Ent instrument

Ent instrument

1. ENT OPD INSTRUMENTS AND PROCEDURES Dinesh Lamichhane

2. OPD Instruments

3. 1.Bulls Eye Lamp 100 watt bulb Plano convex lens in front of bulb to focus Ideally Lamp is placed 6 inch above and behind the left shoulder of the patient(at the level of left ear) Use:provide powerful source of light

4. Mobile Source of light Bulls eye lamp is semi mobile source of light as it can be twisted, rotated , raised and lowered. Clairs Head Light is the mobile source. 9 volt bulb and a adjustable concave mirror is placed in front of the bulb.

5. Head Mirror Concave mirror to reflect light from Bulls eye lamp onto the part being examined. Focal length is about 10 inch (25 cm). Internal diameter of hole is 19 mm and diameter of mirror with hole is 89mm.

6. Focusing of light with Head Mirror Steps Patient sitting on stool must be at same level of doctor. Patient legs must be placed to one side of doctor. Distance between patient and doctor must not be more thab 8 inches Mirror is fixed over the right eye in such a way that part of the mirror touches the nose.

7. The mirror is adjusted in such a way that the right eye sees through the hole in the mirror. Mirror is adjusted while keeping the left eye closed and right eye open. Then both eye are opened.

8. Lacks Metallic Tongue Depressor Use to examine the oral cavity and oropharynx . And also use to check the patency of nostrils by observing fogging.

9. Nasal Speculum Viennas Nasal Speculum Thudicum Nasal Speculum

10. Use of Nasal Speculum To visualise the nasal cavity.

11. Laryngeal Mirror Use to examine the larynx and laryngopharynx To prevent fogging: warmed over spirit lamp or by dipping into hot water. Then tested on the dorsum of hand before inserting.

12. Post Nasal Mirror/ Rhinoscopy Mirror To examine nasopharynx and posterior part of nasal cavity.

13. Ear Speculum Various size available according to the size of ear canal. Largest size that can be inserted conveniently should be used.

14. Siegels Speculum Use for the examination of tympanic membrane, it gives magnifying view. To test tympanic membrane mobility. To elicit fistuls sign.

15. Tuning Fork 256 Hz, 512 Hz, 1024 Hz Commonly used 512 Hz 256 Hz produces more of vibration sense 1024 Hz shorter decay time Site of striking: olecranon , radial styloid , patella or soft tissues like thenar hypothenar eminences, soft rubber strip Use tuning fork tests.

16. Jobsons Horne Probe with Ring Curette Ring curette: to remove wax Probe: use to form a cotton bud to clean the discharge.

17. Blunt Probe Use for the palpation of nasal cavity or ear canal.

18. Forceps Tilleys Forcep Hartmans Forceps

19. Wildes Forceps

20. Use of Forceps Packing of ear canal and nasal cavity.

21. Eustachian Tube Catheter To check the patency of eustachian tube. To remove foreign body from nose.

22. Method of insertion of eustachian tube catheter Nose anaesthetize Catheter pass along the floor of nose Turn medially and slightly withdraw such that it fix to the posterior free border of nasal septum. Turn laterally by 180 degree Catheter lie against the opening of eustachian tube.

23. Otoscope Electric or battery operated device with magnifying glass. Detail examination of ear. Hold in pen holding position.

24. Spirit lamp Use to warm laryngeal and post nasal mirror.

25. Baranys Noise Box Use in audiological testing with tuning fork and speech testing. Baranys test Barany noise box is kept on the side of normal ear and on the other ear examiner shouts, if patient is unable to hear: barany deaf ear.

26. Thank you