EBEORL-HNS.ORG
European Board Examination in Otorhinolaryngology - Head and Neck Surgery by the UEMS - ORL Section
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   Scope of knowledge / European syllabus in ORL
Scope of knowledge / European syllabus in ORL This syllabus has been extracted from the approved UEMS ORL Section and Board log book.

I. BASIC OBJECTIVES 

II. OTOLOGY

III. NOSE AND PARANASAL SINUSES

IV. LARYNX. TRACHEOBRONCHIAL TREE

V. ORAL CAVITY. PHARYNX AND OESOPHAGUS

VI. HEAD AND NECK AND AESTHETICS

 


 

I.       Basic Objectives

1 emergency medicine and resuscitation
2 infection control
3 antimicrobial therapy
4 transfusions medicine/blood grouping/cross-matching etc.
5 haemostasis
6 oncology
7 wound healing
8 general surgical techniques
9 basics in plastic and reconstructive surgery
10 transplantation medicine
11 soft tissue and bone traumatology
12 immunology
13 endocrinology
14 oral and parenteral nutrition
15 basic psychosomatic investigation/management
16 radiation protection
17 medical quality control
18 ethical principles/consent for operation
19 basic nutritional medicine
20 basic laboratory procedures
21 basic laboratory investigations,
      a.     indication, correct taking and handling of
      b.     samples and interpretation of the results
22 normal blood values
23 bacteriology/mycology
24 principal detection of fungi (cell culture)
25 antimicrobial medication
26 analysis of  tumour-markers
27 allergology laboratory investigations
 

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II.     Otology

A.  Diagnostic Procedures

a.)   CLINICAL EXAMINATION
1 otoscopy
2 endoscopy
3 microscopy

b.)   HEARING FUNCTION
1 hearing distance test
2 tuning fork tests
3 impedance audiometry
4 pure tone audiometry
5 speech audiometry
6 supraliminal audiometry
7 objective hearing test
      a.     evoked response audiometry (ERA,BERA)
      b.     oto-acoustic emissions (OAE)
8 paediatric audiology
      a.     screening methods
      b.     objective methods
      c.     subjective methods

c.)    VESTIBULAR FUNCTION
1 spontaneous nystagmus
2 induced nystagmus
      a.     positional nystagmus
      b.     caloric testing
      c.     electronystagmography
      d.     rotating chair test
      e.     spinal reflexes (Unterberger, Romberg)
      f.      posturography
      g.     videonystagmography

d.)   FACIAL NERVE FUNCTION
1 topodiagnostic testing
      a.     e.g. Schirmer´s test, gustatory tests, stapedial reflex
2 neurophysiological testing
      a.     nerve stimulation tests (e.g. MST, NMG (ENoG), TFR ...)
      b.     electromyography

e.)   INTERPRETATION OF RELEVANT IMAGING
1 conventional X-Ray, CT, MRI, Angiography

B.  Non-surgical Management
1 pharmacological treatment and/or physical rehabilitation
2 ear infection
3 sensorineural deafness
4 tinnitus
5 vertigo and disequilibrium
6 facial nerve paresis / paralysis
7 post-op care

C.  Surgical Management
1 temporal bone dissections (lab.)
2 local and regional anaesthesia
3 management of oto-haematoma
4 removal of osteomas
5 otoplasty
6 meatoplasty
7 foreign body removal
8 polyps of auditory meatus
9 myringotomy
10 ventilation tubes
11 myringoplasty
12 tympanotomy
13 antrotomy
14 mastoidectomy
      a.     simple
      b.     modified
      c.     radical
15 tympanoplasty (reconstruction of ossicles)
16 implantation of prosthesis
      a.     middle ear prosthesis
      b.     bone anchored hearing aids
      c.     cochlear implants
17 stapedectomy / stapedotomy
18 saccotomy
19 neurectomy (vestibular nerve section)
20 acoustic neurinoma surgery
21 facial nerve surgery
      a.     decompression
      b.     grafting
      c.     monitoring
22 glomus tumour surgery
23 petrosectomy
24 skull base surgery (otobasis) with reconstruction
25 correction of malformations
      a.     auricle
      b.     fistulas
      c.     outer ear canal
      d.     middle ear
26 repair of injuries
27 auricle
28 outer ear canal
29 middle and inner ear including nerves, vessels and dura of the temporal bone compartment
30 surgery of tumours
      a.     auricle
      b.     outer ear canal
      c.     middle and inner ear including nerves, vessels and dura of the temporal bone compartment
 

