During the ENT OSCE station, candidates are presented with images. They must (1) diagnose the pathology, (2) summarize its mechanism of formation, and (3) propose evidence-based treatment.
Note: Certain cases recur frequently; focus your preparation on these high-yield presentations.
Following are the important cases that come many times
- Auricular Hematoma
- Foreign Body in Ear
- Tympanic Membrance
- Otomycosis
- Nasal Polyps
- Tonsillitis
- Tonsillectomy
- Epistaxis
- Ludwig angina
- Vocal Nodules
1. Auricular Hematoma
Collection of Blood with in the cartiligious auricle. Also known as “Cauliflower Ear”
Causes:
- Trauma
- Boxing
- Wresting
- R.T.A
- Blunt Trauma
Symptoms:
- Change in shape of ear
- Discoloration of ear
- Ear pain
- Bleeding
Treatment:
- Needle Aspiration (I/D)
- Pressure dressing
- Analgesic and Antibiotics
2. Foreign Body in Ear
Any foreign object, which is stuck in ear.
Types:
- Living: Insects, mosquitoes
- Non Living: Cotton swab, broken end of matchstick, piece of chalk
Symptoms:
- Otalgia
- eHL
- Irritation in ear
Management:
- Non Living: Crocodile forecep
- Living: First kill and then remove
3. Tympanic Membrane
- Also known as Ear drum
- It is semitransparent and oval in nature
Ports:
- Pars Tensa (largest)
- Pars Flaccida
- Handle of malleus
- Umbo
- Cone of light
- Annulus
Types of CSOM:
| Conductive Hearing Los | Sensorineural Hearing Loss |
| Any pathology which affect either external or middle ear. | Any pathology which a inner ear |
| Causes | Causes |
| Impacted Wax | Pre Bycusis |
| Foreign body | Meiner disease |
| Otitis medica | Acoustic neuroma |
| ASOM, CSOM | Ototoxic agonits |
Interpret the Following Value
Ranie Test:
- Negative on left side of ear
- Positive on right side of ear
Weber Test:
- Lateral to left side of ear
4. Otomycosis
A fungal infection, which infect external ear. Commonly infect immunocompromised patient.
Causes:
- Candida
- Aspergillus
- Rare fungi
Symptoms:
- Otalgia
- Itching
- Otorrhea
- Mild Fever
Treatment:
i) Keep affected ear dry.
ii) Clotrimazole or fluconazole ear/drops
5. NASAL POLYPS
A benign non-cancerous mass of the paranasal arises from mucosa of the nose and para-nasal sinuses.
| Ethmoidal Polyp | Antrochoanal Polyp |
| A polyp arises from ethmoidal sinus | Polyp arises from maxillary sinus |
| Multiple in number | Single only |
| Grows anteriorly | Grow posteriorly |
| Common | Uncommon |
| Polypectomy | Polypectomy |
6. Tonsillitis:
Inflammation of Tonsils. Most commonly infected tonsils are the palatine tonsils.
Types: Depending upon duration
- Acute = Symptom last < 2 weeks
- Chronic = symptom last > 2 weeks
Types:
- Catarrhal tonsillitis: Viral cause
- Follicular Tonsillitis: Bacterial Cause
- Parenchymatous: Almost touch each other’s tonsils
- Membranous tonsillitis: Diphtheria tonsils
Symptoms:
- Sore throat
- Dysphagia
- Fever
- Tender lymph node
Diagnosis:
- C.B.C
- Swab culture
Treatment:
Analgesic
Antibiotics
Amoxicillin
7. Tonsillectomy
Indications:
- Recurrent sore throat
- Quinsy
- Membranous tonsillitis
- Suspicious of malignancy
8. Epistaxis
Bleeding from nasal mucosa
Causes:
- Nasal Trauma
- Foreign Body
- Bleeding disorder
- Uncontrolled HTN
| Anterior Epistaxis | Posterior Epistaxis |
| Bleeding from little area | Bleeding from woodruff area |
| Most common | Less common |
| Easy to locate | Difficult to locate |
Treatment:
- Trotter methods
- Look downward & forward
- Check B.P
- Nasal Packing
- Cautrization
- Ligation
9. Ludwig Angina
A severe bacterial infection that occurs in the floor of the mouth under the tongue result in submandibular swelling.
Causes:
- Dental Infection (Most Common)
- Facial Trauma
Symptoms:
- Fever
- Chills and Rigor
- Submandibular swelling
- Tenderness underthe jaw
- Dyspnae
Treatment:
- Incision / Drainage
- I/V antibiotics followed by oral
10. Vocal Nodules
- Non-neoplastic condition of larynx
- These are solid nodules
- Mainly seen in the medial side of the larynx
Causes:
- Trauma to vocal fold
- Singers teacher etc
- Idiopathic
Symptoms:
- Hoarseness of voice
- A feeling of a lump in the throat
- Vocal fatigue
- Pain in the throat
Diagnosis:
- Laryngoscopy
Treatment:
- Voice Rest
- Vocal Training
