Course unit title Code Conventional and urgent help in otolaryngology MF/ANG/M- V07 Cycle of course unit Integrated Study programme Medicine Level of course unit Not applicable Course 6 Department Department of Type of course unit Elective ENT Course unit duration weeks Mode of delivery Traditional Part of programme Study area Assessment strategy Examination Number of ECTS credits allocated Student's workload Contact work hours Independent work hours 10 10 7 Study requirements Annotation During this cycle the students become familiar with the directions of otolaryngology, outpatient and inpatient physician work, patient study of ways, most commonly performed ENT operations. Purpose of the course unit: programme competences to be developed To become acquainted with conventional and urgent aid performance in otorhinolaryngology. Learning outcomes of the programme Program: family medicine, gastroenterology, Pulmonology and AllergologyMaxillofacial disease, neurosciences, students learn about and learn to diagnose diseases topographically dependent structures; and to provide first aid to bleeding, laryngeal stenosis, acute hearing loss, foreign body cases. Learning outcomes of the course unit Students learn how to diagnose the most common otorhinolaryngological diseases and first aid emergencies. Course unit methods lectures, seminars, practical work, self-classes Assessment strategy Cumulative assessment Assessment methods Cumulative marks Weighting percentage Practice - 0.; theory - 0.6 Period or date of assessment Last week - a practical test; the last day - the exam of theory [1 questions query] Assessment criteria Practice (ANG examination + clinical situation) - max. + points; theory/query - 6 points 387
Lectures Consultations Seminars Training exercises Laboratory work Internship Tutorials Assessment All contact work hours Independent work hours Cumulative grade formula Practice Max points + theory Max 6 points Course content Topics Contact work hours and planned learning activities Independent work hours and tasks Tasks Introduction to otolaryngology. Historical facs. Developement of otolaryngology in Lithuania, nowadays achievements, prospect. Examination techniques and evaluation of ear, nose and throat. Study of literature, patients consultations, clinical signs analysis, differential diagnosis, creation plan of investigation and treatment. Otosurgery opportunities. Suppurative and non suppurative ear diseases surgery methods; Surgical hearing rehabilitation with cochlear implantation and BAHA systems. Indications, surgery criteria. The semiotics of otological pain and otorrhea urgent treatment. Deseases of external acoustic meatus.erysipelas of external ear, auricle perichondritis, external otitis: diffuse and localised, external ear foreign bodies. Acute otitis media, otitis media with effusion (OME). Symptoms, diagnosis, treatment. Indications for paracentesis and tympanostomy. Acute otitis media in children: anatomical, immune, social causes; diagnosis and treatment. Chronic suppurative otitis media.otogenic complications.mesotympanitis (exacerbation). Epitympanitis (exacerbation). Localised and diffuse labyrintitis. Semiotics of pain, dizziness, otorrhea, differential diagnosis, surgical treatment indications. 388
Symptoms, diagnosis and first aid organisation of otogenic meningitis, sigmoid sinus trombosis, brain abscess. Otorrhea, otalgia.otorrhea nature and causes. Principles of otologic and radiologic diagnosics. Treatment. Etiology, pathogenesis, differential diagnosis, treatment of otalgia. 3 Investigation of otogenic clinical cases. Differential diagnosis and treatment of dizziness.conception, causes, contemporary diagnosis, treatment and rehabilitation principles of peripheral dizziness syndrom. Peripheral vestibular syndrom. Vertigo causes, clinical aspect. Principles of diagnostics and treatment. Emergency aid for pacient with dizziness. Meniere s disease etiopathology, symptoms, differential diagnosis, methods of treatment. The main causes, symptoms, differential diagnosis, first aid organisation of acute sensoneural hearing loss. Causes, diagnostics and hearing rehabilitation of chronic Ototoxity: causes, early diagnosis and principles of treatment. Peculiarities of endonasal sinus surgery.significance of osteomeatal complex, radiological examination, principles of surgical treatment. Mucociliary clearance of nose and paranasal sinuses, the mechanism of nasal polyp formation. 389
Acute diseases of nose and paranasal sinuses.acute rhinitis. Principles of acute rhinitis in children. Allergic rhinitis. Acute inflammation of maxillary, frontal, ethmoid and sphenoid sinuses. Semiotics of pain and nasorea, differential diagnosis, tactics of prompt treatment. Chronic sinusitis.etiopatogenesis of chronic sinusitis, clinical forms. Nasal polyps.odontogenic maxillary sinusitis.endoscopic and radiologic diagnostics.conservative and surgical treatment. Functional endonasal surgery: opportunities, indications. Rinogenic complications.rinogenic orbital (extraconal, intraconal) and intracranial complications.semiotics, radiologic diagnostic and urgent treatment of these conditions. Discussion of clinical cases. Bleeding from nose.local and general causes of bleeding from nose, differential diagnosis, emergency aid. Indications for selective angioembolization. Anterior and posterior tamponade. Inflammatory illness of throat.acute and chronic pharyngitis: etiology, principles of treatment. Classification of acute tonsillitis, diagnostics and treatment. Principles of treatment of chronic tonsillitis. Indications for tonsillectomy. Complications after tonsillectomy: bleeding, dysphagia, dysgeusia. Tonsillogenic complications. Peritonsillar abscesses, tonsillogenic sepsis, deep neck infection (parapharyngeal, retropharyngeal abscess), infection spreading routes.the symptoms, diagnosis and treatment characteristics of these conditions. 390
Thematic discussion of clinical cases. Sleep apnea in otorhinolaryngology causes, symptoms, diagnosis and methods of treatment. Otorhinolaryngological point of view of snoring.snoring and sleep apnea syndrome.conservative and surgical treatment guidelines of snoring and sleep apnea. 3 Examination of snoring patient. Müller's maneuver. Polisomnography. 1 Laryngeal stenosis.causes of congenital and acquired laryngeal stenosis.degrees,clinical manifestations of laryngeal stenosis. Treatment and first aid principles. Diagnosis of stridor in children: diagnosis and treatment. Hoarsneness-causes, alternative diagnoses, treatment recommendtions. Functional and organic types of dysphonia. Multi-parametric laryngological examination:indications, methods,medicl-social significance. Benign laryngeal neoplasms and premalignant conditions.pseudotumors of the larynx, etiology, clinical findings, conservative and surgical treatment. Endolaryngeal microsurgery. The use of CO laser in phonosurgery. Benign laryngeal conditions: chronic laryngitis with keratosis and laryngeal papillomatosis in adults. Disorders of innervation of the larynx.peripheral paralysis of the larynx, clinical findings, diagnostics and treatment. Indications for surgery. Lateralization and medialization of the vocal cord: indications, stages. 391
Laryngeal cancer.the cinical manifestation depending on the topography. Diagnosis, principles of combination treatment. Factors affecting survival. Tracheostomia indications, technique, postoperative care. Ear, nose, throat, laryngeal foreign bodies.semiotics of the following conditions.differential diagnosis. Immediate treatment tactics. Credit Overall: 10 61 7 Required reading 1. Probst R, Grevers G, Iro H. Basic Otorhinolaryngology. Stuttgart: Thieme; 006. Recommended reading 1. K.J. Lee. Essential otolaryngology Head & Neck Surgery. 7 ed, Appleton & Lange, Stamford, Connecticut 1999. p. 1007-1067. Cummings CW. Otolaryngology: Head and Neck Surgery th edition. 00. Coordinating Lecturer Ph.d. Ruta Pribuisiene rutaprib@yahoo.com Valid from Valid until 013 39