otorhinolaryngologyhead

Professor May Khin Thein
M.B.,B.S, M.Med.Sc (E.N.T)
F.R.C.S.Ed (ORL)
Professor and Head

History of Our Department

The Otorhinolaryngology Department of the University of Medicine-2, Yangon was first established in 2002 by Professor Thein Tun who was the Professor and Head of the department at the time. He started to set up the out-patient clinic and actively involved in undergraduate teaching of otorhinolaryngology to Final Part I students.       In 2004, Prof Kyi Maung was posted as the Head of the department and served until 2007. During his days, he extended the clinical services as not only the out-patients, but also the in-patients ward and performed operations. The undergraduate teaching was also upgraded by the use of computer, multimedia projector and also assisted by the ENT consultants from affiliated hospitals of UM-2, Dr. Aung Hein followed by Dr. Thidar Shwe from Insein Hospital and Dr. Khin Khin Phyu followed by AP Dr. May Khin Thein from Thingangyun Sanpya Hospital.In 2005, the first batch of M.Med.Sc (ORL) has been started with 4candidates, Dr. Yin Yin, Dr.Cho War Aung, Dr.Kyaw Htet Win and Dr.Hnin Phyu who have finished their master degree in 2008.After the retirement of Prof Kyi Maung in December 2007, Associate Professor Dr. Saw Aung Hla Win took over the department and worked until 2008. He also actively led the clinical and academic activities.fter the retirement of AP Saw Aung Hla Win in 2008, the activities of the department went down, due to the lack of the head of department. The four doctors who finished their Master degree of ORL from UM-2 continued to run the outpatient clinic and under graduate teaching under the supervision of professor of ORL, UM-1 until 2011.In 2011, the department was revived by the reinforcement of man-power which included Associate Professor Phone Myint Tun and 3 AssistantLecturers, Dr. KK Tin Win, Dr.Yin Yin and Dr.Nyan Win. There were more both in and out patients, who were offered up-to-date treatments, likes videoscopy and audiometric apparatus.In February 2013, AP May Khin Thein was transferred from Thingangyun Hospital to UM-2 as Professor/Head and Dr. Cho War Aung also joined as Lecturer/Consultant, Dr. KK Tin Win moved to um-1as a lecturer and Dr. Yin Yin was also promoted as the lecturer. Therefore, second batch of M.Med.Sc (ORL) course was reopened in December 2012 at which 4 candidates attended and completed the course in April 2015. Dr. Aung Htet Htun, Dr. Myo Min, Dr. Si Thu Naing and Dr. Ngu War San have obtained their Master degree in April 2015. Since then, M.Med.Sc (ORL) course has been continued every year. There are 2 candidates Dr. Thiri and Dr. Hnin Le`Wai in 2014 when 3 year course has been started and seven candidates joined in 2015.Dr.Med.Sc (ORL) course has been started in January, 2014 and 2 candidates Dr. Thet Tin and Dr. Mu Mu Myint are attending their second year of the course.Therefore, postgraduate courses of M.Med.Sc (ORL) and Dr.Med.Sc (ORL) are well established now and students are actively involved in their studies and research projects for the post graduate degrees.     The current activities of the department include teaching of the final PartII students in groups of about 70 students in each group visiting ORL department for 2 weeks and conduct a test of the end of period. The department also takes responsibility of teaching ORL topics for family medicine diploma, SAMA refresher course and other post-grade courses like M.Med.Sc dental surgeon and Paediatrics.

