Instruments

Saturday, April 02, 2022 11:02 AM

Adenotonsillectomy
Name Lac's tongue depressor
Parts It's a 'L' shaped instrument with flat and curved
ends.
Examiner holds the instrument at curved end, placing the
flat end at junction anterior two thirds and posterior one
third of the tongue (if anterior to this position a bulge will
prevent proper visualization, if posterior it will initiate gag
reflex).
Primary use • Examination of oral cavity and oropharynx
• For posterior-rhinoscopy (as an adjunct)
• Cold spatula test.
• Check postnasal bleeding.
• Cheek retraction
• Checking out for loose-teeth
• During intraoral surgical procedures.
• Soft-palate retraction using curved end.
Sterilization

Name Maguaran plate

Parts
Primary use
Secondary use
Sterilization

Name Draffin's metallic bipods & Maguaran plate

Parts Consists of two stands with ring to adjust the height.
Primar To fix the Boyle-Davis Mouth gag to the operation table.
y use During tonsillectomy and other operations in the throat but not used
in adenoidectomy operation to prevent excessive extension in the
atlanto- occipital joint preventing atlanto-occipital joint dislocation.
Sterili
zation

Name Boyle-Davis mouth gag

Parts 1. Tongue blade (by Boyle an anaesthesiology)
2. Jaw piece (Davis mouth gag)
Primary use (a) In dissection method of tonsillectomy
(c) Operations of the palate and the nasopharynx
(c) Operation in the pharynx
(d) Adenoidectomy
(e) Craniovertebral anomalies

Complications Injury to the incisor tooth, injury to the lip and angle of
mouth.
Sterilization

Name St.Clair Thompson's adenoid curette with guard

Parts Two varieties:
l. With cage
2. Without cage
Available in 6 sizes approximately 8, 10, 12, 14,
16 and 18 mm blade.
Primar It is used in adenoidectomy operation.
y use • The instrument is held in dagger holding fashion.
• The cage will prevent the tissue from slipping into the
nasopharynx or larynx.
• The one without cage is used to remove tissue around the
eustachian tube as the cage can injure the E-tube.
• While doing adenoidectomy neck of the patient should be flexed
to avoid atlanto-occipital joint subluxation.
• Another precaution to avoid injury is to bring the adenoid tissue
by a palpating finger from lateral wall to the midline at the onset
of surgery and keeping line of dissection strictly in the midline.
Sterili
zation

Name Denis Brown tonsil holding forceps

Parts • Has got a box joint, angular instrument
• Two sizes: Large and small
Primary Used to hold tonsil and pull inwardly during
use dissection method of tonsillectomy. Because of its special
configuration less tissue trauma while holding the tonsil.
Steriliza
tion

Name Mollisoni's tonsil Dissector and Anterior Pillar Retractor

Parts Double ended, one for retraction of anterior pillar, other for
dissection.

Primary In tonsillectomy (dissection method).

use • Pillar retractor used in the beginning of tonsillectomy to
visualize the tonsil specially in fibrosed tonsil.
• Anterior pillar retractor will give a better view of the tonsil to
grasp the tissue with tonsil holding forceps.
• Also same part of the instrument is used after tonsillectomy to
retract the anterior pillar to visualize the bleeding point or to
see the remnant of tonsillar tissue.
• The dissecting part is used to dissect the tonsil out of tonsillar
fossa after the mucosal incision.
Steriliz
ation

Name Eve's tonsillar snare

Parts A loop is attached at one end has Ratchet action whereas other
end has a thumb ring for better grip.
Primary To snare out the lower pole of the tonsil at the end of dissection
use method.
Advanta Minimize the bleeding by crushing the vascular pedicle not cutting
ges unlike scissors.
It also helps in early hemostasis by release of tissue CUTTING AND CRUSHING ACTION)
thromboplastin factor (external pathway of coagulation cascade)
due to crushing of blood vessels at lower pole.
Steriliza
tion

Name Tonsil dissector forceps with teeth (Waugh's tenaculum)

Parts
Primary use Used during dissection of tonsils.
It can also be used in catching bleeding points and putting
swabs.

