainage.
17. The presentations of head and neck cancer.
18. History for common symptoms and diseases in otolaryngology
19. Hoarseness, Stridor, hemoptysis and breathlessness Oesophageal disease
20. Examination of the oral cavity, larynx and pharynx including the use of
21. the nasendoscopy
22. Examining the neck with reference to lumps, masses and lymph nodes.
23. The role of fine needle aspiration cytology (FNAC).
24. The principles and limitations of radiological investigations of the head and neck region.
25. The management of the airway in patients with a tracheostomy or end tracheostomy after laryngectomy.
26. The postoperative management of a patient who has undergone major head and neck surgery.
27. The role of the multidisciplinary team in head and neck cancer and voice disorders.
28. Assessment of post tonsillectomy bleeding.