FACULTY OF MEDICINE
HAIL UNIVERSITY
HAIL, SAUDI ARABIA
Otolaryngology – Head & Neck Surgery
Section
CURRICULUM & STUDAY GUIDE
(4th year Medical Students)
2015-2016
CONTENTS
Subject
Page No
Introduction…………………………………………………………1
Course contributors……………………………………………..2
Course descriptions ……………………………………………..3
Course objectives………………………………………………… 4
Course structures………………………………………………..11
Rrecommended texbooks……………………………………13
EvalutionMethods……………………………………………….13
Lectures timetable ………………………………………........14
(1)
INTRODUCTION:
Otorhinolaryngology – Head & Neck surgery is an important
and peculiar branch of Medicine that the medical student and
future doctors in different specialties will be confronted with
otorhinolaryngology head and neck related diseases. Therefore
it is important for medical students to acquire adequate basic
otorhinolaryngology clinical knowledge and skills how to
recognize and manage the ORL diseases and to seek specialized
advice when it is needed. The course is organized to reach such
tasks by using different means of education through OPD,
bedside teaching, rounds, OR and lectures .
Dr Abdullah Bin Dakheel Alotaibi
Otolaryngology consultant , Assistant professor
Course Organizer , Hail University
(2)
Course Contributors
1-Dr Fahad Nashmi
Head of Department
Consultant ORL,KKH
2-Mohammed Shahid
Specialist ORL, KKH
3-Yasser Suliman
Specialist ORL, KKH
4- External Lecturers
(3)
Course Description:
Course No: ENT 421
Duration : 4 Weeks
Course Coordinator: Dr.Tarig Mahmoud Ahmed
Location:
1.College of Medicine
Hail
2.King Kalid Hospital (KKH)
Hail
3- General Hail Hospital (GHH)
Hail
(4)
Objectives of Otolaryngology – Head & Neck Surgery Course:
Medical students supposed to meet the following objectives at
the end of the course:
Knowledge:
a) To know the pathology and clinical presentation of common
otorhinolaryngology and upper aero-digestive tract diseases.
b) Understand which symptoms and signs signify potentially
serious conditions.
c) Be aware of common pathology.
Specific Knowledge & skills:
1) Understand the pathology and clinical presentation of
common conditions affecting the upper aero-digestive tract.
2) Understand which symptoms and signs signify potentially
serious disease.
3) Be aware of the management of upper airway obstruction.
4) Appreciate the handicap, educational and social
consequences of hearing loss at different ages and the
rehabilitation of hearing loss.
5) Be aware of appropriate investigations in head and neck
disease.
6) Be aware of the etiology, presentation and management of
malignan tHead & neck diseases
(5)
Pediatric ENT Topics:
(1) Tonsils and Adenoids
SKILLS:
-be able to examine the tonsils
-be familiar with tests for evaluating adenoids and tonsils
-obtain a history of the onset and progression of sore throat
and associated symptoms
-order appropriate investigations for evaluation of a sore
throat
KNOWLEDGE
-know the anatomy and describe the location of the tonsils and
adenoids
-understand the consequences of adenoid and tonsillar
hypertrophy
-distinguish between snoring and obstructive sleep apnea
-know the common causes of an acute sore throat and describe
their presentation and management (including viral
pharyngitis, bacterial tonsillitis, peritonsillar abscess and
infectious mononucleosis)
-know the indications for tonsillectomy and adenoidectomy
(2) Pediatric Airway
SKILLS:
-be able to assess a child with stridor and differentiate stridor
from wheeze
-be familiar with appropriate airway management in a child
with airway obstuction (especially suspected epiglottitis)
(6)
-obtain appropriate investigations in a child with a suspected
foreign body aspiration or ingestion
KNOWLEDGE
-define stridor and understand how the quality of stridor can
help localize the area of obstruction
-know the differential diagnosis and basic management of
common causes of stridor in children (including
laryngomalacia, subglottic stenosis, and subglottic
hemangioma)
-recognize the presentation of epiglottitis and describe
appropriate management of the airway
-identify how foreign body aspiration can present
-know the importance of disk battery ingestion
-give advice on prevention of foreign body aspiration in
children
(3) Pediatric Ear Diseases
SKILLS
-conduct a general assessment of febrile illness in a child
-examine the outer ear, ear canal and tympanic membrane and
describe normal versus abnormal findings
KNOWLEDGE
-understand the pathology and presentation of acute otitis
media (AOM), serous otitis media, chronic suppurative otitis
media (ie.otorrhea)
(7)
-discuss management of the above diseases
-understand the risk factors for AOM
-describe complications associated with AOM
-know the common pathogens for AOM
-describe treatment options for AOM
-recognize the presentation of hearing loss in children
-know when infants and children require hearing testing
-understand prevention and treatment of otorrhea in patients
with tympanostomy tubes or chronic tympanic perforation
-discuss the indications for myringotomy and tubes insertion
(4) Pediatric Neck Masses
SKILLS
-conduct an examination of the neck and recognize normal
and abnormal structures
-describe relevant characteristics of a neck mass
-order appropriate investigations of a neck mass in child
KNOWLEDGE
-have an approach to diagnosis of a neck mass in child
-understand the pathology of common congenital neck masses
including thyroglossal duct cyst and branchial cleft cyst
