1-Month ENT PG Examination Study Schedule

How to Use This Schedule

• Scott-Brown's Vol 1 = Basic sciences, rhinology, laryngology, head & neck
• Scott-Brown's Vol 2 = Otology, audiology, paediatric ENT
• Scott-Brown's Vol 3 = Combined/clinical (the single-volume 8th ed. integrates all)
• Every Sunday has a half-day free + half-day rapid revision

WEEK 1 (15 - 21 July 2026): EAR - Anatomy, Physiology & Otology

Day 1 - Wednesday 15 July | EAR: Anatomy & Embryology

• Embryology of the ear (branchial apparatus, first and second arch derivatives)
• Surgical anatomy of the external ear, tympanic membrane, middle ear cleft
• Anatomy of the ossicular chain (malleus, incus, stapes - ligaments, relations)
• Eustachian tube anatomy and function
• Anatomy of the facial nerve in temporal bone (labyrinthine, tympanic, mastoid segments)
• Cochlear anatomy: basilar membrane, organ of Corti, hair cells (inner vs outer)
• Vestibular anatomy: semicircular canals, utricle, saccule

• MCQs on ear embryology and anatomy
• Landmarks: Prussak's space, scutum, sinus tympani, facial recess, round window niche
• Revision of mastoid air cell system and tegmen relations

• Notes on key anatomical landmarks
• Scott-Brown's Vol 2, Otology chapters: external ear, middle ear anatomy sections

Day 2 - Thursday 16 July | Physiology of Hearing & Vestibular System

• Sound transmission mechanics - outer to inner ear
• Travelling wave theory (von Bekesy), tonotopic organisation of cochlea
• Hair cell transduction: tip links, stereocilia, endolymph ionic composition (K+ rich)
• Cochlear amplifier: outer hair cells, prestin, electromotility
• Tuning fork tests (Weber, Rinne, Schwabach, Bing, Absolute Bone Conduction)
• Impedance audiometry: tympanograms (Type A, B, C, As, Ad), acoustic reflexes
• Otoacoustic emissions (TEOAE, DPOAE) - generation and clinical use
• Vestibular physiology: semicircular canal dynamics, ampullary deflection
• Otolith organs: saccule, utricle, linear acceleration
• VOR (vestibulo-ocular reflex), VSR, cervico-ocular reflex

• Audiogram interpretation: conductive vs sensorineural vs mixed hearing loss
• Speech audiometry: SRT, WRS, PB words
• BERA/ABR: wave identification (I-V), wave V latency, interwave intervals
• MCQs on audiology

• Revision of all tuning fork tests with interpretation table
• Caloric test: Fitzgerald-Hallpike, COWS mnemonic, canal paresis formula

Day 3 - Friday 17 July | Chronic Otitis Media (CSOM) - Safe & Unsafe Types

• Chronic suppurative otitis media: tubotympanic (safe) vs atticoantral (unsafe/dangerous) types
• Pathology of tubotympanic disease: mucosal type, central perforation, types of perforation
• Cholesteatoma: congenital vs acquired (primary vs secondary acquired)
• Pathogenesis theories of cholesteatoma (invagination, basal cell hyperplasia, squamous metaplasia)
• Dangerous ear: attic perforation, marginal perforation, signs of cholesteatoma
• Complications of CSOM: intracranial (meningitis, brain abscess, lateral sinus thrombophlebitis, extradural abscess, otitic hydrocephalus) and extracranial (mastoiditis, Bezold's abscess, subperiosteal abscess, Citelli's abscess, petrositis-Gradenigo's syndrome)
• Surgical treatment: myringoplasty (underlay vs overlay), tympanoplasty types (I-V, Wullstein classification), cortical mastoidectomy, modified radical mastoidectomy, radical mastoidectomy, canal wall up vs canal wall down

• MCQs on CSOM and cholesteatoma
• Management of Gradenigo's syndrome (petrositis): Trautmann's triangle, Dorello's canal
• Revision of mastoidectomy types and indications

• Quick chart: complications of CSOM - pathways and presentation
• Scott-Brown's key points on cholesteatoma surgery

Day 4 - Saturday 18 July | Otitis Media with Effusion, AOM & Mastoiditis

• Acute otitis media: pathogenesis, organisms (Streptococcus pneumoniae, H. influenzae, Moraxella catarrhalis), stages (hyperaemia, exudation, suppuration, coalescence, complication, resolution)
• AOM management: watchful waiting criteria, antibiotics, myringotomy indications
• Otitis media with effusion (Glue ear): pathogenesis, audiogram (flat type B tympanogram), management (watchful waiting, grommets/ventilation tubes, adenoidectomy)
• Grommet types, indications, complications, timing of insertion
• Coalescent mastoiditis: features, subperiosteal abscess, management
• Chronic mastoiditis patterns

