The specialty of the Ear, Nose and Throat (ENT) system is relatively young compared to certain medical practices. Even to function as a unified discipline, pioneers of the specialty had to wage a protracted struggle to surmount considerable hindrances. Initially confined to managing ear infections alone, the introduction of surgical intervention skills gradually led the specialty to adapt a unified approach. Furthermore, with improved technological advances, the specialty’s horizon for surgical intervention broadened enabling it to handle disorders of the face, head and neck. As a result, the discipline has become alternatively to be known as the specialty of Oto-Rhino-Laryngology - Head & Neck surgery (ORL - HNS).
This specialty deals with a system that:
•Occupies a strategic location at the very entrance of the aero – digestive tract. •Performs, among other things, four main sensory functions: hearing, balance, smell and taste, •Is very closely related to the body’s certain vital organs ……… the CNS, Eyes and major blood vessels destined for the head and neck. •Frequently encounters most common disorders (20 – 30% of all cases) – an estimate of a typical primary practice. The above facts obviously imply that the ENT system plays a very significant role for the survival of the individual. Therefore, exposure to and acquiring basic knowledge of the system, would be instrumental to the young medical practitioners.
This short attachment course is designed to accomplish the following aims: •To review essential ENT anatomy and physiology
•To demonstrate the use and application of basic equipments employed in ENT practice. •To show and exercise methods in examining the ear, the nose, the throat, and the head and neck region. •To present trainees with commonly encountered ENT disorders. •To orient trainees with practical approach in the management of ENT disorders:- Planning diagnostic approaches
Considering most relevant differential diagnoses
Enable design and initiate appropriate therapeutic measures. Identify and facilitate referral cases as early as possible. • To assess how much has been absorbed by the trainees regarding attitude, knowledge, examination skill, ability to diagnoses and manage common ENT disorders. • To stimulate enthusiast pursue the ENT practice.
By the end of this brief attachment to the ENT discipline it is hoped that the trainees will: •Have refreshed essential ENT anatomy and physiology
•Be well-oriented to symptoms related to disorders of the ENT system and head and neck. •Have acquired the ability to differentiate normal from abnormal; and recognize the nature of abnormality. •Be able to relate symptoms and physical examination findings to specific disorders of the ear, nose and throat. • Be able to:
Do appropriate investigations to confirm the diagnosis
Do required basic procedure
Give primary care treatment
Design follow ups visits
Plan referral for specialist’s care.
1. Structure and Function
Structurally, the ear is considered to have three parts: the external ear, the middle ear and the inner ear. 1.1 The external Ear
This includes the pinna, the external auditory canal (meatus) and the tympanic membrane. 1.1.1.The Pinna (Auricle) is made up of a framework if elastic cartilage covered by skin. It lies between the temporomandibular joint (TMJ) anteriorly and the mastoid process posteriorly. The covering skin on its anterior surface is adherent to the perichondrium, but is more loosely attached posteriorly. 1.1.2.The External auditory canal is about 3cm long consisting of an outer cartilaginous (1/3) and inner bony (2/3) portions. The cartilaginous portion is covered and lies at an angle to the bony part. The skin over the outer part or portion contains hair follicles and cerumen (wax) secreting glands. 1.1.3.The tympanic membrane is...