FCORL(SA) Final

THE COLLEGES OF MEDICINE OF SOUTH AFRICA

Incorporated Association not for gain
Reg No 1955/000003/08

Final Examination for the Fellowship of the

College of Otorhinolaryngologists of South Africa
24 February 2020
Paper 1 (3 hours)
All questions to be answered. Each question to be answered in a separate book (or books if more than one is required
for the one answer)

1 a) With regard to cancer of the maxillary sinus

i) List the presenting symptoms and signs of squamous cell carcinoma of the maxillary
sinus. (15)
ii) What makes a tumour likely to be inoperable? (5)
iii) How would you investigate a patient with cancer of the maxillary sinus to determine
its operability and to plan the surgery? (7)
b) Preauricular sinus
i) Discuss the embryology and aetiology. (7)
ii) List the differential diagnoses. (2)
iii) Discuss the management of an infected preauricular sinus. (4)
iv) Describe the principles of surgery. (10)
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2 a) List the relative contra-indications for primary chemoradiation therapy for clinically T3
glottic squamous cell cancer. (10)
b) Squamous cell cancer of the lateral tongue
i) Describe, in tabulated form, the TNM/AJCC 2017 Classification of Oral Cancers.
(10)
ii) Depth of invasion (DOI)
a) What is meant by depth of invasion (DOI)? (5)
b) How does depth of invasion affect management? (5)
c) Neck dissection
i) Define the levels of the neck used to describe neck dissection. (10)
ii) List and define the commonly performed types of neck dissection. (10)
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3 a) Discuss the superior semi-circular canal dehiscence syndrome in terms of
i) Presenting symptoms. (7)
ii) Tulio phenomenon. (4)
iii) Relevant Investigations. (5)
iv) Treatment. (4)
b) Discuss the clinical indications for vestibular evoked myogenic potentials (VEMP)? (10)
c) Discuss unilateral posterior choanal atresia under the following headings:
i) Clinical presentation. (5)
ii) Investigations. (5)
iii) Surgical management. (10)
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PTO/Page 4 Question…
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4 a) Define sulcus vocalis. (5)

b) What are the management options for Reinke’s oedema? (5)
c) Discuss laryngeal injuries in terms of
i) Aetiology. (5)
ii) Management. (10)
d) A 15-year-old patient presents to the ENT department with a closed nasal bone fracture
following a rugby injury. His GCS is 15/15 and he has bilateral nasal tampons. He
complains of a headache. His vital signs are within normal range.
i) What are the appropriate investigations that should be performed for this patient?
(7)
ii) What are the ways to manage epistaxis in this patient? (7)
e) Discuss closed rhinoplasty in terms of
i) Indications. (4)
ii) Contra-indications. (3)
iii) Complications. (4)
[50]
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FCORL(SA) Final

THE COLLEGES OF MEDICINE OF SOUTH AFRICA

Incorporated Association not for gain
Reg No 1955/000003/08

Final Examination for the Fellowship of the

College of Otorhinolaryngologists of South Africa

25 February 2020

Paper 2 (3 hours)
All questions to be answered. Each question to be answered in a separate book (or books if more than one is required
for the one answer)

1 a) Write short notes on the risk factors for otitis media with effusion (OME). (15)
b) Write short notes on the complications of adenotonsillectomy. (15)
c) Write short notes on lymphoma in HIV positive patients. (10)
d) Write short notes on salivary gland disease in HIV positive patients. (10)
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2 a) Write short notes on the spaces of the neck. (10)

b) Write short notes on the following airway infections in children under the headings:
clinical features, diagnosis and management
i) Croup. (10)
ii) Supraglottitis/epiglottitis. (10)
iii) Exudative tracheitis. (10)
iv) Retropharyngeal abscess. (10)
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3 a) Describe the clinical presentation of hereditary haemorrhagic telangectasia. (10)

b) With regard to the nasal valve
i) Describe the anatomical structures that form the nasal valves. (10)
ii) Discuss the aetiology of nasal obstruction at the nasal valves. (10)
c) Describe the anatomical abnormalities in paediatric pyriform aperture stenosis. (5)
d) With regard to the lacrimal system
i) Describe the anatomy of the lacrimal system. (5)
ii) Briefly describe the causes of obstruction of the lacrimal system. (5)
iii) List the complications of dacrocystorhinostomy (DCR). (5)
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4 a) With regard to laryngopharyngeal reflux

i) List symptoms of laryngopharyngeal reflux. (5)
ii) Describe how you would manage a patient with laryngopharyngeal reflux. (10)
b) A 46-year-old male, previous nasal surgery is scheduled for a second endoscopic sinus
surgery for chronic rhinosinusitis. List and discuss briefly what you will look for in the CT
before you perform the surgery. (15)
c) Discuss factors, which can cause or contribute to epistaxis. (20)
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