Instruments Used in ENT: A Comprehensive Guide

Jobson Horne Probe with Ring Curette

It is a probe that has a ring on one end and a serrated edge on the other end.

Uses

• Removal of wax 
• Removal of foreign body 
• Removal of granulations from the external auditory canal
• To probe the polyp helps us to understand its origin

Hartmann Tuning Fork 

It is a commonly used instrument in the OPD. Tuning fork frequency varies. It could be 256Hz/512Hz/1024Hz. It is used in Rinne’s test, Weber’s test, and absolute bone conduction tests. Aids in diagnosing conductive hearing loss & sensorineural hearing loss.

Siegel's Pneumatic Speculum

This apparatus consists of aural speculum connected to a pneumatic attachment. Aural speculum is inserted into the external auditory canal. Pneumatic attachment adjusts the pressure accordingly, and the mobility of the tympanic membrane is observed. It is also used for performing the fistula test.

Also read: Essential One-Liners in ENT: Key Facts, Diagnoses & Treatments

Otoscope with Pneumatic Attachment 

The otoscope is inserted into the external auditory canal. It provides us a magnified view (2x-2.5x) of the tympanic membrane. Aids in the detailed assessment of the external auditory canal & tympanic membrane (retraction, perforation, discharge, granulation). The tympanic membrane movement can be evaluated using the pneumatic attachment. It is also used to perform the fistula test.

Simpsons Aural Syringe

Uses 

• Syringing (temperature of the water: 37°C). 
• Removal of foreign body and wax. 
• Caloric test. 

Direction of syringing: posterior wall of the external auditory canal. C/I of syringing: TM perforation, hygroscopic or organic foreign body, otomycosis, history of vaso-vagal attack. 

Politzers Myringotome

It is used to perform myringotomy (opening in the tympanic membrane).

Indications of Myringotomy

In acute suppurative otitis media (ASOM) with no antibiotic response, excruciating ear pain with bulging tympanic membrane, incomplete resolution, persistent effusion beyond 12 weeks, and facial palsy. In serous otitis media (SOM), if not resolved after three months. 

Also read: Essential Pediatric One-Liners: Key Facts and Conditions

Grommet

It is a ventilating tube placed between the middle ear and external auditory canal.

Mollison Self-Retaining Hemostatic Mastoid Retractor

It is a self-retaining retractor that helps to achieve hemostasis by compressing the tissue. It is used in mastoid surgery. It is a hands-free instrument since it is self-retaining. Presence of equal number of prongs in the arm of retractor → Mollison retractor

Plester's Mastoid Retractor

This retractor has unequal number of prongs with one larger prong → Plester's Mastoid Retractor

Wietlaner’s Mastoid Retractor

Unequal number of prongs in the arm of retractor →Wietlaner's retractor

Also read: Understanding Microbial Staining and Sterilization Methods

Jansen Mastoid Retractor

 This retractor has a knob instead of rings to open/close the retractor.

Perkins Mastoid Retractor 

This retractor has a single prong on one side and three prongs on the other side.

Thudicum's Nasal Speculum

Used in anterior rhinoscopy. Used in opening the nasal vestibule to visualize the nasal cavity proper. 

Killian's Long and Short-bladed Nasal Speculum

Self-retaining speculum with screws and can be short or long bladed. Used for performanterior rhinoscopy, septoplasty and turbinoplasty

Also read: How to Prepare ENT for FMGE

St Clair Thompson Posterior Rhinoscopic Mirror

Used in posterior rhinoscopy. The shaft of this mirror has a bend. It helps to visualize the posterior end of the nose and the nasopharynx.

Walshams Forceps

Used to reduce nasal bone fractures. It has rubber tubing on one side, which is placed outside the nasal cavity, and the other end is inserted into the nasal cavity. The rubber tubing helps to avoid orbital trauma. 

Asch Septal Forceps 

Used to reduce septal fractures. It does not have rubber tubing. It is angulated.

Boyle Davis Mouth Gag/Russel Davis tongue blade

Used to keep the mouth open and fixed during the surgery. It has different types of tongue blades, like the Russell Davis tongue blade or Doughty’s tongue blade. It helps visualize the Nasopharynx.

Draffins Bipod   

After the mouth gag is placed, Draffin's bipod is used for stability. It is fixed to the mouthgap with the help of the rings.

Also read: Essential Pediatric One-Liners: Key Facts and Conditions

Magauren Plate

Used to stabilize the Draffin bipod. Magauren's plate forms an assembly with the bipod and the mouth gag to keep the mouth in a fixed position during tonsillectomy. 

St Clair Thompson Adenoidectomy Curette with Cage    

Used to perform adenoidectomy. It may or may not have a cage. Cage is used to prevent aspiration. During the initial period of the procedure, a cage is used, and later a cageless curette can be used to remove the remnants. 

Mollison Tonsillar Dissector and Anterior Pillar Retractor 

Used to perform tonsillectomy. The blunt end is used for tonsillar dissection, and the curved end is used to retract the anterior pillar and to visualize the bleeding points.

Eve Tonsillar Snare

Used to crush and cut off the lower pole of the tonsil from its bed.

Also read: Glomus Tumor - Types, Clinical Features, Diagnosis

Lacs Tongue Depressor

Used to examine the oral cavity, tonsils, and the oropharynx. Used to perform cold spatula tests.

Indirect Laryngoscopic Mirror

Used to visualize the larynx. The shaft of the indirect laryngoscopic mirror is straight. The tongue is pulled out, and the mirror is placed behind the uvula facing downwards to get an unobstructed view of the larynx. A tongue depressor is not used.

Rigid Direct Laryngoscope

The pointed end is used to stabilize the larynx, and the tapered end is used to visualize. Directly inserted through the mouth and fixed on the vocal cords to visualize the larynx. Alternatively, a 70° rigid endoscope can be used.

Kliensasser Suspension Laryngoscope for MLS  

Used while performing vocal cord surgery, laryngeal, or microlaryngeal surgeries. At the circular hollow end, the microscope is fixed and the other end of the tube is fixed on vocal cords →Thus, the vocal cord structures can be visualized in a magnified way. Through this aperture, the instruments are passed for the resection of lesions.

Also read: Chronic Suppurative Otitis Media (CSOM): Symptoms & Treatment

Trousseau Tracheal Dilator

It helps to dilate the opening in the trachea during tracheostomy.

Head Mirror

It has a diameter of 9 mm, a central aperture of 2 mm, and a focal length of 18 cm. This is worn by the examiner on the right eye. Through the reflective surface of the mirror, the light is focused on the area of interest. The light source is placed on the patient’s end, usually behind their left shoulder. 

Bulls Eye Lamp 

A light source was used along with the head mirror. It has a 100-watt bulb that shines light on the head mirror, and the reflection helps to visualize the tissue.

Also read: Important One-Liners in Ophthalmology

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