OBJECTIVES

Describe the instruments used in ENT examination and

their uses.

9 blowing noise differs from hoarsness Vocal card obstr

Mass obstructing upper airway

epiglottis mass

anything black on CT 9 air

fat less dark

Pt
sit at stout legs
Position of

Data

light bell's lamp as behaind slightly

above shoulder

Head Mirror https://youtu.be/S35ba2gKse4

if

1- Consists of concave mirror (3.5 inch) with central hole

(0.5 inch) and head band at Rt eye

2-Used in ENT examination to focus and reflect light

I

from light source onto the examined organ HoweverWeSee

a bothes

to
ensure depth

Head mirror needs external source of

light Disadvantage

Head light need batteries

easy to break
are

However chosing of your

one is preference
by both you
can get Same

findings

Head light used in ENT examination

https://youtu.be/hZy4vK8WcP0

built in light source

straight Vs curved

straight grip leads to hand infront of oral cavity leads to less visualizations

Curved grip leads to hand below level better visualization

better handling of orophaynx

Disposable

Metalic couldbe

sterilized used
again

Difference between metallic

and wooden: the amount of
pressure that can be
applied, and nasal patency
test.

Tongue depressor 5 uses

Uses

Inspection of oral cavity and oropharynx

In posterior rhinoscopy with posterior rhinoscopic

mirror Toexamine PosteriorPart ofnasal cavity nasopharynx
https://youtu.be/ckGlRiLi2lE

3 To evaluate nasal patency in cold spatula test https://youtu.be/N7dia8fDBaM

See anymisting

4 In removal of pharyngeal FB(fish bone)

5 In drainage of peritonsillar abscess as a pirif.ru Essa

G Is base of tongue

Biopsy of
class Tonsil tf IS Tonsil

first i needle their knife

This
does not indicate Absolute Mechanical

obstruction Some people fromthissite

may not breath well

Some have other Problems ratherthanMechanical

Posterior Rhinoscopic Mirror used

in posterior rhinoscopy to examine

postnasal space

in Post Rhinoscopy

nasopharynx

anaesthesia

Loca

to Preventgagreflex

insert

curved Tongue deep

warm a

mirror Preventfog

insert mirror on Tongue depressor

Ask.pt to breath

from his nose

Suft Palate opened

Thudicum Nasal Speculum used in

anterior rhinoscopy 1.28
https://youtu.be/OSfN-4_FKXk

7 15
https://youtu.be/zM-dSmowZ9U

Killian Nasal Speculum

Self Retaining Nasal Speculum

You could
release
your hand

from this inst

it remains

opened

Usually used in

Surgery but here

is never used

1
Submucous resection

Thudicum and KillianNasal Specula

Uses

Anterior rhinoscopy(examination of anterior half of

trophy f inf
Per he

nasal cavity) Can find I Deviated nasal septum

Is any polyp mass

2 Nasal packing

3 May be used in the procedure of nasal foreign body

removal and nasal cautery

Self retaining nasal speedum so in SMR septoplasty operations

As well as above uses

Dressing Forceps used to insert

wick in the ear canal or pledgets in

the nose

Tilley DressingForceps https://youtu.be/Jz2JQO8LXaA

Turbinectomy is a procedure in
which some or all of the turbinate
bones in the nasal passage are
removed, generally to relieve nasal
obstruction.

Single

boxjoint

Tilley Dressing Forceps

Has 1 box joint and serrated ends

Uses

I Insertion and removalof anterior nasal pack

2 Insertion of pledgets soaked with drugs into the nose

Removal of non-rounded nasal foreign bodies(FB),

also may be used to remove aural FB

Karl Rounded FB Gnat

5
Removal of fish bone in the throat be removed by

6 Insertion of aural wick forceps because

https://youtu.be/6QGyjiv2fwM

maydislodge deep

7 Maybe used to remove wax hard notsoft

8 In drainage of peritonsillar abscess

after opening Abscess We insert forceps break up loculi to remove pong

from destructed local



Crocodile forceps

Crocodile Forceps

Proximal Sliding joint

Has 2 joints Distal I

Only the upper jaw of the distal end is movable

Is more stable and allow better vision in limited spaces than

Tilley forceps better in ear limitedspaces

Uses

Removal of wax

Removal of non rounded aural FB

Insertion of aural wick

Removal of non rounded nasal FB

May be used in anterior nasal packing , insertion of pledgets

soaked with drug solution into the nose , in peritosillar abscess

drainage and removal of fish bone in the throat

Posterior Nasal Pack

B Ippp most
common used Pack
Bismuth

insert Two NG Tubes from nose get it exit from

mouth under GA i in operation

Post nasal pack has 3 Suture 2 front 7 behind

2 Sutures are bound w 2 NG Tube

I Pull NG Tube from nose to get Paek enter

from mouth until it 15

then whee we in at front t na

Lst suture is attached at cheek

to get pack removed

n n

Cather

g inserted from nose

Aural Speculum

Aural Speculum https://youtu.be/ajmJCily6VI

Wide for general inspection.

