List of instruments used in otorhinolaryngology, head and neck surgery

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Instruments used specially in Otolaryngology (Otorhinolaryngology, head and neck surgery) i.e. ENT are as follows: [1] [2]

Contents

Instrument list

InstrumentUses
Head Mirror with head bandto focus light into the cavity under inspection; mirror is concave and is used with a Chiron lamp to produce a parallel beam of light; doctor views through the hole (average diameter of mirror is 3 & 1/2" & that of hole is 1/4")
Head mounted lights with head bandto focus light into the cavity under inspection
Chiron lampsource of light
Katz extractorto remove nasal foreign body
Bull's eye lampsource of light; exiting lens is convex and produces a divergent beam of light
Speculum to dilate orifices and to see inside
•Thudichum's nasal speculum-do-; short blades ( uses: anterior rhinoscopy - to see the Little's area, ant-inferior part of nasal septum, anterior part of inferior and middle turbinate and meatus, as well as any pathological lesion in the area; also used in certain nasal operations )
•St. Clair Thompson's long bladed nasal speculum-do-; long blades ( uses: in operations such as Submucous Resection of the nasal septum )
•Killian's long bladed nasal speculum-do-; long blades and with handles; used more operations like SMR & Septoplasty. ( advantage: blade can be adjusted and fixed with screws, to avoid strain due to holding )
•Lempert's endaural speculumopen the ear canal
•Seigle's pneumatic speculumopen the ear canal and give a magnification; test the mobility of tympanic membrane; see a magnified image of small perforations; introduce medicine into middle ear; perform Fistula test for vestibular function
•Aural/Ear speculumto fit in and straighten the external ear canal
Lack's tongue depressorto depress or remove the tongue or other structures from the field of inspection or to view them from all sides; examine oral cavity; posterior rhinoscopy; minor operations; foreign body removal; biopsy ;peritonsillar abscess drainage; retraction of cheek and lip.
Forceps to hold things [3]
•Asch's septum forcepsused to work on the nasal septum
•Tilly's nasal dressing forcepsfor use in the anterior part of the nasal cavity Jmost importantly, anterior nasal packing; larger than Hartmann's, serrated tip & box joint ( uses: all nasal operations; nasal packing; removal of fish bone )
•Tilly's aural dressing forcepsfor use in the ear canal; larger than Hartmann's
•Hartmann's aural forcepsfor use in the ear canal; smaller than Tilly's and has a better "biting" action
•Hunter Tod's forcepsfor use in the ear canal
•Fagge's aural forcepsfor use in the ear canal
•Waugh's long dissecting forcepsused for dissection like on the tonsils, also to catch bleeding points and putting in swabs
•Wilson's tonsil artery forcepsas a haemostat ( same as Negus )
•Negus tonsil artery forcepsas a haemostat, replaces tonsil artery forceps; used to tie ligature at a depth and ligature won't slip due to its curve tip.
•Peritonsilar abscess forcepsto drain abscesses in the soft tissue adjacent to the palatine tonsils
•Denis Brown's tonsil holding forcepsto hold the tonsil during dissection
•Luc's nasal forcepsused in Caldwell-Luc operation on the maxillary sinuses
•Walsham forcepsused to work on the nasal septum
•Citelli's punch forcepspunching out holes in bones or other tissues
•Henckle's punch forcepspunching out holes in bones or other tissues
Eustachian (tube) catheter on certain procedures of the eustachian tube or the middle ear like patency test; inflate middle ear and clear eustachian tube blockade; removal of foreign body of the nose; as a suction cannula.
Mirrors
•Laryngeal mirrorstraight mirror for indirect laryngoscopy (seeing the larynx); structure seen are the base of tongue, vallecula, glossoepiglottic fold, epiglottis, pharyngo-epiglottic folds, aryepiglottic folds, epiglottis, interarytenoid region, pyriform sinus, inlet of larynx, supraglottic region, ventricular bands, vocal cord, subglottis and few rings of trachea; used for removal of fish bone, biopsy, anaesthesia of larynx, trachea, bronchi; removal of vocal nodule and papilloma.
•Postnasal/Posterior rhinoscopy mirror (St. Clair Thompson's)for posterior rhinoscopy (seeing the inner parts of the nose like the choanae)
Bronchoscopehollow tube to see within the respiratory tract without obstructing respiration
Oesophagoscopehollow tube to see within the oesophagus
Laryngoscope used in direct laryngoscopy; video link
Jobson Horne's probe with ring curetteto access or clean the external ear