• MCQs on AOM, OME, mastoiditis
• Bezold's abscess, Citelli's abscess, Luc's abscess locations
• Paediatric ear disease revision

• Antibiotic choices in AOM by guideline
• Compare OME management algorithms

Day 5 - Sunday 19 July | Sensorineural Hearing Loss & Audiological Rehabilitation

• Classification of SNHL: cochlear vs retrocochlear
• Noise-induced hearing loss (NIHL): 4 kHz notch, C5 dip, temporary vs permanent threshold shift
• Ototoxicity: aminoglycosides (streptomycin, gentamicin, tobramycin - vestibulotoxic vs cochleotoxic), cisplatin, loop diuretics, quinine
• Sudden SNHL: definition, etiology, investigations, treatment (systemic vs intratympanic steroids)
• Presbycusis: types (sensory, neural, metabolic/strial, mechanical), audiogram pattern
• Meniere's disease: endolymphatic hydrops, triad (hearing loss, tinnitus, vertigo), Lermoyez variant, treatment (betahistine, diuretics, low sodium diet, surgical options)
• Autoimmune inner ear disease, syphilitic labyrinthitis

• Week 1 rapid revision: all ear topics covered
• Create summary sheet: CSOM complications

Day 6 - Monday 20 July | Facial Nerve, Otosclerosis & Tympanosclerosis

• Facial nerve anatomy: 5 segments, branches, relations in temporal bone
• Facial nerve grading: House-Brackmann grading system (Grade I-VI)
• Bell's palsy: diagnosis, investigation, treatment (steroids within 72 hrs, antiviral)
• Herpes Zoster Oticus (Ramsay Hunt syndrome): triad, findings, prognosis
• Facial nerve trauma: investigations (ENoG, EMG), timing of surgery
• Otosclerosis: pathology, histology (blue mantles of Manasse, Schwartze sign/flamingo pink), audiogram (Carhart's notch at 2 kHz), negative Rinne with normal tympanogram, treatment (stapedectomy/stapedotomy, sodium fluoride, hearing aids)
• Tympanosclerosis: definition, management

• MCQs on facial nerve palsy and otosclerosis
• ENoG interpretation and surgical decision-making in facial palsy
• Stapedectomy complications

• House-Brackmann grading chart
• Differentials of conductive hearing loss with normal tympanogram

Day 7 - Tuesday 21 July | Vertigo & Vestibular Disorders

• BPPV: pathophysiology (canalolithiasis vs cupulolithiasis), posterior > horizontal > superior canal
• Dix-Hallpike test, Epley maneuver, Semont maneuver, Barbecue roll (horizontal canal BPPV)
• Vestibular neuritis vs labyrinthitis: differences, HINTS exam
• Meniere's disease (recap) + Tumarkin otolithic crisis
• Central vs peripheral vertigo: key distinguishing features (fatigability, direction of nystagmus, fixation suppression, HINTS: Head Impulse, Nystagmus, Test of Skew)
• Vestibular migraine
• Perilymph fistula
• Superior semicircular canal dehiscence (Minor's syndrome): symptoms, Tullio phenomenon, HRCT diagnosis, occlusion treatment
• Fistula test: positive Hennebert's sign
• Valsalva-induced vertigo

• MCQs on vertigo and vestibular disorders
• Caloric testing, video head impulse test (vHIT)
• Vestibular rehabilitation

• Central vs peripheral nystagmus chart
• BPPV maneuvers step-by-step

WEEK 2 (22 - 28 July 2026): NOSE & PARANASAL SINUSES

Day 8 - Wednesday 22 July | Nasal Anatomy, Physiology & Examination

• External nasal anatomy: bones, cartilages (upper lateral, lower lateral/alar, septal)
• Nasal septum: bony (perpendicular plate of ethmoid, vomer, palatine, maxillary crest) and cartilaginous parts
• Ostiomeatal complex (OMC): its components and surgical significance
• Turbinates: inferior, middle, superior, supreme (concha bullosa)
• Lateral nasal wall: semilunar hiatus, uncinate process, ethmoidal bulla, hiatus semilunaris
• Nasal blood supply: Kiesselbach's plexus (Little's area), Woodruff's plexus (posterior), sphenopalatine artery (main), anterior and posterior ethmoidal arteries
• Nerve supply: olfactory (CN I), nasociliary, sphenopalatine ganglion branches
• Nasal physiology: mucociliary clearance, nasal cycle (6-8 hr alternating congestion), nasal resistance (40% of airway resistance)
• Olfaction: olfactory cleft, cribriform plate, olfactory nerve fibres, olfactory testing

