Basic Instruments

Head
mirror

Bull’s
eye
Ear speculum
lamp Head light
 Microscope Tuning fork
Otoscope
Pulling the auricle
upwards and
backwards to
straighten the EAC
 Ear examination
using head mirror
and ear speculum
Ear examination
using otoscope
Normal tympanic
membrane
Upper arrow: lateral process
of malleous
Middle arrow: handle of
malleous
Lower arrow: cone of light
 Microscopic
Examination of the ear
Rinne Test
Weber test
Caloric Test
Tympanometry
device
Type A curve: It indicates normal tympanic membrane
Type B curve: It indicates immobile tympanic membrane as in
secretory otitis media and tympanic membrane perforation
Type C curve: It indicates Eustachian tube dysfunction
Type AD curve: It indicates hypermobile tympanic membrane as
in ossicular discontinuity or scarred tympanic membrane
Type AS curve: it indicates ossicular fixation with restricted
tympano-ossicular chain mobility.
Audiometry
apparatus
Normal hearing: Normal air and bone conduction thresholds
with no air bone gap
Conductive hearing loss : Air bone gap with normal bone
conduction threshold with elevated air conduction threshold
Sensorineural hearing loss: Both air and bone conduction
thresholds are elevated with no air bone gap.
Mixed hearing loss: Both air and bone conduction thresholds
are elevated with air bone gap.
Auricular Hematoma Cauliflower ear
External auditory canal Auricular perichondritis
furuncle
 Ex auditory canal
Diffuse otitis externa Otomycosis
Preauricular Sinus
Ear wax
Ear wash

Ear wash syringe

 Traumatic tympanic Healing traumatic
membrane perforation tympanic membrane
perforation
Tympanosclerosis
Acute otitis Secretory otitis
media media
 Grommet in place: most
Grommet Tube common sites
anterosuperior then
anteroinferior parts of
tympanic membrane
Chronic suppurative otitis
Acute mastoiditis
media tubotympanic type
 Left LMNL facial nerve paralysis
Chronic suppurative otitis
media atticoantral type
 Teflon Piston
Stapedotomy operation
 Pure tone audiometry showing
low frequency SNHL (Meniere’s
disease)
Right sided Bell’s palsy
 Schirmer’s test for
topographic
localization of facial
nerve paralysis
 Basic Instruments
Thudicum nasal
speculum

Killian nasal
speculum

Postnasal mirror
Nasal Endoscope
Cottle’s Test to test
nasal patency
 .

Anterior rhinoscopy
V: Vestibule, IT: Inferior Turbinate, F: floor of the nose, S: Septum,
MT: Middle Turbinate
 Posterior
rhinoscopy
 Endoscopic
examination of the
nose and
nasopharynx
CT nose and paranasal
sinus, coronal cut
showing complete
opacification of left
maxillary sinus
Nasal dermoid cyst
CT nose and paransal sinuses,
axial cuts showing bilateral A baby with bilateral choanal
choanal atrsia atresia with postoperative
nasal stents
Endoscopic view of the right Anterior rhinoscopy view
nasal cavity showing metalic of the right nasal cavity
foreign body showing vestibulitis
Anterior rhinoscopy view of the right
nasal cavity showing intranasal
adhesions
 A patient with fracture A patient with surgical
nasal bones with twisted emphysema of the left
nose to the left lower eyelid
 Anterior rhinoscopy Saddle nose
showing septal hematoma deformity
 Anterior rhinoscopy
Anterior rhinoscopy showing showing septal perforation
left sided septal deviation
 Strobscopic view of the
Anterior rhinoscopy view larynx showing subglottic
of right nasal cavity stenosis
showing nasal
granuloma
 Anterior rhinoscopy view of the
right nasal cavity showing acute Orbital cellulitis
sinusitis with congested mucosa
and mucopurulent discharge in
middle meatus
Orbital abscess
Frontal mucocele
 CT nose and paranasal sinuses
coronal cut showing left frontal
mucocele with left orbital invasion
Opening the anterior wall of
the maxilla during radical Sublabial oroantral
antrum operation fistula
Alveolar oroantral fistula
Anterior rhinoscopy view of Broadening of the nose
both nasal cavities showing due to long standing
nasal polyposis
bilateral nasal polyposis
 CT nose and paranasal
sinuses coronal cut showing
pansinusitis with complete
opacification of all
paranasal sinuses
CT nose and paranasal sinuses
coronal cut showing left
Endoscopically removed
antrochoanal polyp
antrochoanal polyp
Anterior rhinoscopy view of
A patient with right
right nasal cavity showing
cheek swelling due to
malignant nasal mass with
malignant nasal mass
surface ulceration
 Basic Instruments