Tuning forks for various clinical tests of hearing loss; vibration sense test
Pritchard's politzerization apparatusvideo link
Aural/Ear syringe used to flush out anything like ear wax or foreign bodies from the external ear
Toynbee's auscultation tube
Otoscope/Auriscopeto examine the external auditory canal and ear drum; used during aural toileting, removal of wax, myringotomy, stapedectomy and to dilate the stenosis of canal
Mouth gag-
•Doyen's mouth gagto keep the mouth open, mostly operate the mouth
•Boyle Davis mouth gagto keep the mouth open and depress the tongue to operate within or through the mouth; operations in which it is used: tonsillectomy, operation of palate, pharynx, nasopharynx.
•Jenning's mouth gag-do-
Draffin's bipod metallic stand and Magauran's plateused to hold the Boyle Davis mouth gag fitted head in a particular place.
Guillotineused in guillotine method of tonsillectomy
Gwyenne Evans Tonsil dissector and anterior pillar retractorused in tonsillectomy
Snares-
•Eve's tonsil snareto remove tonsil - used at the end to minimize bleeding
•Krause's nasal snare used to remove nasal polyps
•Glegg's nasal polyp snareused to remove nasal polyps
•Aural snareused to remove aural polyps
Tonsil knifeused in tonsillectomy.incission of anterior pillar of tonsil in the beginning of operation
Yorke's tonsil haemostatic clamphaemostatic clamps
Negus' ligature slipper/knot tierused with Negus's or Wilson's artery forceps to help tie sutures; help to slip the ligature over the tip of Negus or Wilson forceps during ligation of vessels following tonsillectomy.
Negus' artery forcepsas a haemostat; replace tonsil artery forceps; ligature will not slip due to curve tip.
St. Clair Thompson adenoid curette with cage and guardused in adenoid surgery.held in dagger holding fashion and passed behind soft palate.
Yankauer's nasopharyngoscopefor a direct access or look at the nasopharynx
Yankauer suction tip double bent sucker; used as a sucker in operations of the mouth
Lichtwitz antrum-puncture trocar and canulaused in nasal sinus surgery; conform presence of puss in maxillary sinus; cytological examination of antral wash out fluid; lavage of the maxillary sinus; introduction of medication and indwelling polythene tube into the sinus
Tilly's antral harpoon trocarto create an artificial passage into the maxillary sinus through the nose; puncture medial wall of inferior meatuses
Tilly's antral burto enlarge the artificial passage into the maxillary sinus through the nose made by the harpoon trochar; dilate and smoothen the antrostomy opening
Freer's double-ended mucoperichondrium elevatorseparation of the mucosa from the cartilage in nasal surgery like Septomarginal resectiondisplacement of inferior turbinate
Farabuef's periosteal elevatorused in mastoid surgeries like mastoidectomy
Rose's sinus washing canulato irrigate the maxillary sinuses
Higginson's syringeirrigating the antrum,nasal douching for atrophic rhinitis
Ballenger's swivel knifecutting septal cartilage; SMR operation
Nasal foreign body hookto remove nasal foreign bodies
Electric drillfor bone drilling
Mollison's self-retaining haemostatic mastoid retractorused in mastoid surgeries to retract overlying tissues
Staecke's guide and protectorused in mastoid surgeries
Chisel removing parts of bones
Mastoid gouge removing parts of mastoid bones
MacEwen's cell seeker with curetteused to curette within the mastoid
Lempert's curette or scoopremoving parts of the nasal septum
Killian's nasal bone gougebayonet shaped; removing parts of the nasal septum
Myringotomeused to cut the ear drum
Grommet stapedectomy setused in surgeries of the ear drum
Tracheostomy tubeused in tracheostomy to bypass the airway above its point of insertion, due to any reason
•Fuller's bi-valve typemetal double tube; used in a new tracheostomy or during closing it for a few days
•Portex typeused in permanent tracheostomy
•Cuffed typein unconscious patient (single cuff is sufficient); used in permanent tracheostomy (with two cuffs); has a balloon (cuff) that is inflated to occlude the airway around the tube to prevent aspiration of fluids into the lungs
•Jackson'smetal double tube and a pilot
Retractor's (single or double hook)to retract tissues
Tracheal hooks (blunt or sharp)used in tracheostomy
Lempert's endural retractorused in ear surgery
•Jansen's self retainingself retaining retractor used in mastoid surgery
•Mollison's self retaining haemostaticself retaining retractor used in mastoid surgery
Tracheal dilatorused in tracheostomy to dilate the cut edges of the trachea
Long gauze piecesfor anterior nasal packing

