-

Otoscope: held like a pencil

Enamination Ear Tonsillitis
intec" may spread
Sore Throat Recurrent Tonsillitis
◦ if perfor" tut → describe EAC : inlax, discharge , F. B to ear → effusion
1. Inspection = indic" for Sx
M-E mucosa , any ossicles 1- Tonsillitis
not during an acute
if any seen Post-auricular 2- Pharyngitis ◦ Odynophagia
pinna Pre - attack 2 bleeding
auricular 3- Laryngitis ◦ H/0 mouth breathing →
◦ subtotal perfor" - normal in ◦ : wait for 3- 4 weeks
shape, size, posh 4- Oral Ulcers to rule out adenoid hyperplasia
no scars, sinuses
incus & stapes seen Acute Tonsillitis Adenoid Facies?
in postero-sup quadrant • Tragal tenderness - Otitis Externa Quinsy if ◦ open mouth
• enlarged tonsils
- unilateral ◦ long , dull face
☆. Fistula test: intermittent ◦ Mastoid tenderness 1. Mastoid tip • tender jugulodigastric
Three finger - uvula = not in ◦ high arched palate
pressure on tragus → look for 2. Cymba concha (corresponds to central
salute Chronic Tonsillitis • pinched nose
nystagmus or giddiness ◦ Facial N Mc Evan's Δ) - trismus (severe)

3. Root of Zygoma ◦ enlarged tonsils Management

facial asymmetry
• won tender j-d in

G- Can a pt. with Unsafe CSOM ◦

•
flushing

Irwin
of

Moore
ant pillar

sign
Analgesics
Amoxicillin (after throat swab

CSOM
have normal hearing? " Temporal lobe Absces,/ absent seizures
1. s nominal aphasia
& culture test)
Yes , the cholesteratoma
2. Cerebellar Abscess
formed itself bridges

r Tuning Fork Tests

the gap & helps in subdural abscess: dull, boring
sound conduction ⊛ Headache: rule out intracranial complications pt not Consent
meningitis: throbbing supposed to
speak - subjective test
so after surgery , hearing ④ CHL → soft + monotonous speech
might deteriorate SNHL → no speech discrim"
resonance ① Rinne's 2- Weber's 3- ABC
of sound
* Fluctuating HL (while taking) ◦ -skull ◦ teeth - Tragus kept
speaks loudly
(SNHL) can affect
hearing ◦ glabella ◦ chin closed
Peripheral ¥ Central 1- Meneire's > endo lymphatic hydrops
◦ nasal bone
2. OME (CHL)
+ ye - Ye
rotatory swaying feeling 3. Perilymph fistula (SNHL)
severe
Vertigo (only imbalance) URT? medica" µ. SNHL HL SNHL
(labyrinthitis)
l Foul Smelling Discharge
aggravates improves (gram + we & -ve)
1. Unsafe CSOM ② Due to anaerobic organisms [gram -ve]
SAFE CSOM 2. Otomycosis 2. bone erosion ☆ Moraxella
☆.
Post aural swelling + Neck
3. Malignancy
Mastoid Abscess No aggravating /relieving
factors : UNSAFE CSOM
* Blood Stained Discharge

ENT instruments
Bezold's Abscess (SCM)
1. Trauma
Luc's Abscess (EAC skin)
⊛ Vertigo in Csona 2. Unsafe CSora > enzymes released cause
Cittelis Abscess (occipital osteitis & gramer form"
region) 3. Malignancy
labyrintuitis cerebellar 4. Glomus
abscess
☆. Lateral sinus thrombosis
*. Diplopia : seen in Petrositis [alt involvement

of CN 6 → lat- rectus
⑬ Boyle's Davis Mouth Gag
9, 10, 11 C. N affected Tinni-us Gradenigo syndrome
i. Jobson - Horne ear probe with ring curette
◦ Tonsillectomy self -retaining
in the jugular fossa
Otorrhea 2 - Ear vectis I cerumen spud
◦ Adenoidectomy
Speech at sowing problems low high
Aural forceps • Sx of nasopharynx , palate
pitch pitch
3.