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III.   Nose and paranasal sinuses

A.  Diagnostic Procedures

a.)   CLINICAL EXAMINATION
1 assessment and ethnic variation
2 aesthetic proportions of the face
3 effects of aging process
4 anterior and posterior rhinoscopy
5 endoscopy
6 microscopy
7 photography

b.)   TESTS OF FUNCTIONS
1 rhinomanometry
2 acoustic rhinometry
3 olfactory tests (subjective, objective)
4 ciliary function tests

c.)    IMAGING
1 ultrasound scan (a- and b-mode)
2 X-ray conventional
3 interpretation of
      a.     CT-scan
      b.     MR-imaging
      c.     Isotope scan (szinti-scan)
      d.     Angiography

d.)   ALLERGY  INVESTIGATIONS
1 epicutaneous allergen tests
2 intracutaneous allergen tests (Prick, Scratch)
3 nasal provocation tests
4 nasal cytology
5 eliminative tests
6 interpretation of serological tests (RAST, IgE)

B.  Non-surgical Management
1 pharmacological therapy
2 specific immunotherapy (hyposensitization)
3 anaphylaxis reaction therapy

C.  Surgical Management

a.)   NOSE
1 local and regional anaesthesia
2 control of nasal epistaxis
      a.     nasal packing
      b.     nasal cautery
3 foreign body removal
4 nasal polypectomy
5 turbinate surgery
6 reposition of nasal fractures
7 incising abscesses
8 septal surgery
9 revision septoplasty
10 septum perforation repair
11 closed rhinoplasty
12 open rhinoplasty
13 revision rhinoplasty
14 complicated rhinoplasty
15 augmentation rhinoplasty
16 cleft patient rhinoplasty
17 reduction rhinoplasty
18 rhinophyma operation
19 correction of malformations (e.g. choanal atresia, fistulas, dermoids, etc.)
20 management of immediate post-operative complications

b.)   PARANASAL SINUSES
1 sinus endoscopy
2 antral lavage
3 endoscopic antrostomy
4 radical antrostomy (Caldwell-Luc)
5 frontal sinus trephination
6 external frontal sinus surgery
7 external ethmoidectomy
8 endonasal ethmoidectomy (endoscopic, microscopic)
9 fronto-ethmoidectomy (endoscopic)
10 sphenoid sinus surgery
11 revision paranasal sinuses operation
12 closure of oro-antral fistula
13 ligation of maxillary or ethmoidal artery
14 orbital decompression procedures
15 dacryo-cysto-rhinostomy
16 management of CSF leak
17 tumour surgery
      a.     maxillectomy (partial, total)
      b.     lateral rhinotomy
      c.     midfacial degloving
      d.     combined approach to the anterior skull base
      e.     orbitotomy
      f.      exenteration of orbit
      g.     surgery of the anterior skull base (incl. osteoplastic flap, dura plasty and related techniques)
18 repair of  injuries (traumatology)
      a.     soft tissue injuries
      b.     nasal fractures
      c.     septal haematoma
      d.     paranasal sinus fractures
      e.     fractures of orbit including blow out fracture
      f.      fractures of zygoma
      g.     optic nerve decompression
      h.     reconstruction of the anterior skull base
 

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IV.    Larynx. Tracheobronchial tree

A.  Diagnostic procedures

a.)   CLINICAL EXAMINATION (in adults and children)
1 Indirect mirror laryngoscopy
2 Flexible endoscopic examination of larynx, trachea, bronchi, with or without washings for cytology
3 stroboscopy
4 Direct laryngoscopy with or without swabs for microbiological assessment
5 microlaryngoscopy
6 Endolaryngeal, endotracheal and endobronchial biopsy

b.)   INTERPRETATION OF RELEVANT IMAGING
1 ultrasound scan, plain X-Ray, CT, MRI, PET

c.)    INVESTIGATIONS
1 Techniques in voice analysis
2 electromyography

B.  Non-surgical Management
1 Care of the professional voice
2 Voice restoration following laryngectomy/ total laryngectomy (care of the valve prosthesis)
3 Medical management of laryngotracheal disease

