Universitat Internacional de Catalunya
Otolaryngology
Teaching staff
Students may ask lecturers questions at the end of each class. For enquiries outside of class time, students must make an appointment by email:
Dr. Francesc Xavier Subirana: fxsubirana@uic.es
Dr. Eusebi Matiñó: ematino@uic.es
Dra. Paloma Puyalto: ppuyalto@uic.es
Dr. Jordi Serra:
Dra. Francina Aguilar:
Dr. Ferran Ballesteros:
Dr. Luís García-Ibañez:
Introduction
Othorinolaryngology is the specialty that embraces the necessary practical and theoretical knowledge for the diagnosis and treatment, both medical and surgical, of ears, nose and throat (pharynx and larynx), para-nasal sinuses and neck pathology
Pre-course requirements
In order to study Othorinolaryngology the student should have passed the subject “Structure and Function: skin and sensory organs”.
It would be also advisable for the student to have a good understanding and basic knowledge of the physiology and anatomy of the following:
-Anatomy and functional anatomy of Head and neck
-Anatomy and physiology of the Nervous and Endocrine systems.
-Anatomy and Physiology of the Respiratory system specially upper respiratory tract (trachea and Larynx).
-Anatomy and physiology of the upper Gastrointestinal tract and salivary glands.
Also basic knowledge on the following subjects would be advisable:
-Genetics and Human Embryology
-Imaging techniques
-Semiology
-Emergencies: history taking and Semiology
-Surgical Physiopathology
Objectives
The overall objective of this subject is for the student to acquire the theoretical knowledge and clinical skills which would allow him/her recognizing the main pathologies of the specialty, differentiating their degree of severity and possible consequences ,diagnostic orientation and sensible approach to diagnostic resources.
Knowing the best therapeutic approach considering the patient and his pathology, and promoting prevention. Awareness of the patient’s global view as a patient and as a human being.
Specific Objectives
The overall objective will be complemented with the next specific aims:
To develop professional practice with respect to patient autonomy, beliefs and culture, with respect for other health professionals, demonstrating teamwork skills
To know the basic anatomy and functions of the organs and systems involved in the domain of Othorinolaryngology.
Acquiring a global view of the interaction between these organs and systems and the related ones.
To get an integrated and global view of the mechanisms altering the normal function of the different structures which form the subject of Othorrhinolaryngology.
To know the basic physiopathology leading to different diseases and syndromes in Othorrhinolaringology.
To define the causative agents of the existence of the pathology including in the field of ENT
To acquire the basics in order to obtain a good history taking related to the different pathologies and syndromes of the specialty.
To obtain and develop a medical record that contains all relevant information structured and patient-centered, taking into account all groups of age, gender, cultural, social and ethnic
Conduct a medical history that allows diagnostic orientation of the main pathologies integrated knowledge in the area of ENT
To acquire the knowledge and the skills to perform basic anatomical examinations: frontal light examination, otoscopy, rhinoscopy and oropharyngoscopy and neck palpation.
To conduct a basic examination of the ear, a basic examination of the nasal passages and sinuses and oral cavity, larynx, pharynx and cervical structures
To know the different anatomical and functional investigations available to complete the diagnosis.Properly interpret the basic tests specialty (hearing tests, balance and functional endoscopic examination of the upper aerodigestive tract)
To learn about imaging techniques in relation to Othorrinolaringology’s pathology.
To know when and which imagining technique should be requested in accordance with the pathology suspected in every clinical situation.
To make a differential diagnostic algorithm based on the accurate and systematic reading of any imaging exploration related to the otolaryngology system.
Ability to logically gather all diagnostic elements available to reach a final diagnosis in a quick,safe and sensible way.
To attain the necessary knowledge to make accurate differential diagnosis.
To diagnose the most common diseases including in the field of Otology, Rhinology, Faringolaringología Neck Surgery and Pathology
To identify pathologies in the field of ENT requiring priority action or are tributaries of specialized care
To be aware of the different treatment options in order to plan a therapeutic strategy in a reasonable and efficacious way.
To understand the different prevention measures and promoting social awareness in order to reduce the impact on ENT pathology.
To list the public health standards to prevent the occurrence of the diseases included in the field of ENT. To promote public health standards in the field of performance
To acquire enough knowledge to be able to make accurate prognosis.
To have a rigorous scientific approach when analyzing and solving clinical problems.