Related Research Articles

Otorhinolaryngology Medical specialty

Otorhinolaryngology ( oh-toh-RYE-noh-LAR-in-GOL-ə-jee, abbreviated ORL and also known as otolaryngology, otolaryngology – head and neck surgery, or ear, nose, and throat is a surgical subspecialty within medicine that deals with the surgical and medical management of conditions of the head and neck. Doctors who specialize in this area are called otorhinolaryngologists, otolaryngologists, head and neck surgeons, or ENT surgeons or physicians. Patients seek treatment from an otorhinolaryngologist for diseases of the ear, nose, throat, base of the skull, head, and neck. These commonly include functional diseases that affect the senses and activities of eating, drinking, speaking, breathing, swallowing, and hearing. In addition, ENT surgery encompasses the surgical management and reconstruction of cancers and benign tumors of the head and neck as well as plastic surgery of the face and neck.

Tracheotomy Temporary surgical incision to create an airway into the trachea

Tracheotomy, or tracheostomy, is a surgical procedure which consists of making an incision (cut) on the anterior aspect (front) of the neck and opening a direct airway through an incision in the trachea (windpipe). The resulting stoma (hole) can serve independently as an airway or as a site for a tracheal tube or tracheostomy tube to be inserted; this tube allows a person to breathe without the use of the nose or mouth.

Speculum (medical) Medical device for investigating body orifices by direct vision

A speculum is a medical tool for investigating body orifices, with a form dependent on the orifice for which it is designed. In old texts, the speculum may also be referred to as a diopter or dioptra. Like an endoscope, a speculum allows a view inside the body; endoscopes, however, tend to have optics while a speculum is intended for direct vision.

Forceps Handheld, hinged instrument used for grasping and holding objects

Forceps are a handheld, hinged instrument used for grasping and holding objects. Forceps are used when fingers are too large to grasp small objects or when many objects needed to be held at one time while the hands are used to perform a task. The term "forceps" is used almost exclusively in the fields of biology and medicine. Outside biology and medicine, people usually refer to forceps as tweezers, tongs, pliers, clips or clamps.

Choanal atresia Congenital disorder where the nasal passage is blocked

Choanal atresia is a congenital disorder where the back of the nasal passage (choana) is blocked, usually by abnormal bony or soft tissue (membranous) due to failed hole development of the nasal fossae during prenatal development. It causes persistent rhinorrhea, and with bilateral choanal atresia and obstructed airway that can cause cyanosis and hypoxia.

Laryngectomy

Laryngectomy is the removal of the larynx and separation of the airway from the mouth, nose and esophagus. In a total laryngectomy, the entire larynx is removed. In a partial laryngectomy, only a portion of the larynx is removed. Following the procedure, the person breathes through an opening in the neck known as a stoma. This procedure is usually performed by an ENT surgeon in cases of laryngeal cancer. Many cases of laryngeal cancer are treated with more conservative methods. A laryngectomy is performed when these treatments fail to conserve the larynx or when the cancer has progressed such that normal functioning would be prevented. Laryngectomies are also performed on individuals with other types of head and neck cancer. Post-laryngectomy rehabilitation includes voice restoration, oral feeding and more recently, smell and taste rehabilitation. An individual's quality of life can be affected post-surgery.

Patulous Eustachian tube (PET) is the name of a physical disorder where the Eustachian tube, which is normally closed, instead stays intermittently open. When this occurs, the person experiences autophony, the hearing of self-generated sounds. These sounds, such as one's own breathing, voice, and heartbeat, vibrate directly onto the ear drum and can create a "bucket on the head" effect. PET is a form of eustachian tube dysfunction (ETD), which is said to be present in about 1 percent of the general population.

Empty nose syndrome Medical condition

Empty nose syndrome (ENS) is a potential complication of nasal surgery. ENS is a clinical syndrome that is often referred to as one form of secondary atrophic rhinitis in the medical literature. People with ENS have usually undergone a turbinectomy or other surgical procedures that interfere with turbinates; the overall incidence is unknown but it appears to occur in a small percentage of people who undergo nasal surgery. People with ENS may experience a range of symptoms, most commonly feelings of nasal obstruction, nasal dryness and crusting, and a sensation of being unable to breathe.