Former Heads

Prof Thein Tun                  M.B.,B.S.D.LO.M.Med.Sc (ORL)

F.R.C.S.Ed (ORL)                                                2002-2004

Prof Kyi Maung                M.B.,B.S,DLO.M.MedSc (ORL)                         2004-2007

A/P Saw Ag Hla Win       M.B.,B.S.DLO.M.MedSc (ORL)                         2007-2008

CoursesA.        Undergraduate – Final PartII MB.B.S-  Didactic Lectures

– Outpatient clinics

– Duration 10 days (morning season only)

– Test at the end – MCQ ( 20×5 stems in each )

 

 

 

 

B.      Post graduate Course

M.Med.Sc (ORL) – 3 years course

Aim & objective

 

Aim:    To produce a qualified, competent, health care providing Doctor in assessing, planning investigations and treatment, health promotion and rehabilitation of patients with otorhinolaryngological diseases

 

Institutional Objectives:

To produce Otorhinolaryngologists who are capable of

1. Managing common otorhinolaryngological conditions and   emergencies

2. Displaying appropriate behavior towards patients, staff and society in general

3. Pursuing advanced training

 

Departmental Objectives:

After attaining Master of Medical Science (Otorhinolaryngology), the graduate should be able to

1. Understand basic principles of Otorhinolaryngology and Surgery

2. Integrate the history and physical findings to construct a working   diagnosis and formulate plan for investigations and treatment of the clinical problem in the light of available evidence-base

3. Manage common otorhinolaryngological problems in community

4. Manage complications of diseases and treatments

5. Rehabilitate appropriately

6. Participate in prevention of otorhinolaryngological diseases

 

4.         Selection of Candidates

4.1.      Criteria for application

  • Myanmar national (exception for students of inter-governmental agreement)
  • M.B.,B.S graduate from Universities of Medicine, Myanmar or other recognized Medical Institutes
  • Not older than 45 at the time of last date for application
  • Must be a permanent service personnel of at least two year service
  • Must pass the selection examination

4.2.      Selection Examination

  • MCQ (Multiple response), minus system, not carried over

2 hours – 60 questions (each with 5 digits), covering Otorhinolaryngology Head and Neck Anatomy, Physiology, Pathology, Microbiology, and undergraduate level ENT knowledge

  • English Proficiency test
  • Personal interview

4.3.      Number of Candidates

According to health manpower needs

5.         Duration of Course:  3 years inclusive of basic science

6.         Board of Study

  • Chairman – Professor and Head

Board of Studies for ORL of respective University of Medicine

  • Secretary – Associate Professor /Lecturer /Consultant

Board of Studies for ORL of respective University of Medicine

  • Members: (from respective University of Medicine)
  1. Professor and Head, Dept. of Surgery
  2. Professor and Head, Dept. of Maxillofacial and Plastic Surgery
  3. Professor and Head, Dept. of Thoracic Surgery
  4. Professor and Head, Dept. of Neurosurgery
  5. Professor and Head, Dept. of ORL of other Universities
  6. Senior/Consultant ENT Surgeon of affiliated hospitals of UM-2
  7. Professor and Head of other departments of respective University as necessary

 

7.         Training Programme

First year

  • 4 month – PG basic science course of respective University
  • 8 months- basic science concerning Otolaryngology, theory and clinical training in ENT Department of respective University, preparation for protocol submission

Second year

  • 2 months – General Surgery
  • 2 weeks – ICU
  • 1 ½ months – Maxillofacial and Plastic and Reconstructive surgery
  • 1 month– Thoracic surgery
  • 1 month – Neurosurgery
  • 2 months – Radiation Oncology, Medical Oncology, Radiology and Nuclear Medicine (2 weeks each)
  • 4 months- theory and clinical training in ENT Department of respective University

Third year

  • 12 months – theory and clinical training in ENT Department of respective University

Assessment.   

1.   Formative Assessment

  • At the end of 1styear – assessment I (Theory and viva)
  • At the end of 2nd year – assessment II (Theory, viva and clinical)
  • 3 months before final examination – Mock examination

 

2.   Summative Assessment

Will be at the end of third year.

It includes theory, clinical and viva. The candidate must have the score of 60% in every compartment at the final assessment.