Sterilization

Name Yankauer suction tube

Parts Blunt end - atraumatic suction
Primary Used to remove blood clot from the operating field during
use tonsillectomy, adenoidectomy and oral and oropharyngeal
surgeries.
Steriliza
tion

Name Tonsillar artery forceps

Parts 2 types
1. Birkett's Straight artery forceps
2. Curved/replacement forceps
Primary use • Straight are used to catch bleeding points
• Curved are used as replacement forceps before tying with a
ligature
Sterilizatio
n

Name Negus artery forceps/ replacement forceps

Parts Sharply curved tip
Primary Use to replace the straight artery forceps after grasping the soft
use tissue around the tip of straight artery forceps.
Advanta Because of curved tip, it is easier to slip the knot around it for
ge ligating the bleeding vessel at a depth and ligature will not slip out
during tying due to its curved tip.
Steriliza
tion

Nasal septum proper

Name Thudiculum speculum/
St.Claire Thomson nasal speculum (has longer
blades than thudiculum speculum)
Parts A U-shaped holding part with curved blunt
blades directed at right angles to the U handle.
Primary Diagnostic: Anterior rhinoscopy to observe:
use • Nasal septum
• Little's area
• Lateral wall of the nose
• Floor of the nose
Therapeutic
• Removal of foreign bodies
• Antral wash
• For initial step of polypectomy, SMR and
septoplasty.
Steriliza Boiling
tion

Name Killians's long-bladed self-retaining nasal

speculum
Parts Long nasal blades and a screw for self-retaining
Primary Diagnostic: to examine the deeper structures of
use the nasal cavity including middle meatus.
Therapeutic
l. Use in SMR and septoplasty to retract the
mucoperiosteum
2. Polypectomy
3. Foreign body removal
4. Anterior nasal packing
5. Excision of rhinosporidiosis.
Advanta • Self retaining mechanism.
ges • Blades are adjustable and fixed in particular
position with the help of screw, during the
operation causing less strain to surgeons
hand.
Steriliza
tion

Name Freer's double-ended elevator

Parts It is a long slender instrument with central
holding part and two curved flat ends. One end is
sharp and the other is blunt.
Primary • periosteal elevation
use • septoplasty for mucoperichondrial &
mucoperiosteal elevation.
• FESS to identify uncinate process, middle
meatal opening and bulla.
• To separate temporalis fascia in myringoplasty
Steriliza
tion

Name Turbinectomy scissors

Parts It has a bend at the center with narrow stout
blades and blunt tip.
Primary • For partial and total inferior turbinectomy
use • For septal spurectomy (Endoscopic)
Advantage The bend of the scissors, offers better field
s of vision.
Sterilizati
on

Name Blakesly nasal forceps

Parts Various types of Blakesly forceps are cutting
forceps available like straight, 30° upturn, 45°
upturn, 70° upturn, 90° upturn in different sizes.
Primary They are used in endoscopic sinus surgeries for
use grasping and removal of tissue including polyps.
Steriliza
tion

Name Through cut nasal forceps

Parts
Primary use
Secondary use
Sterilization

Nasal fractures
Name Walsham's forceps
Parts Handle, blades with flat and blunt tips and a
screw joint.
Primary use For disimpaction of fractured nasal bones.
Rubber covering of the tip prevents injury to
the skin.
Sterilizatio
n

Name Asch's septum forceps

Parts Similar to Walsham's forceps but both the
blades are curved to enclose a space when blades
are closed, so to prevent crush injury to septum.
Primary • To reposition the displaced septum following
use trauma.
• Used for reducing fractures of nasal septum.
Steriliza
tion

Name Tilleys nasal pacing forceps

Parts Two ring shaped finger grip handles and two long
slender blades with transverse serrations at flat
straight tip.
It has a bend, so that hand Of the surgeon does
not obscure the view of nasal cavities.
Primary • For nasal packing
use • Removal of foreign bodies
• For inserting cottonoids.
Steriliz
ation

Name Hartman's forceps https://en.wikipedia.org/wiki/File:Hartmann-Zange-Funktion.webm

Parts Shape of the tip is larger, oval and serrated
Primary use • For nasal packing
• Removal of foreign bodies
• For inserting cottonoids.
Sterilization

