ENT INSTRUMENTS
OTOLOGY
Uses:
a. Removal of wax
b. Removal of foreign body in the ear and nose
c. Removal of granulations in the ear
d. The probe end is used to probe polyp in the nose and
ear
e. The probe end can act as a cotton swab carrier and can
clean the ear or apply medication.
Jobson-Horne probe with ring curette
• Wilde aural forceps
This is a forceps used both in the ear and nose. It can be used
to pack and unpack spaces and cavities. It can also deliver
medications in dressings.
TUNNING FORK
• Parts: The 512Hz tuning fork is commonly used for the
• a. Two prongs following reasons.
a. It is present in the mid speech frequency range
• b. Shoulder
b. Overtones are minimal
• c. Stem c. Sound is more auditory than tactile in nature
• d. Base. d. Tone decay is optimal.
Uses of the tuning fork:
a. To detect the type of hearing loss
b. To make an approximate estimate of the degree of
hearing
loss.
• Siegel pneumatic speculum with bulb
• Parts:
• a. Rubber bulb
• b. Rubber tube
• c. Aural speculum
• d. Eye piece with an oblique convex lens [Parallel to the
• tympanic membrane].
• Uses:
• a. Siegelization
• b. Fistula test
• c. Examination of external ear canal and tympanic
membrane.
• d. Instillation of medications.
• Eustachian tube catheter
• Uses:
• a. To test the patency of Eustachian tube
• b. To inflate the middle ear
• c. To instill medications in the middle ear
• d. To remove foreign bodies from the nose
• e. As a suction cannula.
• Uses:
• a. To remove softened wax
• b. To remove non hygroscopic foreign body and small hygroscopic
foreign bodies.
• Contraindications:
• a. Perforated tympanic membrane
• b. Otitis externa
Simpson aural syringe • c. CSF otorrhea
• d. Large hygroscopic foreign body
• e. Atrophic or thinned out tympanic membrane.
• Complications:
• a. Tympanic membrane rupture
• b. Vasovagal attack
• c. Injury to the external auditory canal
• d. Vertigo due to stimulation of labyrinth.
Otoscope
Adult rigid
otoendoscope
• Hartman aural speculum Tumarkin aural speculum Shea aural speculum
• Uses:
• a. Examination of the external ear canal and tympanic
• membrane
• b. Removal of wax, foreign body, otomycosis or ear discharge
• c. In operative procedures like myringotomy, myringoplasty,
• stapedotomy, stapedectomy
• d. For transcanal injections.
• Myringotome
It is an instrument used to make an
incision on the tympanic
membrane for serous otitis media
(OME) or unresolved acute otitis.
GROMMET
Goode ‘T’ tube
Sheehy type grommet
Shepard
Shah type
MASTOIDECTOMY & TYMPANOPLASTY
Micromotor unit for drilling
Uses:
1. For drilling mastoid and ear canal
2. Can also be used to drill bone for choanal
atresia, endoscopic dacryocystorhinostomy
3. Ossicular sculpting
4. During stapedotomy to remove overhang
5. Dental and maxillofacial surgeries
6. Caldwell-Luc operation
7. Frontal sinus wall drilling
8. Mandibulectomy.
Mollison self-retaining
heamostatic mastoid retractor
• This is a self-retaining mastoid retractor with four prongs on either blade.
Besides retracting the tissue and fascia from the field of operation it can also
secure hemostasis by compressing the vessels.
• Uses:
1. Harvesting temporalis fascia
2. M astoidectomy, tympanoplasty
3. In head and neck surgeries like tracheostomy and
laryngofissure.
Farabeuf mastoid periosteal
elevator
Uses:
a. To elevate periosteum over
mastoid bone in mastoidectomy.
b. Can also be used to elevate
periosteum and soft tissues
during maxillectomy, lateral
rhinotomy and mandibulectomy.
Jenkin mastoid gouge
Uses:
a. Remove hard bone during
mastoidectomy Lempert mastoid curette
b. Caldwell-Luc operation Uses:
c. Excision of exostosis in external a. To curette chunks of bone from mastoid and
auditory canal. ear canal during ear surgeries like tympanoplasty,
mastoid exploration or stapedotomy.
Can also be used to remove granulation tissue
and cholesteatoma.
Micro ear sickle knife
Uses:
a. To freshen the margins of tympanic membrane
perforation
b. For myringotomy incision
c. Skeletonization of the handle of malleus
d. To break the middle ear adhesions
e. Dislocation of incudostapedial joint during
stapedectomy
Plester flag knife
Rosen micro ear round knife Uses:
To make a horizontal incision on the external
Uses: canal wall skin during elevation of
a. External canal skin tympanomeatal incision tympanomeatal flap. It is also used to elevate
b. Elevation of tympanomeatal flap during myringoplasty, tympanomeatal flap.
tympanoplasty Hence used in middle ear surgeries like
c. Freshening the margins and undersurface of the
myringoplasty, tympanoplasty
perforation
during myringoplasty and tympanoplasty
d. To break middle ear adhesions
RHINOLOGY
Thudicum nasal speculum
Uses:
a. Diagnostic: Anterior
rhinoscopy—nasal septum,
Little’s
area, lateral wall of nose, nasal
cavity
b. Therapeutic: removal of
foreign bodies, antral wash, nasal
packing, surgical procedures
inside the nose.
Vienna nasal speculum Killian short and long bladed nasal speculum
Uses:
a. Diagnostic: Anterior rhinoscopy—nasal septum, Little’s
area, lateral wall of nose, nasal cavity
b. Therapeutic: Removal of foreign bodies, antral wash,
nasal packing, surgical procedures inside the nose like
polypectomy, SMR, septoplasty, etc.
