Practical ENT

Dr. SAAD Y. Sulaiman

Ninevah college of medicine
ENT Instruments

ENT head mirror

Reflect the light from the light source to see dark cavities of the ear and mouth

Bull Lamp

This lamp focus the light toward the head mirror. Its position must be above the left shoulder of the patient.

Head Light

Killian nasal speculum : used for anterior rhinoscopy

Thudicum nasal speculum: used for anterior rhinoscopy

Tilly nasal dressing forceps
1-nasal packing in case of epistaxis or after syrgery
2-removal of F.B. in from the
throat specially fish bone
3-biopsy

Aural speculum

Examination of external ق ear(with head light or mirror)+pinna is pushed upward,outward and backward

Auroscope ( otoscope )

1-examinationo of external auditory meatus
2-examination of tympanic membraine
3-anterior rhinoscopy in children

Ear (Aural) Syringe

preparation:aural drops(5%sodium bicarbonte in 30%glycerine) or olive oil in case of hard wax
-water at the T of the body is used.
Indication:…1-wax removal . 2-hard F.B removal 3-removal of otomycotic debris
Contraindication:1-ORGANIC F.B.
2-WOUND IN EXTRNAL EAR
3-PERFORATION OF TYMPANIC MEMBRANE
4-DISK BATTERY(CONTAIN KOH)
Complication:1-truama to external auditory canal.2-perforation of T.M.

Jobson horne probe

1-serrated end:by rolling cotton on to it , it is used for mobbing
2-ring end : removal of wax , F.B , otomycotic debris and discharge from ear+putting substances inside nose like silver nitrate

Aural Dressing Forceps:

the joint is proximal. It is used for insertion of wick inside the ear ( ear dressing ) in cases of otitis externa and during ear surgery.









Crocodile ear forceps : note that the joint is distal. It can be introduced through the aural speculum and used for removal of certain types of foreign bodies and biopsy.+packing+narrowing space of ear

Seigle pneumatic speculum

Used to assess the mobility and integrity of tympanic membrane

Tuning Fork

DETECTION OF HEARING LOSS AND HELP TO DIFERENTIATE BETWEEN CONDUCTIVE AND SENSORINEURAL HEARINH LOSS
Q/MENTION 2 TESTS USED IT?
1-WEBER TEST
2-RINNE TEST









Tongue depressors: used for examination of oral cavity and oropharynx AND USED with nasopharyngeal mirror to examin nasopharynx

Nasopharyngeal Mirror:

Steps:1-warming of the mirror to avoid fogging.3- introduced behind the soft palate to reflect the image of nasopharynx.2- The tongue is depressed by tongue depressor. This procedure is called posterior rhinoscopy
(it is used for posterior rhinoscopy)

Laryngeal Mirror

Laryngeal Mirror: used for indirect larygoscopy. The structures that can be visualized by the mirror are, the base of the tongue, the vallecula, the epiglottis, the false vocal cords and the true vocal cords.ask to say eeee






Indirect laryngoscopy is done after 1-warming the mirror ( to avoid fogging) and after 2-pulling the tongue by a piece of gauze. 3-insertion of the mirror 4- direct light 5-ask the patent to say eeee and watch focal cords.

Left False vocal cord

Left True vocal cord

For checking of vocal cord mobility

ask the patient to say EEE
FIXED FOCAL CORD causes:
1-injury to recuurent laryngeal nerves or superior laryngeal nerves during nick or chest surgry
2-stroke
3-nick trauma
4-laryngeal trauma
5-laryngeal tumors








TracheostomyINDICATION:1-SEVERE FACIAL TRAUMA,2-NECK CANCERS.3-ACUTE ANGIOEDEMAMAIN COMPLICATION: HOLE OBSTRUCTION.Site:cricotheroid membranec.i.:laryngeal disruption. 2-obstruction of laryngotracheal lumen .3-midface fractures .4-cervical spines instability.

Tracheostomy Tubes

Silver Jackson tube

C.I:1-RADIATION. 2-MRI
الاوبتريتر نخلي داخل الاوتر تيوب اثناء البروسيجر حتى نمنع دخول الدم والانسجة للاوتر تيوب وبعدين انشيله(مثل الكانيولا) ونخلي الاينر تيوب بداله , اذا اختنك المريض باي وقت بس طلع الاينر تيوب ونضفه ورجعه راح يرجع المريض تمام
*


Portex Tracheostomy tube*CUFF:PREVENT PASSAGE OF BODY SECERTION TO TRACHEA

Non cuffed

IF TEMPORARYLY USED
Double cuff
IF USED FOR LONG PERIOD
Single cuff
IF USED FOR SHORT PERIOD