Metallic speculum of different sizes Narrow for focus.

Used to examine the ear canal, to take rough idea of

TM, in removal of some aural foreign bodies and in

nasal cautary

put it so that cautery does net drug ex vest hi

Siegle Speculum

first by lens we conclude Idx of either perf or retraction

Siegle Speculum

Consists of rubber bag connected to tube and lens

Uses: magnifies men

1-Examination of tympanic membrane(TM)

2-Asses TM mobility by applying pressure a need air tight i3

air

3-Diffrentiate between TM perforation and retraction

pocket T I
Tympanic membrane retraction describes a
condition in which a part of the eardrum lies
deeper within the ear than its normal position.
Eardrum except
Does not
moves
4-To perform fistula test move at edges

5-Insuflation of drugs as instillation of drugs in external ear i pressure

insufflation of Siegle speculum Middle ear

 Fistula test is a test done to detect a fistula in the bony labyrinthine wall of the inner ear.

What is the basis (principle) on which Fistula test works?

Principle: Pressure changes in the external auditory canal are transmitted to the labyrinth via the fistula which produces nystagmus.

How is Fistula test done?

In Fistula test, pressure changes in the external canal are brought by applying intermittent pressure on the tragus or by Siegel's speculum. In a normal person, the test is negative
because the pressure changes cannot be transmitted into the labyrinth (when there is no fistula).

fistualn usually accompagniel

by TM Perford

co fistula there is another connection 2.1 Middle d inner

car

Gardiner Brown Tuning Fork

i 1

Prongs shoulder foot

Gardiner Brown Tuning Fork

Consists of foot, shoulder and 2 prongs

Set range is 128-4096 Hz

Used in Rinne and Weber tests https://youtu.be/FgF91K7dU8Y

Detect the presence of hearing impairment

as Detect type of hearing impairment

Give rough idia about the hearing threhsold not used rightnow

Use Puretoneandigr

Detect tone decay

A Low frequency induce Vibration Tactile sensations rather than

sound false fire results

High frequenc Tunic Sound rapidly disappear

Tone decay initially hear Sound

remove you can hear

re Put it wont 46 he can hear it again

Sensing nerd Problem

Laryngeal Mirror

EsLocal anaesthesia

sterilization

hotting mirror

catch tongue

in gauze

ask.pt to

breath from

his mouth

If it shows ^ then it is mirror and the sides are opposite to mine.

if v the it is fiber optic and the sides are opposite to me.
IF you see ^ and there is endotracheal tube, then it is direct rigid laryngoscope and the sides are the same to me.

Laryngoscopy
NII

Indirect Direct
using mirror
If
Rigid Laryngoschy fiber optic
If flexible
F
x a
µ Laryngoscope
Direct rigid laryngo.
RMff
Hart

HUH

Jobson Horn Probe

Jobson Horn Probe for ear

Has 2 ends (ring and serrated ends)

The ring end used to remove hard wax and rounded FB

Cotton is raped around the serrated end and use for

is i

mopping of ear canal, removal of soft wax, chemical

cautery and application of druges go

Plastic Tracheostomy Tube

Plastic Trachiostomy Tube

Single tube https://youtu.be/FsL8LgYlFxY

Cuffed 6 There is a ballon inflated to prevent blood other

material to be aspirated
Used in tracheostomy
Advantages
1-More comfortable
2-Cuff prevent aspiration
3-Can be used with MRI, CT scan and with ventilator
Disadvantages
1-More difficult to clean
2-Can not be used with radiotherapy and laser surgery
Metallic Tracheostomy tube

outer Tube

inner tube

introduce just used at

opening f Tracheostomy
 aka fortex

Metallic Tracheostomy Tube

Consists of inner tube, outer tube and introducer
Uncuffed
Used in tracheostomy
Advantages
1-Easier cleaning just remove clean it 4 re insert 1
2-Can be used with radiotherapy and laser surgery
Disadvantages
1-Uncuffed 3 Does not Prevent aspiration
2-Less comfortable
3-Not used with MRI, CT scan and ventilator