Name luc's forceps

Parts It has got a long arm and a short arm for better
grip. The forceps has got a bend.
Primary • Septoplasty for removal of bony septum
use • SMR for removal of cartilaginous and bony
septum
• As a substitute for tonsil holding forceps
• To remove left over tags after adenoidectomy.
• To remove polyps
• Punch biopsy
• Excision of angiofibroma and other benign
tumor.
Steriliza
tion

Tracheostomy
Name Tracheal hook
Parts Sharp and blunt
Handle and curved tip
Primary use Blunt hook is used to retract the isthmus of
thyroid gland to expose tracheal wall.
Sharp hook is used to retract cricoid cartilage
by hooking at its lower border to stabilize trachea
before making incision.
Sterilization

Name Troussean's tracheal dilator

Parts It is similar to curved artery forceps, but Stout,
cross action blades without lock mechanism
(in case of an artery forceps while closing the
handle the tip closes , but in dilator the tip opens,
while closing the handle. Blades are curved with
blunted tips (atraumatic).
Primary use For dilatation of tracheostomy opening at surgery
to facilitate insertion of tracheostomy tube and
also during tracheostomy tube changing.
Sterilization

Name Chevaiier-Jackson's Tracheostomy Tube

Parts It is made of German silver.
Outer tube • Lock mechanism for inner tube
• Holes on either side for straps
• Shield for protection.
Inner tube •Longer than outer tube to
prevent outer tube blocking.
Obturator • Guides the tube insertion.
Primary use
Advantages Speaking valve can be used with the metal tube.
Sterilization

Ear
9 Mollisons self-retaining hemostatic mastoid retractor

In mastoid surgeries to retract soft tissues after incision

and elevation of flaps.

Ear speculum

Name Farabeuf's mastoid periosteal elevator

Parts • Made up of stainless steel
• Has a cutting edge
Primary use To elevate the periosteum in mastoidecomy.
Sterilization

Name all tuning forks The 512 Hz tuning fork is commonly used for the
Parts Commonly used : 256 Hz, 512 Hz, 1024 Hz following reasons.
a. It is present in the mid speech frequency range
• Prongs
• Shoulder b. Overtones are minimal
c. Sound is more auditory than tactile in nature
Base
Stem d. Tone decay is optimal.
Footplate
Primary use In tuning fork tests viz. Rinne's test, Weber's
test, absolute bone conduction test.
• Type of heaaring loss
• Approximate degree of hearing loss
Sterilization

Name oesophagoscope
Parts
Primary use Diagnostic
• Malignancy of esophagus
• FB in oesophagus
• Cadiospasm
• Stricture of the esophagus
• Tracheoesophageal fistula
• Take biopsy from the esophageal lesion under
direct vision
Therapeutic
• Removal of esophageal foreign body
• To guide bougies through the esophageal
stricture
• To pass the M.B.tube CI for all scopys
• Esophageal stenting to overcome obstruction Aortic aneurysm
and treatment of fistula Severe Trismus
• Injection of sclerosing agent in esophageal Cervical spondylosis
varices
Prognostic
To follow up the patient after definitive therapy
Sterilization

Name laryngoscope
Parts
Primary use Diagnostic
• For detailed examination of the hypopharynx;
and larynx
• For biopsy
Therapeutic
• Removal of foreign body
• Excision of benign tumor or nodule from the
Handle - held with left hand vocal cord.
Suction - right hand
Sterilization

Name Bronchoscope
Parts Types
• Chevalier Jackson
• Negus type
• Fiberoptic
Negus type — Proximal illumination
C. Jackson type — Distal illumination
Sizes Available
Pediatric: 2.4 / 3.5 / 4.5
Adults: 6.5 / 7.5 / 8.5
Primary use Diagnostic
• To examine the bronchial tree for any
pathological changes
• Take biopsy from a suspected site and
collect bronchial secretions.
Therapeutic Bronchoscope can be used for esophagoscopy but
• Removal of foreign bodies in bronchus esophagoscopes cannot be used for bronchoscopy due to
• Bronchial aspiration to remove viscid, absence of vents for aeration
purulent secretions.
• Tracheal and bronchial stenting
Sterilization