C.  Surgical Management
1 Topical, local and regional anaesthesia
2 removal of foreign bodies from larynx, trachea and bronchi
3 endotracheal intubation
4 Tracheotomy - tracheostomy (including percutaneous)
5 closure of tracheostome
6 Incision of crico-thyroid membrane
7 Endolaryngeal, endotracheal and bronchial laser surgery
8 surgery for unilateral cord palsy
9 surgery for bilateral cord palsy
10 Phonosurgery ( surgery for voice and speech)
      a.     Frame work surgery (thyroplasty)
      b.     Vocal cord augmentation
      c.     Botulinus toxin injection
11 Management of blunt and open laryngo-tracheal injury

a.)   SURGERY FOR LARYNGEAL TRACHEAL AND BRONCHIAL NEOPLASMS
1 endolaryngeal surgery for early cancer
2 endolaryngeal laser surgery for tumours in upper aerodigestive tract
3 Laryngectomy
      a.     total
      b.     partial
4 Laryngo-pharyngo-oeseophagectomy with flap reconstruction or viscus interposition
5 Techniques for insertion of valves for voice rehabilitation
6 Management of laryngo-tracheal stenosis
7 Tracheal and bronchial stenting
8 Repair of tracheo-oeseophageal fistula in adults

b.)   LARYNGEAL TRACHEAL AND BRONCHIAL DISEASES IN CHILDREN
1 Assessment and management of acute airway obstruction in children

c.)    SURGICAL MANAGEMENT OF CONGENITAL MALFORMATIONS
1 Supraglotic stenosis
2 Laryngeal web
3 Subglottic haemangioma
4 Vocal cord paralysis
5 Laryngeal cleft
6 Vascular compression

d.)   SURGICAL MANAGEMENT OF ACQUIRED CONDITIONS IN CHILDREN
1 Laryngeal papilloma
2 Tracheal stenosis
3 Inhalational injury
 

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V.      Oral Cavity. Pharynx and Oesophagus

A.  Diagnostic procedures

a.)   CLINICAL EXAMINATION
1 inspection and palpation of oral cavity and oropharynx
2 endoscopic assessment of oral cavity, pharynx and oesophagus, with flexible and rigid endoscopes, including biopsies, preparation of swabs, washings, and related techniques.
3 gustometry
4 functional tests of swallowing disorders
5 principles of assessment and diagnosis of sleep apnoea
6 principles of speech assessment and rehabilitation

b.)   INTERPRETATION OF RELEVANT IMAGING
1 ultrasound scan, conventional X-Ray, OPG, CT, MRI, esophagogram
2 diagnosis and interpretation of swallowing disorders including reflux

B.  Non-surgical Management
        1 pharmacological therapy
        2 swallowing and aspiration rehabilitation
        3 non surgical treatment of sleep apnoea and roncopathy

C.  Surgical Management
1 local and regional anaesthesia
2 adenoidectomy
3 tonsillectomy
4 abscess tonsillectomy (hot tonsillectomy)
5 arrest of tonsillar haemorrhage
6 drainage of abscess
      a.     peri- and retrotonsillar
      b.     para- and retro-pharyngeal
      c.     base of tongue
7 correction of malformations
      a.     lingual frenulum
      b.     ranula
      c.     cysts inclusion
      d.     macroglossia
8 sialendoscopy
9 transoral removal of salivary calculi
10 transposition of salivary duct
11 lithotripsy
12 removal of foreign bodies
13 surgery of pharyngeal pouch (open or endoscopic)
14 endoscopic biopsy and tumour staging
15 pharyngostomy
16 closure of pharyngostoma
17 cricopharyngeal myotomy
18 surgery of injuries
      a.     simple injuries
      b.     complex injuries

a.)   TUMOUR SURGERY
1 laser surgery of oral cavity and pharynx
2 resection of the tongue
      a.     partial glossectomy
      b.     hemi glossectomy
      c.     total glossectomy
3 reconstruction of the tongue
4 microvascular anastomoses
5 resection, osteosynthesis and reconstruction of mandible
6 pharyngotomy
7 pharyngectomy
      a.     partial
      b.     total
8 surgery for tumours of the nasopharynx
9 surgery for tumours of the oropharynx and reconstruction
10 resection of the lips and plastic reconstruction
      a.     simple
      b.     complex
11 surgery of roncopathy and obstructive sleep-apnoea disorders including radiofrequency, UPPP, LAUP
 

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VI.    Head and Neck and aesthetics.