Wooden tongue depressors Metallic tongue depressors

t has the advantage of being It has the advantage of being strong and
disposable. But they can be broken unbreakable. But it needs sterilization to
easily with struggling patients avoid transmission of infection.
Oropharyngeal
view
Avoid evaluation of tonsillar
size with maximum
protrusion of the tongue
Avoid evaluation of tonsillar
size with maximum
depression of the tongue
 X-ray nasopharynx lateral view
Adenoid facies showing enlarged
nasopharyngeal tonsil (adenoid)
Excised adenoid
with observed
surface rugea
Bifid uvula: It indicates possible submucous
cleft palate
 Endoscopic view of the nasopharynx
Bilateral enlarged showing nasopharyngeal mass
cervical lymph nodes (nasopharyngeal carcinoma)
Aphthous ulcer of the vestibule of
the mouth
Oral ranula
Plummer Vinson syndrome with
glossitis and angular stomatitis
Hairy tongue
Ankyloglossia (tongue tie)
Geographic Tongue
 Oropharyngeal view
showing lingual thyroid
Leukoplakia of the tongue
Carcinoma of the tongue
 Enlarged jagulodigastric
Oropharyngeal view lymph node
showing acute follicular
tonsillitis
Oropharyngeal view showing infectious
mononucleosis
Oropharyngeal Candidiasis (Thrush)
Tonsillar retention cyst Tonsilloliths: (calculus of
the tonsil)
 Instruments for tonsillectomy
Tonsillar
Dissector

Tonsil holding
forceps
Excised palatine tonsil with lingual
pole
 Postoperative tonsillar fossae showing
Postoperative tonsillar fossae blood clots and granulation tissue (2ry
showing whitish healing post tonsillectomy hemorrhage)
membrane
 View of the oropharynx of the patient
Showing unilateral tonsillar enlargement
affecting left side
Papilloma arising from the base of right
tonsil
A tonsil and palate carcinoma
View of the oropharynx showing left
peritonsillar absces
View of the neck of the patient showing left
parapharyngeal abscess
Oropharyngeal view showing left
retropharyngeal abscess
X-ray neck lateral view showing widening of the
retropharyngeal space due to retropharyngeal
abscess
Ludwing’s Angina
 Basic Instruments

Laryngeal Mirror
It is used for indirect laryngoscopy

Flexible and rigid endoscope

Both can be used for examination of the
larynx which can be video monitored
 Indirect laryngoscopy
Examination of the larynx using the
laryngeal mirror.
Fiberoptic endoscopy of the
upper respiratory tract
Endoscopic view of the larynx which shows
bilateral normal vocal cords
Laryngomalacia
Laryngeal web
 Flexible Fibro-optic X-ray neck –lateral view
examination showing swollen showing thumb like epiglottitis
epiglottis in acute epiglottitis
X-ray neck –posteroanterior view showing
steeple sign in acute
laryngotracheobronchitis
Chronic diffuse non Right vocal cord
specific laryngitis leukoplakia
Bilateral vocal cord
nodules
Left pedunculated
vocal fold polyp
Left intubation
granuloma
Left vocal cord paralysis standing in paramedian position
(left complete RLN paralysis)
 Juvenile multiple
Patient with
papillomatosis of the
tracheosyomy
larynx
Left vocal cord mass
(mostly malignant)
 Stomal stud used for keep the
Total laryngectomy with left opening of post laryngectomy
neck dissection tracheostomy permanently open
Blom Singer valve (Provox) to be inserted in
tracheo-esophageal fistula after total
laryngectomy
Barium swallow of the patient showing pear
shaped outpouching of the pharyngeal
lumen : Pharyngeal pouch
Branchial Cyst
External laryngocele
 X-ray neck posteroanterior view
showing foreign body oesophagus
X-ray postero-anterior view showing jet black translucency of the
right lung with shift of the mediastinum to the other side: partial
obstruction of the right bronchus by FB
X-ray postero-anterior view showing collapse of left lung with shift
of the mediastinum to the same side: complete obstruction of the
left bronchus by FB
Left sided parotid swelling (mostly
poleomorphic adenoma)
Right sided parotid
calculus (stone)
Parotid swelling with overlying
oedema and redness: Mumps
(Viral Parotitis)
 X-ray occipitomental view showing
three radiopaque stones along the
Right submandibular duct of right submandibular gland
swelling
Thyroglossal
cyst
Thank you