ENT (Otorhinolaryngology) for MBBS

High-yield areas for university examinations

• Ear anatomy and physiology: the middle ear cleft with its six walls, ossicles and muscles, the mastoid air system, and the mechanics of sound transmission and Eustachian tube function.
• Hearing loss: conductive versus sensorineural deafness, tuning fork tests (Rinne, Weber, absolute bone conduction), pure tone audiometry, tympanometry and screening tests such as BERA and otoacoustic emissions.
• Ear infections: otitis externa including furuncle and otomycosis, acute otitis media, chronic suppurative otitis media with the safe tubotympanic versus unsafe atticoantral distinction, and cholesteatoma.
• Complications of otitis media: mastoiditis, facial nerve palsy, labyrinthitis, petrositis and the intracranial complications — meningitis, extradural and subdural abscess, brain abscess, lateral sinus thrombosis and otitic hydrocephalus.
• Middle ear surgery: myringotomy and grommets, myringoplasty, tympanoplasty with the Wullstein types, ossiculoplasty and mastoidectomy.
• Vertigo and balance: Meniere disease, benign paroxysmal positional vertigo with the Dix-Hallpike test and Epley manoeuvre, and a basic approach to vestibular versus central causes of dizziness.
• Facial nerve: intratemporal course, branches, causes of lower motor neuron facial palsy, Bell palsy management and Ramsay Hunt syndrome.
• Nose and paranasal sinuses: epistaxis and its graded management, acute and chronic sinusitis with orbital and intracranial complications, nasal polyps, deviated nasal septum and turbinate hypertrophy.
• Oral cavity and oropharynx: acute and recurrent tonsillitis, peritonsillar abscess (quinsy), oral ulcers and premalignant lesions, and the basics of salivary gland disease.
• Obstructive sleep apnoea: clinical features, Epworth sleepiness score, polysomnography and the role of CPAP versus surgery.
• Larynx and tracheobronchial tree: laryngeal cartilages and nerve supply, hoarseness and vocal cord paralysis, laryngeal carcinoma, and inhaled foreign bodies.
• Tracheostomy: indications, the operative steps at the second and third tracheal rings, aftercare, complications and decannulation.
• Neck spaces and deep neck infections: Ludwig angina, parapharyngeal and retropharyngeal abscess, and the danger space with its risk of mediastinitis.
• Foreign bodies and congenital swellings: foreign bodies of the ear, nose and airway, preauricular sinus, branchial cyst and fistula, and thyroglossal cyst as the standard differential.

Theory preparation

Long questions in ENT usually follow set templates — classify the condition, list causes, describe clinical features, investigations and treatment — and examiners award marks for the classification more than the prose. Prepare classifications first: types of hearing loss, types of CSOM, complications of otitis media, causes of epistaxis, causes of hoarseness, indications and complications of tracheostomy and tonsillectomy. Support answers with simple labelled diagrams of the tympanic membrane on otoscopy, the tuning fork test interpretations, the lateral wall of the nose and the larynx, because a quick diagram communicates the whole answer. For short notes, write in point form and lead with the defining fact, then two or three clinical or operative details.

Practicals and viva

The practical examination typically rotates through a short case (often chronic ear discharge, hearing loss, epistaxis, nasal obstruction or a neck swelling), otoscopy on a model or patient, tuning fork demonstration on a volunteer, instruments and radiographs. Rehearse describing a tympanic membrane systematically — light reflex, margins, perforation position and type, and any attic crust or discharge. Practise interpreting Rinne and Weber results aloud for every combination of ear until it is automatic. For instruments, learn the name, one identifying feature and the specific use of the common set: aural speculum, Jobson-Horne probe, Luer's forceps, Tilley's forceps, nasal speculum, tongue depressor, indirect laryngoscopy mirror, trocar and cannula, and tracheostomy tubes. Viva examiners frequently cross-check clinical knowledge at the bedside, so link every instrument to the procedure it serves.

Preparation with PrepElephant

The PrepElephant app supports ENT preparation with question banks built around previous university and NEET-PG pattern questions, revision checklists for each region, and viva-style rapid revision. The free topic notes on this website, such as tuning fork tests, CSOM, epistaxis and tracheostomy, follow the same direct-answer format and pair naturally with app-based practice; clinical exposure during the ENT posting remains irreplaceable.