To get the necessary skills and confidence to handle emergency situations and to deal with unexpected events properly.
To gather clear and effective communication skills, both verbally and in writing with patients and work colleagues.
To develop team work skills and liaison with other medical professionals.
To maintain and update professional skills with special emphasis on learning autonomously new knowledge and techniques and the motivation for quality
knowledge and accurate critical view of clinical information sources to process and deliver scientific information.
Responsable and ethical approach to patient’s care.
Competences/Learning outcomes of the degree programme
- 07 - Understand and recognise normal structure and function of the human body at the molecular, cellular, tissue, and organ and systemetic levels, at different stages of life and in both sexes.
- 09 - Understand and recognize the effects, mechanisms and manifestations of disease on the structure and function of the human body.
- 10 - To understand and recognise the agents and risk factors which determine health status, and learn how they determine the symptoms and natural development of acute or chronic diseases in individuals and populations.
- 11 - Understand and recognize the effects of growth, development and aging on the individual and their social environment.
- 13 - Obtain and develop a clinical history that contains all relevant information.
- 15 - Ability to formulate an initial diagnosis and establish a rationalised diagnostic strategy.
- 16 - Recognize and deal with situations that put life in immediate danger and those that require immediate attention.
- 17 - Establish the diagnosis, prognosis and treatment, applying principles based on the best information possible and safe clinical practice..
- 18 - To indicate the most appropriate (pharmacological, surgical, psychological, social or other) treatments that are pertinent to the most prevalent procedures, in terms of rehabilitation and also terminally ill patients, including an evaluation of their effectiveness.
- 19 - Propose preventive measures appropriate to each clinical situation.
- 20 - Acquire adequate clinical experience in hospitals, health centers and other health institutions under supervision, as well as basic knowledge of clinical management and patient-centered proper use of tests, drugs and other health system resources.
- 21 - Listen carefully, obtain and synthesize relevant information about the problems affecting the patient and understand the contents of this information.
Learning outcomes of the subject
To master ENT’s terminology and specific language.
To develop a professional approach respecting patient’s opinion believes and culture.
To develop a professional approach respecting other health professionals and team working skills.
To carry out a proper physical Ear ,nose throat and neck examination.
To be able to incorporate different data from physical examination and history taking into a syndrome that corresponds to a specific ENT pathology. To interpret the cluster of symptoms and signs in order to narrow down a differential diagnostic list.
To be familiar with the different ENT diagnostic techniques both anatomical and physiological. To learn about their utility, how to perform and to request them with their possible complications and contraindications being able to justify their request.
To be acquainted with medical and surgical treatments in ENT’s wild spectrum pathology.
To know how to proceed in both urgent and non urgent situations and to be familiar with therapeutic options being able to choose the correct one for each case.
To learn about post-operative care, possible complications and how to deal with them.
To know how to do a critical use of clinical information sources learning to obtain, organize ,interpret and deliver scientific information.
To be familiar with the basis of patient and health professional interaction ,communicating clinical information, informed consent and resolution of related conflicts.
Syllabus
INFECTIOUS AND INFLAMMATORY PATHOLOGY OF THE EXTERNAL AND MIDDLE EAR.
Master Class
External ear pathology: External Otitis, foreign bodies and tumours
Ear maformations
Eustachian Tube physiopathology. Barotraumatisms
Acute middle otitis and chronic middle none suppurate otitis (Otitis media with effusion)
Chronically benign middle otitis and cholesteatoma
HEARING PATHOLOGY: HEARING LOSS
Master Class
Hearing pathology and hearing loss classification and examination methods
Transimissive hearing loss. Concept, Diagnostic and treatment.
