OTORHINOLARYNGOLOGY COURSE DESCRIPTION a) Goals The goal of training in this subject is to make the candidate familiar with common problems, He should be competent enough to diagnose and treat routine problems. He should be in 2 position to identify the cases, which require specialist care and identify the deaf individuals at the earliest and refer them for proper rehabilitation. b) Objectives At the end of the course, the student should be able to Knowledge 1. Describe surgical anatomy and physiology of Ear, Nose and Throat and Head and Neck 2. Describe basic Patho-Physiology of common ear, nose and throat diseases and emergencies 3, Suggest common investigative procedure and their interpretation 4, Describe common infective conditions of ENT and treat them. 5, Identify congenital deafness as early as possible Skills 1, _ Examine and diagnose common disorders of the Ear, Nose and Throat region and manage at first level of care. 2, Recognize premalignant and malignant cases of head and neck region at an carly stage 3. Remove foreign bodies in the ear and nose 4, Perform life saving surgical procedures like tracheostomy. 5, Should be familiar with drainage of intra oral and neck abscesses, 6, Able to do anterior and posterior nasal packing, to control epistaxis. Integration ‘Neurosurgery ~ Knowledge of intracranial complications caused by diseases of ENT region (meningitis, intracranial abscess, cavernous sinus thrombophlebitis) Ophthalmology ~ Knowledge of orbital complications of sinonasal disease. General Surgery ~ General princip . of surgical management like wound healing, acid base balance, blood transfusion and sterilization. 9c) Course Contents Diseases of the Ear Surgical anatomy ; external, middle and inner ear. Physiology of hearing and vestibular function. Examination of the Ear : Tuning Fork tests, hearing assessment in children ~ broad outline, referred pain in the ear, otalgia, tinnitus. Deafness ; Types and causes Diseases of the external ear perichondritis, otitis externa, cerumen, foreign body, furunculosis, keratosis. Diseases of middle ear ; Acute and Chronic suppurative otitis media, Obturans, Otitis media with effusion, Otosclerosis, Cholesteatoma. Audiometry — pure tone Functional examination of inner eat (vestibule): caloric test, positional nystagmus test Deaf mutism Meniere’s disease. Complications of otitis media: Mastoiditis (acute and chronic), lateral Sinus thrombosis, labyrinthitis, otogenic brain abscess. Mastoidectomy- principles Tumours of the ear- Glomus, Acoustic neuroma. Diseases of ¢ and Para nasal sinuses (PNS) ‘Surgical anatomy and physiology of nose and P.N.S including olfaction. Congenital diseases of the Nose, Cleft lip and Palate and Choanal Atresia Diseases of external nose ~ furunculosis, vestibulitis, Rhinophyma, rodent ulcer, ‘Trauma, nose & PNS - fracture of nasal bones, blowout fracture of orbit, fracture of maxilla with Leforte’s classification. Foreign body in the nose — Classification of foreign bodies & management of animate and inanimate foreign bodies, Rhinolith Causes of epistaxis and management 20Diseases of nasal septum — Haematoma, abscess, DNS, perforation. Diseases of nasal cavity — Acute rhinitis, Nasal Diphtheria, Granulomatous conditions Of the nose, allergic rhinitis, vasomotor thinitis, atrophic rhinitis, fungal infections of nose and paranasal sinuses. Diseases of PNS: Acute and Chronic sinusitis. Complications of sinusitis and management, Sino nasal polyposis ~ Diagnosis and management. Basic principles of FESS (Functional Endoscopic Sinus Surgery) Tumours of the nose and PNS — Benign tumours like papilloma, inverted papilloma, fibrous dysplasia. Malignant tumours like squamous cell carcinoma, Melanoma, Olfactory neuroblastoma. Diseases of the Nasopharynx Surgical anatomy and physiology of nasopharynx ‘Nasopharyngeal carcinoma diagnosis and management Adenoid diagnosis and management Juvenile angiofibroma: Diagnosis and management Diseases of the Pharyax ‘Surgical anatomy and physiology of oral cavity, oropharynx, tonsils, Waldeyer’s ring, ‘Anatomy of retropharyngeal and parapharyngeal spaces. Physiology of mastication Diseases of the tonsils: acute and chronic tonsillitis, Vincent's angina, Diphtheriatic tonsillitis - diagnosis and management ‘Neck space infections and abscess — Reiropharyngeal, parapharyngeal abscess, peritonsillar abscess, Ludwig's angina Surgical anatomy and physiology of salivary glands, submandibular Sialadenitis, Salivary calculii, Parotitis, tumours of salivary glands, ‘Diseases of the Larynx Surgical anatomy and Physiology of Larynx with reference to phonation and respiration, Acute infection of the larynx — Acute laryngitis, LTB, Diphtheretic laryngitis, Acute epiglottitis 2Stridor ~ Causes of stridor and management. Hoarseness of voice — History taking, causes, management. Chronic infections of Larynx — Chronic nonspecific and specific laryngitis, granulomatous conditions of larynx. Neurological infections of larynx — Cord palsy - Diagnosis and management. Tumours of larynx — Diagnosis of laryngeal tumours and management. Diseases of Trachea Surgical anatomy of trachea, stridor, tracheostomy in detail Ocsophagus Surgical anatomy, physiology of deglutition Causes of dysphagia, diagnosis and management. Diseases such as congenjtal atresia, injuries (traumatic and chemical), Foreign body, Oesophakgony, Neurological problems and oncology, Bronchoscopy — Indication, contraindication and complications of foreign body in bronchus oo ©) Teaching hours Theory: 70 hours, Clinical : 8 weeks as per 4) Scheme of Examination Internal Assessment Theory: 30 marks There shall be at least two theory examination one at the end of VI term and another during VIT term. The marks obtained should be reduced 10 30 and sent to the university Clinical: 20 marks It should be based on : Log book in which records of at least 10 case are maintained for which 5 marks be allotied and Clinical examination which shall be held at the end of each posting ‘The marks obtained for clinical examination and log book should be reduced {0 20 and sent to the university nUniversity Examination i) Written Paper ‘There shall be one theory paper of three hours duration carrying 100 marks. It shall have three types of questions 1. Long Essay Questions ~ 2 questions x 10 marks each = 20 2. Short Essay Questions ~ 10 questions x 5 marks each = 50 3, Short Ansier Questions ~ 10 question x 3 marks each = 30 i) Clinical Examination Clinical examination - Two cases (40 marks for each case): 80 Marks iii) Viva-Voce 20 Marks a) Instruments + Viva 10 Marks. b)X-Rays + Viva 10 Marks Recommended Books 1, Logan and Turner's Diseases of the ENT, edited by AGB Maran (Wright), 10 Ed, Butter worth. K. M. Verghese & Co, Bombay, Rs 425. 2. Ramalingam KK, A Short Practice of Otolaryngology, 2™ Ed, All India Publishers and Distributors, Chennai, Rs 210. Mohd Magbool, Text book of ENT Diseases, 8 Ed. Jaypee Publishers. SK De Fundamentals of Ear, Nose and Throat, 6° Ed. The New Book Stall, Rs 100. Ramanjaneyulu P, Diseases of Ear Nose & Throat , Paras Publishing Dhingra P. L. Diseases of Ear Nose & Throat 2 Ed. Churchill Livingston Bhargava, Text book of ENT, 5" ed. Usha Publications, Mumbai, Rs 155. Boies, Fundamentals of Otolaryngology. ae eaae References 1, Ballyntyne Groove - Synopsis of Otolaryngology 2. Ballenger - Text Book of Otorhinolaryngology 3. Saunders - Text Book of E.N.T. 2B