Instruments used in general surgery

There are many different surgical specialties, some of which require very specific kinds of surgical instruments to perform.

Functional endoscopic sinus surgery (FESS) is a minimally invasive procedure which uses nasal endoscopes to enlarge the nasal drainage pathways of the paranasal sinuses to improve sinus ventilation and allow access of topical medications. This procedure is generally used to treat inflammatory and infectious sinus diseases, including chronic rhinosinusitis that do not respond to drugs, nasal polyps, some cancers, and decompression of eye sockets/optic nerve in Graves ophthalmopathy.

Instruments used in obstetrics and gynecology

The following is a list of instruments that are used in modern obstetrics and gynecology.

Neurotology or neuro-otology is a subspecialty of otolaryngology—head and neck surgery, also known as ENT medicine. Neuro-otology is closely related to otology, clinical neurology and neurosurgery.

Hypernasal speech Medical condition

Hypernasal speech is a disorder that causes abnormal resonance in a human's voice due to increased airflow through the nose during speech. It is caused by an open nasal cavity resulting from an incomplete closure of the soft palate and/or velopharyngeal sphincter. In normal speech, nasality is referred to as nasalization and is a linguistic category that can apply to vowels or consonants in a specific language. The primary underlying physical variable determining the degree of nasality in normal speech is the opening and closing of a velopharyngeal passageway between the oral vocal tract and the nasal vocal tract. In the normal vocal tract anatomy, this opening is controlled by lowering and raising the velum or soft palate, to open or close, respectively, the velopharyngeal passageway.

Antral lavage is a largely obsolete surgical procedure in which a cannula is inserted into the maxillary sinus via the inferior meatus to allow irrigation and drainage of the sinus. It is also called proof puncture, as the presence of an infection can be proven during the procedure. Upon presence of infection, it can be considered as therapeutic puncture. Often, multiple repeated lavages are subsequently required to allow for full washout of infection.

Hartmann alligator forceps

The Hartmann alligator forceps or Hartmann foreign body forceps, named after the German physician Arthur Hartmann, are medical forceps for removing foreign bodies. It is used in addition to surgery mainly in otorhinolaryngology (ENT). Their quality depends on the origin and quality of the stainless steel. Indian steel is used often for hobbyist use. FDA and CE certified instruments also veterinary instruments are normally made of Japanese or German steel.

Lakhumal Hiranand Hiranandani (1917–2013) was an Indian otorhinolaryngologist, social activist and philanthropist, known for pioneering several surgical procedures which later came to be known as Dr. Hiranandani's Operations. He was the founder chairman of Hiranandani Foundation Trust which runs two schools in India and was reported to have been active in the social movement against organ trade in India. He was a recipient of the Golden Award of the American Academy of Otolaryngology–Head and Neck Surgery, the first Indian and the fifth overall to receive the honour. The Government of India awarded him the third highest civilian honour of the Padma Bhushan, in 1972, for his contributions to medicine and society.

Eustachian tube dysfunction (ETD) is defined as pressure abnormalities in the middle ear that result in symptoms.

George Fayad FRCS, FICS, is an ear nose and throat surgeon, who introduced the use of nasal titanium implants in the UK to open up the nasal valve and improve breathing in people with nasal valve dysfunction. In addition to general conditions of the ear, nose and throat, he treats snoring, sleep problems and vertigo. He also performs the operation of ear-pinning without an incision. He is chairman of the ENT department at the Basildon and Thurrock University Hospitals NHS Foundation Trust and head of the allergy clinic at Basildon Hospital.

Muaaz Tarabichi is a Syrian American otolaryngologist, lecturer, researcher, and author. He is recognized around the world as the father of endoscopic ear surgery. He is the co-founder of Tarabichi Stammberger Ear and Sinus Institute. He was elected as the chairman of the International Advisory Board of the American Academy of Otolaryngology–Head and Neck Surgery.

References

  1. ↑ ENT and head neck surgery by Dr. S K. De, ISBN   81-87447-16-8
  2. ↑ Diseases of the ear, nose and throat by Dr. P. L. Dhingra, 4th Edition, ISBN   81-312-0327-1
  3. ↑ DOWNS Surgical
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