Conductive hearing loss causes: Otitis media with effusion, Otosclerosis, Chronicle otitis media complications
Neurosensorial hearing loss. Concept, Diagnostic and Hearing Aids
Neurosensorial hearing loss causes: Ototoxicity, Presbyacusis, and Noise-induced hearing loss
Hearing loss causes in childhood
Screening methods and hearing loss approach
Treatment and Rehabilitation of infant hearing loss
MIDDLE EAR PATHOLOGY
Case Method
Clinical cases of infectious and inflammatory pathology of middle ear
BALANCE PATHOLOGY: DIZZINES. EAR TRAUMATISMS AND TUMOURS
Master Class
Dizziness pathology: Diagnostically and therapeutically approach
Differentiation between central and peripheral dizziness
Specifically Illness of central and peripheral dizziness: Meniere’s syndrome, Benign Paroxysmal positional vertigo, Acoustic Neuroma
Petrosal temporal bone traumatisms
Middle and inner ear tumours
OBSTRUCTIVE NASAL PATHOLOGY
PBL
Nasal breathing insufficiency. Causes and diagnostically and therapeutically approach
Septal dysmorphia. Nasal and facial traumatisms
Medical and surgical treatment of nasal obstructions
Facial malformations and Nasal Foreign bodies
Benign and intermediate malignity nasal tumours
Central facial granuloma
Nasal obstruction and dentofacial development
HEARING LOSS AND BALANCE ASSESSMENT:
Skill laboratory
Hearing function assessment systems:
ACUMETRY
AUDIOMETRY
TYMPANOMETRY
AUDITORY BRAINSTEM RESPONSE
VESTIBULAR EXAMINATION
INFLAMATORY AND INFECTIOUS SINONASAL PATHOLOGY
Master Class
Acute and chronicle rhinitis. Nasal Allergy. Concept, diagnostic and treatment
Acute and chronicle sinusitis. Sinonasal Polyposis. Concept, diagnostic and treatment
Sinusitis complications
Medical and surgical treatment of sinonasal infectious processes.
FACIAL NERVE AND IEC
Case Method
Objectives:
Intraotical Facial nerve anatomy
Causes and clinics of injury and facial palsy
Diagnostic and therapeutic approach
NASOSINUSAL PATHOLOGY AND SRBD
Case Method
Clinical cases of obstructive and inflammatory pathology of nasosinusal system
PHARYNGEAL INFLAMMATORY PATHOLOGY
Master Class
Pharyngeal concept and anatomy. Pharyngeal functions
Waldeyer lymphatic ring. Anatomy and function
Infectious pharyngeal pathology: Pharyngitis and tonsillitis. Concept, diagnostic and
treatment Waldeyer’s ring children pathology.
Pharyngeal Chronic pathology. ENT Manifestations of Gastroesophageal Reflux
EPISTAXIS
PBL
Objectives:
To learn the nasal vascularization anatomy
Light and several Epistaxis
Diagnostically and therapeutically approach
VOICE TROUBLES
Master Class
The Larynx as a phonation organ. Voice anatomy and physiology
Voice, speech and language concepts
Voice troubles: Dysphonia. Causes
Acute and chronicle laryngitis
Phoniatry and Logopedia. Voice treatment and Rehabilitation
Laryngeal palsies
DYSPHAGIA
PBL
Objectives:
To learn the swallowing functional anatomy
Swallowing pathology: Upper dysphagia
Diagnostic approach of the swallowing troubles on oral and pharyngeal phases
Treatment and Rehabilitation
PHARYNGO-LARYNGEAL PATHOLOGY
Case Method
Clinical cases of pharyngolaryngeal pathology
ONCOLOGY OF THE UPPER AERODIGESTIVE TRACT
Master Class (I & II)
Head and Neck cancer epidemiology
Rhinopharyngeal and sinonasal cancer
Laryngeal and Hypopharyngeal cancer
Oral cavity and Oropharyngeal cancer
Lymphatic metastasis: concept and diagnostic and therapeutic approach. Prognostic value
Salivary cancer
Acute Upper airway obstruction concept. Approach and differential diagnosis. Causes.
Acute obstruction of the upper airway treatment. Tracheotomy and Intubation
BASIC EXAMINATION ON ENT CONSULTING ROOM
Skill Laboratory
Basics concepts of ENT examination. Lighting Techniques
Otological examination
Rhinological examination
Oral cavity and pharyngeal examination
Laryngeal examination
Cervical examination
CERVICAL AND SALIVARY PATHOLOGY
Master Class
Cervical anatomy of the neck flexion area: Contents and departments
Cervical nodes: Distribution and drainage
Semiology and examination of the neck area
Cervical neck’s benign pathology: Adenitis, cysts and cervical fistulae
Salivary Glands anatomy and function
Benign pathology of salivary glands
Examination methods and therapeutically approach
ONCOLOGICAL AND CERVICAL PATHOLOGY
Case Method
Clinical cases of Upper airway tumours
SLEEP RELATED BREATHING DISORDERS
Master class
Objectives:
Sleep-disordered breathing concept
Clinical and health consequences
Diagnosis and treatments
IMAGING IN OTOLARYNGOLOGY.