A.  Diagnostic Procedures and multidisciplinary approach

a.)   CLINICAL EXAMINATION
1 investigation of the cranial nerves
      a.     clinical
      b.     electrophysiological
2 functional tests of salivary glands
3 fine needle biopsy

b.)   INTERPRETATION OF RELEVANT IMAGING
1 Conventional X-RAY. OPG
2 CT, MRI Scan
3 Ultrasound and PET
4 Treatment planning

B.  Non-surgical Management

              1 pharmacological therapy
2 conservative treatment of wounds
3 chemo-radiation-therapy
4 application of botulinum toxin

C.  Surgical Management

              1 Topical, local and regional anaesthesia
2 management of wounds
      a.     management of wounds breakdown
      b.     management of scar tissue
3 management of open neck wounds
4 fistula care
5 removal of
      a.     branchial cysts
      b.     surgery of benign tumours
      c.     fistulae
6 incision and drainage of abscess
7 surgery of  skin tumours
      a.     Benign skin tumours
      b.     Malignant skin tumours
      c.     Treatment of melanoma
8 correction of malformations

a.)   REPAIR OF INJURIES
1 management of soft tissue injuries of the lateral and middle part of the face
2 combined fractures of the lateral and middle part of the face
3 osteosynthesis

b.)   SURGERY OF CRANIAL NERVES (N.V, Nn.VII-XII)
1 exploration, decompression or neurolysis
2 plastic reconstruction

c.)    DISSECTION OF TUMOURS
1 removal of cervical lymph-nodes
2 neck dissection
      a.     selective neck dissection level I to III
      b.     selective neck dissection level I to V
      c.     modified radical neck dissection
      d.     radical neck dissection
      e.     extended neck dissection
3 soft tissue neoplasms
4 vascular tumours
5 neurogenic tumours

d.)   SURGERY OF THE SALIVARY GLANDS
1 removal of the submandibular gland
2 removal of the sublingual gland
3 Removal of minor glands
4 Parotidectomy
      a.     partial parotidectomy
      b.     suprafacial parotidectomy
      c.     subtotal parotidectomy
      d.     total parotidectomy
      e.     radical parotidectomy

e.)   SURGERY OF VESSELS
1 preparation and ligation of vessels
2 direct or indirect catheterization of the internal jugular vein
3 vascular grafting
4 microvascular anastomosis

f.)    SURGERY OF THE THYROID GLAND
1 hemithyroidectomy
2 total thyroidectomy
3 Parathyroidectomy
4 Level VI neck dissection

g.)   PLASTIC AND RECONSTRUCTIVE SURGERY
1 limited regional sliding and rotation flaps
2 free skin grafts
3 extensive plastic reconstruction
      a.     myofascial flaps
      b.     myocutaneous flaps
      c.     microvascular flaps
4 facial rehabilitation
      a.     dynamic muscle flaps
      b.     static procedures
      c.     face-lifting procedures
      d.     blepharoplastia procedures
      e.     chin procedures
5 bone replacement
6 cartilage replacement

h.)   FACIAL PARALYSIS
1 grading
2 gold weight insertion
3 temporalis muscle transfer
4 suborbicularis occuli fat pad lift
5 tarsorrhaphy

i.)      AESTHETICS
1 face and brow  lifting including endoscopic
2 upper lid blepharoplasty
3 lower lid blepharoplasty
4 otoplasty
5 genioplasty
6 liposuction
7 facial resurfacing
8 botox
9 injectable and implantable materials for rhytids / lip augmentation
10 genioplasty / mentoplasty
11 hair loss
 

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