☆ . Recurrent URTI ME inner ear ⑭ St. Claire Thompson adenoid curette I cage
Retrorbital Diplopia • To instill
pain • Adenoidectomy
Eustachian tube block undicated
Hartman's
Vick Tilley's
- held like a dagger - inserted in oral cavity
Pt- more prone to CSOM ◦ To clean ↳ box joint ↳ screw joint (screene the heart)
ear - seaceeping movements at wrist it - adenoids
a distal end distal end =
◦ To pack & = Serrated are shavedi off - fixed in cage prevents
unpack nose Spade like
slipping of adenoids
◦ Remove F. B
from ear prongs
15. Dennis Browne tonsil holding forceps as used for holding

NOSE
④ Tuning Fork shoulder • during adenoidectomy , it is used blunt margins

* Chilateral nasal obstruct 128, 256, 512, 1024 H2 to hold tonsils & pull medially
◦ stem • To hold Autro choanal
- produces overtones
I. Antiocho anal polyp Nasal Facial Pain polyp
¥
block sneezing when struck on base
2. F. B (children) 16. Luc. forceps
Discharge mouth hard surface • To take biopsy
WE 3. DNS breathing - sharp margi (used to cut) ◦ remove nasal polyps
Hyposmia Epistaxis - 1. 5-2 am away from EAC
4. malignancy curved tip
⑤ Eustachian Tube Catheter 17- Mollison's tonsillar dissector & ant pillar retractor
1. Nose block ③ Epistaxis ant bleed: Little's Area
* Bilateral nasal obstruce" 1 Constant block ---→ DNS ◦ Check E-T patency • as suction
cannula ⑱ Eve's tonsillar share 286 wire loop]
- site - partial / complete - site, dur" post bleed: Woodruff plexus, mass ◦ Catheterize ET
1- Adenoid hyperplasia § ◦ To share out lower pole of tonsil to crush + cut
- duration - quantity lower pole
2. Ethmoid polyps - frequency - recurrent? ✓ hemostasis achieved
- severity / progressive / fluctuating 6.
Hand held, battery driven Otoscope
3. S-shaped DNS \ profuse less
- Agg. /relieving gradually prog. children adults - convex lens pinna is ⑲ Burkitt's first A- forceps
• Angiofibroma pulled
4- C-shaped DNS + Opp- side turbinate factors. I ◦ Exam" of EAC , TM
U B L 20. Megus second A. forceps
• HTN use picking malignancies
hypertrophy ◦ check for perforations
2- Discharge
☆. Negative History purment vestibulitis 210 Yankover's suction cannula
☆. ④ Facial pain ⑦ Pulitzer myringotome side holes +
- site - quality unco purulent sinusitis side of nose: maxillary sinusitis ◦ Sx of OP , NP
- recurrent sneezing: allergic rhinitis main notes tht
- duru / uncoid rhinitis - site occipital: sphenoid " / HTN • Maxillectomy, adenoidectomy
for suction
watery Aorta sora
- epistaxis - Agg/rel. forehead: frontal sinusitis curvilinear radial
office bent = won't obstruct operating field
allergic CSF rhinorrhea headache
- ear: any nasal disease can block ET rhinitis
8. Lempert's Suction Cannula
↓
Mollison's self-retaining
effusion, infect of ear
Examination
9.

pain
Hemostatic mastoid retractor
discharge 2. Thudicum's Nasal Speculum
- 4×4 prong's
external ◦ Ant rhinoscopy → . nasal cavity
hearing • turbinates
- no external deformity (saddle nose, crooked nose)
⑩ Plexter Jensen's " ◦ nasal septum o

mucosa
- vestibule n. (vestibulitis: can spread to cavernous sinus)
- 2×2 prongs
- ant. rhinoscopy ◦ Nasal packing
it it
to caudal disloch to at 11. Jenkin's mastoid chisel no longer blades
Nasal Valve (narrowest area in
o
DNS to it side 3 - mastoidectomy 23. St- Claire Thompson's " "
nasal cavity)
• inf. turbinates paradoxical hypertrophy - now Micromotor drill is used
of turbinates ⑭ citeri Punch forceps
◦ nasal mucosa status I Burrs (steel, Ti)
25. Frees elevator To raise MP flaps in hose
Cold spatula test : tongue depressor kept below
Cutting Diamond
the nostrils pt- asked to
breathe normally a equal misting? 12. Ear Speculum (Hartman's)

- sinus tenderness - Cottle's test • Ear examinn ◦ Put medici

maxillary: canine fossa the • clean ear

nasal valve area affected
frontal : below medial part of eyebrow
ethmoidal: medial to medial canthus.
- Oral cavity
- Post rhinoscopy choana ET opening - Head , neck examin"
uvula
adenoids