Skill Laboratory
Review of the principal techniques, main indications and systematic reading.
Revision of the main imaging techniques that study the ear, paranasal sinuses- nose, larynx and pharynx: plain radiography, computed tomography, magnetic resonance, scintigraphy and positron emission tomography. Indications, contraindications and systematical reading.
Teaching and learning activities
In person
The master class is the scenario in which a teacher transmits knowledge in a classroom to the whole group of students. The format, however, allows the introduction of small group activities within the classroom and the deployment of strategies that encourage active student participation.
The case method is the process of solving clinical cases of the profession. Group activities resolved with the active participation of the teacher after the deliberation of the students.
Problem based learning (or Active Methodology in reduced groups) has similarities with the case method but differs in that students are responsible for the solution to the problem. The teacher acts as a guardian who facilitates the process of learning from their metacognitive abilities. Is also performed in groups.
The skills lab is a device in which the student can develop basic communication skills and physical examination based on mannequins, robots, devices, and simulated patients and real patients. Are conducted with small groups. It is also an area for a more practical approach to investigations and surgical techniques.
The training activities with distribution by groups (Case Methods, MAGR and Skills Laboratories) will be totally presencial
The master classes will be face to face.
All this, obviously, if sanitary regulations do not change this approach.
Evaluation systems and criteria
In person
Final exam type test
At the moment the exam will be done in person if the health regulations do not change between now and December
The same is valid for the repechage exam.
WRITTEN PAPER EVALUATION
FINAL EXAM: 70%
50 MCQs with 4 possible answers. The exam content includes all the topics embraced in the different formative categories. Each correct answer will be worth 1 point. An incorrect answer will suppose a penalty worth 1/3 of a point. It represents 70% of the theoretical part.
VIVA EXAM EVALUATION: 30%
Case method: after each CM the student will be asked to provide the correct solution to the case as well as to answer related questions. There will be 4 CM.: 62,5% of practical evaluation
Problem based learning: 50% of total practical qualification
Skills lab: attendance is mandatory and more than 2 unjustified non-attendances will be penalized deducting 10% of the Viva score.
Master class: at the end of each master class there will be an exam on the subject taught. Only in those students who have attended a minimum of eight of the 10 possible exams (10 master classes), the 8 best marks will be chosen, which will serve to raise a maximum of 0.5 extra points in the final mark.
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Exam |
Assessment |
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Theoretical: 70% |
MCQs: 100% |
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Practical: 30% |
Cas Method: 62,5% MAGR: 37,5% |
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Master classes exams: 8 of 10 (conditional) |
Weighted mark at 0,5 extra points |
In the practical part of the exam (cas methods and Problem base learning) will be taken into account also the attitude of the student and the degree of participation at the discretion of the teacher in charge
TO IMPROVE QUALIFICATION IN FIRST CALL EXAM
Those students in which the final grade has a 9,1 or higher, may qualify for honors. Honors will be given in order of the highest marks, and up to the maximum number authorized by the subject's credits.
2ND CALL EXAM
Those students who fail the exams in first instance will have a second opportunity a few months later.
WRITTEN PAPER: will be made up of an MCQ test embracing all the topics covered in the course. The score system will be the same described above. The Viva exam score will remain the same obtained in the first instance.
FINAL SCORE
To pass the final exam a mark above or equal to 5 will be required. The final score will be based on a scale of nil to ten.
Qualitative Score : not passed (suspenso), passed (aprobado), good (notable),excellent (excelente) and mark of distintion (matrícula de honor)
EXAM REVIEW SYSTEM
Exam reviews: will be conducted face-to-face following a written request before a pre-established closing date.
Bibliography and resources
1. Otorrinolaringología. Manual Clínico
José Luis Llorente Pendás, César Álvarez Marcos y Faustino Núñez Batalla
Editorial Médica Panamericana 2012. ISBN 978-84-9835-371-6
2. Manual de Otorrinolaringología
Segunda Edición
Rafael Ramírez Camacho
McGraw-Hill. Interamericana 2007. ISBN 978-84-481-4677-1
3. Otorrinolaringología y Patología Cervicofacial
Jorge Basterra Alegría
Masson S.A. 2005. ISBN 84-458-1328-5
4. Lecciones de Otorrinolaringología Aplicada Tomo I y II.
Constantino Morera Pérez y Jaime Marco Algarra.
Editorial Glosa 2004