(8)
Adult ENT Topics:
(1) Adult ear disorders
SKILLS
-describe landmarks on visualization of the tympanic
membrane
-recognize and describe abnormal findings on ear examination
-perform Weber and Rinne tuning fork tests and be able to
differentiate between conductive and sensorineural hearing
loss using tuning fork tests, i.e. understand the difference
between bone conduction and air conduction
-obtain a history characterizing dizziness to differentiate
vestibular versus non-vestibular causes of dizziness
KNOWLEDGE
-understand the anatomy of the ear
-understand the etiology, presentation and management of
common ear disorders including: otitis externa, cerumen
impaction, tympanic membrane perforation, hearing loss,
cholesteatoma
-give a differential diagnosis of conductive and sensorineural
hearing loss
-recognize the presentation of sudden sensorineural hearing
loss and initial management
-define tinnitus
-define vertigo
(9)
-recognize the presentation of benign paroxysmal positional
vertigo, Meniere’s disease and vestibular neuronitis
-list management
(2) Nasal Diseases
SKILLS
-examine a nose using a headlight and nasal speculum
-identify Little’s area, a common site of epistaxis
-recognize a septal deviation
-recognize nasal polyps and differentiate from normal
anatomy (turbinates)
-advise a patient with recurrent epistaxis on epistaxis
precautions
-order appropriate investigations for acute and chronic
sinusitis
-manage a simple nosebleed
KNOWLEDGE
-know the major blood supply of the nose
-list factors that contribute to epistaxis
-list treatment options for epistaxis
-list causes of nasal obstruction
-understand allergic rhinitis and list treatment options
-define acute and chronic sinusitis and know signs and
symptoms for each
(10)
-identify the common pathogens for sinusitis
-describe treatment options of acute and chronic sinusitis
-understand the etiology and natural course of sinusitis
-list possible complications from sinusitis
(3) Sore throat and neck masses in adults
SKILLS
-conduct an examination of the neck and recognize normal
and abnormal structures
-describe relevant characteristics of a neck mass
-order appropriate investigations of a neck mass in an adult
-identify Wharton’s and Stensen’s ducts
KNOWLEDGE
-list different causes of sore throat & management
-list risk factors for head and neck cancers
-identify common presenting symptoms of a patient with head
and neck cancer
-understand basic treatment of oral cavity, laryngeal and
nasopharyngeal cancer
-have an approach to differential diagnosis of a neck mass in
an adult
-understand the basic presentation and treatment of common
salivary gland disorders
-list causes of hoarseness , & vertigo
(11)
Course Structure:
Otolaryngology – Head & Neck surgery course last four weeks:
During this course students introduced to core aspects of
Otorhinolaryngology, Head and Neck diseases and its
management. Also they will be taught how take proper history
taking from ENT patients and physical examination of ear,
nose, pharynx, larynx, head and neck. In addition, they will
learn how to assess hearing in adult and children. Acquire
knowledge and clinical skills in knowing and using different
types of instruments used in daily ENT practice. These tasks
approached through:
1) Lectures : 20 lectures
2) Bed-side teaching & Rounds ( 4)
3) Out-patient clinic 5 clinics ( 15 hours )
4) Small group discussions (tutorials ) total 6
5) OR : (2)
Lectures:
Are study guide providing general knowledge, but not
detailed information. Basic sciences e.g. anatomy, physiology
related to subject is discussed as well as etiologies ,
manifestations and out line principles of medical and surgical
treatments also will be highlighted.
(12)
OPD:
Students able to see daily Otorhinolaryngology, Head & Neck
practice, how pt. interviewed / learn ethics in dealing with
patients and staff. Additionally they able to recognize and
taught how to examine ear, nose, throat, head and neck. To use
common instrument in diagnosis and management strategy to
confronted disease seen. Also they learn basic audiological test
and its interpretation
Tutorials:
Different Otolaryngology topics will be distributed for students
to be presented & discussed by them in small group Fashion
according to Timetable .
Bed Side & Rounds:
To do General & Grand Rounds on Patients with staff also
selection of common Otolaryngology cases for further
discussion after taking history & examination by students
OR:
Learn & watch different surgical approaches with different
techniques for common otolaryngology cases. Log books will
be distributed for each student for writing and recording
surgical procedures seen . Every surgical staff has to discuss
cases and sign in log book for each students.
(13)
Recommended Textbooks:
1) Lecture Notes : Diseases of the Ear, Nose & Throat,
By Bull ( 10th edition)
2) Color Atlas of ENT Diagnosis By T. Bull (5th edition)
3) Ballenger,s Otorhinolaryngology H& N Surgery (17th
edition)
Further Reading:
- Cummings Otolaryngology H& N Surgery by Mosby (5th
edition)
Web Sites :
-E Medicine , www.entuk.org & American Academy Of
Otolaryngology –Head & Neck Surgery .
Evaluation Method
1) One Quiz (MCQ) with Total
two Quizzes
=
15 marks
2) Final Written Exam (MCQ): at week 4 =
35 marks
3) Final OSCE examination type : at week 4 =
35 marks
4) Attendance & Log books
10 marks
every day =
5) Tutorials
5 marks
Total Marks = 100
Pass Marks = 60
Best Wishes