 

Theory

  • Number of papers – 2
  • Paper 1 – Principle and Practice of surgery
  • Paper 2 – Otorhinolaryngology, Head and Neck Surgery
  • Type of question – Multiple ShortQuestion
  • Number of questions – 6
  • All questions must be answered
  • Time allowed – 3 hours
  • Marking Scheme – 16 marks for 5 questions

20 marks for the 6th question

Clinical

  • one long case – 1 hour

½ hour for history taking and             physical examination

½ hour for discussion and assessment

  • Clinical OSCE – 1 hour and 20 min (Medium cases -History/ Examination of ear ,nose and throat, Audiology, Specimen , X-rays, Interpretations– 8 stations)

10 min each

Assessment will include

  • Student attitude
  • Communication skill
  • Analysis of symptoms
  • System examination approach
  • Idea developing and organization of thoughts
  • Rational decision making
  • Practical action and plan
  • Marking Scheme – long case – 100

Medium cases History/Examination- Ear, Nose and Throat, Audiology, specimen, X-rays, Interpretations– 8 stations (20 marks each) Total 160 marks

 

Viva voce

  1. Number of viva tables – 2
  • ENT Instruments and Operative surgery
  • Principle and Practice of Surgery
  1. Time allowed – 20 min each
  2. Marking scheme – 20 marks for each table (Total-40)

Candidate must pass each compartment (Theory/Clinical-Viva/ Dissertation) independently.

Weightage for each paper

  • Class work – attendance, tests, log book
  • Theory – Paper I

Paper II

  • Clinical-Viva Voce
    • Pass marks – 60%
    • Distinction marks – 80%
    • Credit marks – 90%
    • Supplementary examination – after 6/12 and after 1 year
    • Candidate can only be allowed for three attempts

10.       Resources

10.1     Personnel

10.2     Departmental Library

10.3     Library of respective University

10.4     Medical Research Library

Otology

Specific Learning Objectives:

At the end of this section, the candidate must be able to:

  1. recapitulate and apply anatomy of external, middle and inner ear
  2. explain physics of sound and mechanism of sound transmission
  3. describe the middle ear transformer mechanism
  4. mention  vestibular receptors and their connections
  5. explain reflex responses of  balance
  6. state and diagnose various types of nystagmus
  7. examine ear and assess hearing and balance systems
  8. mention and perform pure tone audiometry, tympanometry and Oto-Acoustic-Emission
  9. describe various radiological assessments for ear, with their advantages and disadvantages
  10. diagnose and treat congenital malformation of auricle, external auditory canal, middle ear and inner ear
  11. manage auricular injuries
  12. manage  foreign bodies in external auditory canal
  13. manage haematoma auris and its complications
  14. diagnose and treat various infections of external, middle and inner ear
  15. manage complications of otitis media
  16. perform cortical mastoidectomy and modified radical mastoidectomy
  17. manage otitis media with effusion
  18. perform myringotomy and grommet tube insertion
  19. diagnose and treat benign and malignant conditions of external, middle and inner ear
  20. manage malignant otitis externa
  21. describe anatomy, aetiology, pathophysiology, and treatment of Otosclerosis

22. Describe anatomy, aetiology, pathophysiology, and treatment of Perilymph fistula

  1. describe aetiology, pathology, classification and treatment of deafness

24. Perform various audiological tests

25.describe aetiology, physiology and pathology of tinnitus and manage properly

26.describe aetiology, physiology and pathology of vertigo and manage properly

27.describe anatomy, aetiology, pathophysiology, and treatment of Meniere’s disease

28.describe anatomy, aetiology, pathophysiology, and treatment of facial nerve paralysis

29.aware of hearing and ear care in community

30.orientate the concept of research in any clinical situation

 

Rhinology

Specific Learning Objectives:

At the end of this section, the candidate must be able to:

  1. recapitulate and apply anatomy of nose and paranasal sinuses
  2. explain mucociliary blanket of the nose
  3. describe respiratory function of nose
  4. describe physiology of smell
  5. investigate nasal airway
  6. perform basic rhinological tests
  7. assess and treat smell disorders
  8. describe various radiological assessments for nose and paranasal sinuses with their advantages and disadvantages
  9. perform nasal endoscopies
  10. describe mechanism of nasal allergies
  11. describe investigations and treatment of nasal allergies
  12. explain aetiology and pathology of nasal polyposis
  13. investigate and treat nasal polyposis
  14. perform nasal polypectomy
  15. describe aetiology and pathology of infections of nose and paranasal sinuses
  16. diagnose and treat various types of nose and paranasal sinuses infections
  17. perform antral wash-out
  18. perform Caud-well-luc operation
  19. manage injuries of nose and paranasal sinuses
  20. mention aetiology and pathology of epistaxis
  21. investigate and treat epistaxis
  22. explain basic principles of septorhiniplasty
  23. describe indications, preoperative assessment, limitations, procedure and complications of septorhiniplasty
  24. perform septoplasty
  25. mention types, aetiolgy and pathophysiology of sleep apnoea
  26. investigate and diagnose sleep apnoea
  27. treat sleep apnoea
  28. describe types and management of head ache and facial pain
  29. explain causes, clinical features, investigations and management of velopharyngeal insufficiency
  30. understand basic principle of endoscopic sinus surgery
  31. mention indications, preoperative assessments, indications, contraindications, procedure and complication of endoscopic sinus surgery
  32. describe and management diseases around the orbit and lacrimal passage
  33. mention granulomatous lesions of nose and paranasal sinuses
  34. describe aetiology, pathology, staging, investigations, diagnosis and management of benign and malignant tumors of nose and paranasal sinuses
  35. perform maxillectomies
  36. diagnose and treat cerebrospinal fluid rhinorrhoea
  37. orientate the concept of research in any clinical situation

Larynx, Trachea, Pharynx and Esophagus

Specific Learning Objectives

At the end of this section, the candidate must be able to:

  1. recapitulate and apply anatomy of larynx, trachea, pharynx and esophagus
  2. explain physiology of phonation
  3. describe respiratory function
  4. describe physiology of swallowing
  5. perform endoscopies
  6. describe various radiological assessments for larynx, trachea, pharynx and esophagus, with their advantages and disadvantages
  7. mention mechanism, types and diagnosis of laryngeal trauma
  8. manage acute laryngeal trauma
  9. manage chronic laryngeal stenosis
  10. describe causal organisms, clinical features, investigations and management of acute and chronic infections of tonsils, adenoid, larynx and pharynx
  11. perform tonsillectomy
  12. explain aetiology, pathology, staging, clinical features, investigations and various treatments of benign and malignant tumors of oropharynx
  13. explain aetiology, pathology, staging, clinical features, investigations and various treatments of benign and malignant tumors of larynx
  14. explain aetiology, pathology, staging, clinical features, investigations and various treatments of benign and malignant tumors of hypopharynx
  15. perform direct laryngoscopy and biopsy
  16. perform esophagoscopy and biopsy
  17. perform laryngectomy
  18. explain anatomy and physiology of voice control, types and assessment of voice disorders
  19. investigate and treat voice disorders
  20. investigate and treat swallowing disorders
  21. describe causes, assessment and management of acute and chronic airway obstruction
  22. explain neuroanatomy of larynx and pharynx
  23. describe aetiology and management of laryngeal and pharyngeal neurological lesions
  24. mention classification, clinical features and management of laryngocoele
  25. mention embryology, anatomy, classification, aetiology, clinical features and management of pharyngeal diverticulum
  26. explain aetiology, clinical feature, investigations and treatment of chronic aspiration
  27. explain aetiology, pathophysiology, clinical features and management of gastro-esophageal reflux disease
  28. orientate the concept of research in any clinical situation

Head and Neck

 

Specific Learning Objectives

At the end of this section, the candidate must be able to:

  1. recapitulate and apply anatomy of head and neck
  2. describe various radiological assessments for head and neck and their advantages and disadvantages
  3. describe causes, clinical features, investigations and treatment of benign neck swellings
  4. perform excision of branchial cyst, thyroglossal cyst and dermoid cyst
  5. mention anatomy of facial spaces
  6. explain aetiology, clinical features, investigations and treatment of Ludwig’s angina
  7. explain aetiology, clinical features, investigations and treatment of parapharyngeal abscess
  8. explain aetiology, clinical features, investigations and treatment of retropharyngeal abscess
  9. describe aetiology, classification, investigations and treatment of penetrating neck injuries
  10. describe classification, clinical features, investigations and treatment of malignant neck swellings
  11. mention classification of lymph node groups, types of neck dissection and their indications
  12. perform fine needle aspiration cytology and excisional biopsy of lymph node
  13. explain detail procedure of each type of neck dissection and their complications
  14. describe classification, clinical features, investigations and treatment of parapharyngeal tumours
  15. mention different approaches to parapharyngeal space
  16. describe anatomy, physiology, classification, clinical features and management of benign thyroid tumors
  17. describe anatomy, physiology, classification, clinical features and management of malignant thyroid tumors
  18. perform various types of thyroidectomy
  19. describe anatomy, physiology, classification, clinical features and management of benign parotid tumors
  20. describe anatomy, physiology, classification, clinical features and management of malignant parotid tumors
  21. perform parotidectomies
  22. mention immediate, intermediate and late complications of head and neck surgery and their management and prevention
  23. describe principle of rehabilitation after head and neck surgery
  24. explain principle of reconstructive surgery
  25. describe principle and types of free grafts
  26. describe principle and types of pedicle flaps
  27. describe principle and types of musculocutaneous flaps
  28. describe principle and types of free flaps
  29. mention HIV in E.N.T practice
  30. ear nose and throat manifestations of systemic diseases
  31. describe diagnostic and interventional neuroradiology
  32. describe clinical features, investigations and management of temporal bone neoplasm
  33. describe principle and different approaches to temporal bone and lateral skull base
  34. describe clinical features, investigations and management of anterior cranial fossa neoplasms
  35. describe clinical features, investigations and management of middle cranial fossa neoplasms
  36.  describe clinical features, investigations and management of posterior cranial fossa neoplasmsorientate the concept of research in any clinical situation

 

Paediatric Otorhinolaryngology

Specific Learning Objectives

At the end of this section, the candidate must be able to:

  1. recapitulate and apply paediatric head and neck anatomy
  2. mention developmental anatomy of childhood
  3. understand otorhinolaryngological condition of childhood
  4. describe clinical features, investigations and treatment of congenital malformations of ear
  5. describe clinical features, investigations and treatment of congenital malformations of nose
  6. describe clinical features, investigations and treatment of congenital malformations of throat
  7. mention tests for early identification of hearing loss and management of these cases
  8. mention clinical and functional anatomy of middle ear cleft
  9. mention aetiology, clinical features and management of otitis media
  10. explain aetiology, pathology and clinical features of otitis media with effusion
  11. manage otitis media with effusion
  12. perform myringotomy and grommet tube insertion
  13. mention classification, pathophysiology and clinical features of obstructive sleep apnoea
  14. manage different types of sleep apnoea
  15. perform tonsillectomy and adenoidectomy
  16. manage cleft lip and palate and their ear problems
  17. explain Velopharyngeal anatomy and function and velopharyngeal closure pattern
  18. state the causes of velopharyngeal incompetence
  19. mention investigations and management of velopharyngeal incompentence cases
  20. mention causal organisms, clinical features, and management of adenotonsillar disease
  21. mention causal organisms, clinical features, and management of pharyngitis
  22. state the causes of stridor
  23. investigate and treat the paediatric stridor cases
  24. mention aetiology and pathophysiology of glottic and subglottic stenosis
  25. mention clinical features, investigations and treatment of glottic and subglottic stenosis
  26. explain causes of aspiration and investigate and manage these cases
  27. explain aetiology, pathology and management of swallowing disorders
  28. explain aetiology, pathology and management of voice disorders
  29. manage of foreign bodies of ear, nose and throat
  30. mention clinical features, investigations and management of congenital neck masses
  31. mention causal organisms, clinical features, investigations and management of infective neck masses
  32. describe aetiology, classification, staging and management of primary neoplasms of head and neck
  33. orientate the concept of research in any clinical situation