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Oto-Rhino-Laryngology
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or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or
otherwise, without the prior permission of the Copyright Holders.
This book is sold subject to the condition that it shall not, by way of trade or otherwise, be lent, resold,
hired out or otherwise circulated without the publisher’s prior consent in any form of binding or cover
other than that in which it is published and without a similar condition including this condition being
imposed on the subsequent purchaser.
Copyright © 2016
All Rights Reserved
ISBN: 978-696-637-155-7
Printed in Pakistan
Contents
SECTION–01
Ear
01 Mastoid Retractor 3
02 Periosteal Elevator 5
03 Otoscope 7
04 Ear Syringe 9
05 Myringotomy Knife 11
08 X-ray Mastoid-Mastoiditis 17
13 Tympanogram-Type A 27
14 Tympanogram-Type As 29
15 Tympanogram-Type B 31
16 Tympanogram-Type Ad 33
17 Tympanogram-Type C 35
19 Pre-Auricular Sinus 39
21 Cauliflower Ear 43
22 Keloid of the Pinna 45
23 Boil in the Ear 47
24 Otomycosis 49
25 Bullous Myringitis 51
26 Wax in the Ear 53
27 Ear Syringing 55
28 Acute Suppurative Otitis Media 57
29 Chronic Suppurative Otitis Media-Tubo-Tympanic Type 59
30 Chronic Suppurative Otitis Media with Cholesteatoma 61
31 Chronic Suppurative Otitis Media with Aural Polyp 63
32 Chronic Suppurative Otitis Media with Facial Paralysis 65
33 Otitis Media with Effusion 67
34 Otitis Media with Effusion-After Grommet Insertion 69
35 Mastoid Abscess 71
36 Post-Aural Fistula 73
37 Stapedotomy Operation 75
38 BTE Type Hearing Aid 77
SECTION–02
Nose and Paranasal Sinuses
39 Posterior Rhinoscopy Mirror 81
40 Killian’s Nasal Speculum 83
41 Tilley’s Forceps 85
42 Luc’s Forceps 87
43 SMR Dissector 89
44 Lichwitz’s Trocar and Cannula 91
45 Nasal Gouge 93
46 Ashe’s and Walsham Forceps 95
SECTION–03
Oral Cavity and Pharynx
77 Boyle Davis Mouth Gag 159
78 Tonsil Holding Forceps 161
79 Draffin’s Suspension Rod 163
80 Tonsillar Dissector 165
81 Tonsillar Snare 167
82 Pharyngeal Suction Nozzle 169
83 Adenoid Currette 171
84 Crocodile Forceps 173
85 X-ray Nasopharynx-Enlarged Adenoids 175
86 Orthopentomogram-Normal 177
87 Orthopentomogram-Carcinoma Oral Cavity 179
88 X-ray Skull-Temporo-mandibular Joint Dislocation 181
89 X-ray Barium Swallow-Pharyngeal Web 183
90 Tongue Tie 185
91 Oral Thrush 187
92 Aphthous Ulcer 189
93 Acute Follicular Tonsillitis 191
94 Chronic Hypertrophic Tonsillitis 193
95 Rose’s Position 195
96 Adenoid Facies 197
SECTION–04
Larynx and Trachea
104 Rigid Direct Laryngoscope 215
105 Flexible Fibre-Optic Direct Laryngoscope 217
106 Rigid Oesophagoscope 219
107 Rigid Bronchoscope 221
108 Tracheal Dilator 223
109 Portex Tracheostomy Tube 225
110 Shilley’s Tracheostomy Tube 227
111 Electrolarynx 229
112 X-ray Chest and Neck-Foreign Body Hypopharynx 231
113 X-ray Chest-Foreign Body Bronchus 233
114 X-ray Neck-Foreign Body Hypopharynx 235
115 X-ray Neck-Epiglottitis-Thumb’s Sign 237
116 Heimlich’s Maneuver 239
117 Flexible Fibre-Optic Direct Laryngoscopy 241
118 Microlaryngoscopy 243
119 Laryngomalacia 245
120 Laryngeal Papillomatosis 247
SECTION–05
Head and Neck
126 X-ray Floor of the Mouth-Salivary Calculi 261
127 X-ray Neck-Retropharyngeal Abscess 263
128 Sialogram-Normal 265
129 Acute Viral Parotitis-Mumps 267
130 Benign Parotid Gland Tumour 269
131 Multinodular Goiter 271
132 Cervical Lymphadenopathy 273
133 Thyroglossal Cyst 275
134 Branchial Cyst 277
135 Ludwig’s Angina 279
Index 281
Dedicated to
My parents, family, teachers. collegues
students and patients
Preface
It is a matter of great pleasure and contentment to present this book,
OSCE stations in Oto-rhino-laryngology. The trends in medical education
and evaluation are constantly changing every day. It is moving towards
greater objectivity. Objective Structured Clinical Examination (OSCE)
is a relatively newer method for the assessment of clinical skills. Some
students find it very difficult to appear in and pass OSCE examination.
Keeping this in mind, I have made an effort to write a book, so that medical
students can practice OSCE examination beforehand. Reading material in
this regard is very inadequate in almost every subject but it is truer in the
field of Oto-rhino-laryngology. Practicing with the OSCE station is in
itself a unique learning experience.
The format of this book is very simple. Whole subject of Oto-rhino-
laryngology is divided into five sections. Only the common problems
prevalent in our region are included in this book. The range of stations
given in the book encompasses the subject of ENT which a medical
graduate ought to know within a specific time. The format of OSCE
stations is almost the same as is being followed by most of the universities
in the region. A photograph of a clinical finding, X-ray, investigation,
procedure, surgical operation or an instrument is given, with or without a
short clinical scenario, and then a few questions are asked related to it. The
answers are shown overleaf in a precise bulleted format.