St. Clair Thompson posterior rhinoscopy mirror
Use:
1. Examination of the post nasal space.
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SEPTAL SURGERY
Uses:
a. To elevate mucoperichondrial and
periosteal flap in septal surgeries
b. For elevating canal skin and cartilage
perichondrium in mastoid surgeries
c. For elevation of mucosa in Caldwell-
Luc operation
d. To spread and tease temporalis fascia
Freer double-ended mucoperichondrial graft
elevator
This is a knife that can rotate 360 degrees
within its two prongs.
It can be used in submucous resection of
septum and also to harvest cartilage for
rhinoplasty and tympanoplasty.
Ballenger swivel knife
Mallet/Hammer
Nasal gouge
ASCH FORCEP WALSHAM FORCEP
ASCH FORCEP WALSHAM FORCEP
Angled blade Straight blade
No rubber tube on the tip Rubber tube on the tip
Gap seen between 2 prongs on approximation No gap seen between the prongs
Use to elevate and straighten the septum Use to resurface and realign the nasal fracture
Stout Smaller in size
Merocel nasal dressing
EPISTAXIS
NASAL SURGERY Epistaxis catheter
THROAT INSTRUMENTS
LAC TONGUE DEPRESSOR
A. EXAMINATION OF ORAL CAVITY AND OROPHARYNX
B. TO RETRACT LIPS AND CHEEK
C. TO TEST GAG REFLEX
.D FOR COLD SPATULA TEST TO CHECK PATENCY OF NASAL
PASSAGE
F. FOR POSTERIOR RHINOSCOPY
G. FOR ORAL CAVITY PROCEDURES LIKE INJECTION OF
STEROIDS, BIOPSY, EXCISION OF CYSTS, ETC.
For examination of tongue base,
valleculae, glossoepiglottic
fold, pharyngoepiglottic fold,
arytenoids, aryepiglottic
folds, ventricular bands, vocal
Indirect laryngoscopy mirror cords, interarytenoid region,
pyriform fossae and posterior
Structures not seen in this procedure: pharyngeal wall.
a. Postcricoid region
b. Apex of pyriform fossa
c. Ventricles
d. Undersurface of vocal cords and adjoining subglottic
region
e. Laryngeal surface of epiglottis.
ADENOID/TONSILLECTOMY INSTRUMENTS
Indications:
a. Tonsillectomy
b. Adenoidectomy
c. Surgeries of palate and nasopharynx
d. Excision of choanal polyp.
Boyle Davis mouth gag with tongue blade
DRAFFIN BIPOD MAGAUREN PLATE
St. Clair Thompson adenoid curette with cage
It is held like a dagger and the adenoid
is curetted from the nasopharyngeal wall in the midline by
sweeping movement.
The cage is used to prevent slipping of the excised tissue into the throat.
Dennis Browne tonsil holding forceps
It is used to hold the tonsil and pull it
medially during the process of
dissection
Mollison tonsillar dissector and pillar
retractor
It has a blunt end used for initial atraumatic dissection of the tonsil. The
retracting end is used to retract the anterior pillar to look for bleeding
points and tags of tonsillar tissue left behind.
It is used to snare the lower
pole of the tonsil after dissection. The
lower pole is crushed on snaring and
thromboplastin is released which is a
powerful vasoconstrictor.
Eve tonsillar snare
Negus artery
forceps
Ligating blood vessels in a deep site.
RIGID OESOPHAGOSCOPE
It is a long rigid hollow tube of 40 to 45 cm length
Uses:
Diagnostic
a. Malignancy
b. Foreign body examination
c. Tracheoesophageal fistula
d. Stricture.
Therapeutic
a. Removal of foreign body
b. To guide bougies through esophageal
strictures
c. Esophageal stenting
d. Sclerosing agent injection into esophageal
varices.
RIGID BRONCHOSCOPE
• Uses:
• Diagnostic:
a. For examination of tracheobronchial tree for pathology—growth, ulcer,
stricture, etc.
b. Biopsy from a suspicious growth or ulcer
c. Bronchial lavage from secretions
Therapeutic:
a. Foreign body removal
b. Tracheobronchial stenting
c. Aspiration of secretions
d. Removal of tumors.
Direct
laryngoscope
Uses:
a. For examination of larynx, hypopharynx, cricopharynx
and upper esophagus
b. Removal of foreign bodies from the above regions
c. For biopsy from tumors
d. For excision of tumors or nodules from the glottis or
supraglottis
TRACHEOSTOMY TUBES
• Mettalic Tracheostomy tubes/Non metallic Tracheostomy tubes
Jackson tracheostomy tube Fuller bivalved tracheostomy tube
NON METALLIC TRACHEOSTOMY TUBES
Parts:
a. Single tube with collar
b. Cuff
c. Balloon with valve for air
d. Pilot obturator
Advantages:
a. Made up of soft material, hence less damaging to the tracheal wall
b. Since it has a cuff it is particularly useful for intensive care unit patients
c. It is useful during radiotherapy
d. It has a blue radiopaque line all along the tube for radiological detection of the site
of the tube.
Disadvantages:
a. Cleaning the tube is more difficult—requires removal
b. Phonation not possible usually
c. Cuff might injure the tracheal wall (tracheal necrosis) if overinflated and left for a
longer period of time. Pressure should be preferably less than 30 mm of Hg.
Features Metallic Non-metallic
Inner & outer tube Present Only one tube
Cuff Absent Present or absent
Positive pressure Not possible Possible if cuffed
ventilation
Prevention of Not possible Possible if cuffed
aspiration
Radiotherapy Incompatible Compatible
Phonation Possible in Fuller type Not possible usually
Cleaning the tube Easier Removal of entire tube
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