• Nasal examination technique: anterior rhinoscopy, posterior rhinoscopy, nasal endoscopy
• MCQs on nasal anatomy
• Radiological anatomy of sinuses (X-ray, CT, MRI)

• Key anatomy revision: blood supply of nose
• Diagram of lateral nasal wall landmarks (for endoscopic sinus surgery)

Day 9 - Thursday 23 July | Rhinitis: Allergic & Non-Allergic

• Allergic rhinitis: classification (ARIA 2008 - intermittent vs persistent, mild vs moderate-severe)
• Pathophysiology: IgE-mediated, early phase (mast cell degranulation) vs late phase (eosinophils)
• Allergens: perennial (HDM - Dermatophagoides pteronyssinus, cockroach, pet dander, mould) vs seasonal (pollens)
• Investigations: skin prick test, specific IgE (RAST), total IgE, nasal cytology
• Treatment: allergen avoidance, second-generation antihistamines, intranasal corticosteroids (first-line), decongestants, leukotriene antagonists, immunotherapy (SCIT vs SLIT)
• Non-allergic rhinitis: vasomotor, eosinophilic (NARES), hormonal, drug-induced (rhinitis medicamentosa - oxymetazoline rebound), occupational
• Atrophic rhinitis: primary (Klebsiella ozaenae, Coccobacillus foetidus) vs secondary, young females, crusting, fetor, anosmia
• Treatment of atrophic rhinitis: Young's operation, saline irrigation, estrogen

• MCQs on rhinitis
• Comparison chart: allergic vs non-allergic rhinitis
• Immunotherapy protocols

• ARIA classification table
• Rhinitis medicamentosa pathophysiology and management

Day 10 - Friday 24 July | Sinusitis: Acute, Chronic & Surgical Management

• Acute rhinosinusitis (ARS): definition (< 12 weeks), organisms (S. pneumoniae, H. influenzae, S. aureus), diagnostic criteria (EPOS 2020)
• Recurrent ARS: ≥4 episodes/year
• Chronic rhinosinusitis (CRS): definition (>12 weeks), CRS with polyps vs without polyps
• Investigations: CT sinuses (Lund-Mackay scoring system), diagnostic nasal endoscopy
• Complications of sinusitis: orbital (Chandler classification: I periorbital oedema, II orbital oedema, III orbital cellulitis, IV subperiosteal abscess, V orbital abscess), intracranial (meningitis, brain abscess, superior sagittal sinus thrombosis, subdural empyema), Pott's puffy tumour (frontal bone osteomyelitis)
• FESS (Functional Endoscopic Sinus Surgery): principles, Stammberger technique, Messerklinger technique, uncinectomy, maxillary antrostomy, anterior and posterior ethmoidectomy, sphenoidotomy, Draf frontal sinus drainage procedures (I, II, III - "Lothrop")
• Complications of FESS: CSF leak, orbital complications, anosmia, bleeding (anterior ethmoidal artery, sphenopalatine artery)

• Chandler classification and management of orbital complications
• MCQs on sinusitis
• EPOS 2020 treatment algorithm for CRS

• Lund-Mackay CT scoring revision
• FESS anatomy and surgical steps

Day 11 - Saturday 25 July | Nasal Polyps, Deviated Nasal Septum & Epistaxis

• Nasal polyps: pathogenesis, associations (ASA triad/Samter's triad = aspirin sensitivity + polyps + asthma, cystic fibrosis, Churg-Strauss/EGPA)
• Grading of nasal polyps (Mackay-Lund staging, Meltzer grading)
• Medical treatment of polyps: intranasal steroids, systemic steroids, biologics (dupilumab, mepolizumab)
• Deviated nasal septum (DNS): Cottle's classification (5 areas), septal deviation types, symptoms
• Septoplasty: timing (after 17 yrs), approaches, submucous resection (SMR) vs septoplasty, Killian's incision vs hemitransfixation incision
• Turbinate surgery: inferior turbinate hypertrophy, submucosal diathermy, microdebrider turbinoplasty, submucous resection of turbinate, LASER turbinoplasty
• Epistaxis: anterior (Little's area - most common) vs posterior (Woodruff's plexus, sphenopalatine artery)
• Management of epistaxis: first aid, anterior nasal packing, BIPP packing, Foley catheter balloon, sphenopalatine artery ligation (endoscopic), anterior ethmoidal artery ligation (external), embolisation, Hereditary Haemorrhagic Telangiectasia (Rendu-Osler-Weber syndrome)

• MCQs on polyps, DNS, epistaxis
• Septoplasty vs SMR comparison
• Epistaxis management algorithm

• Samter's triad and management
• Sphenopalatine artery anatomy and endoscopic ligation

Day 12 - Sunday 26 July | Revision Day + Tumours of Nose & Sinuses

• Rapid revision: Ear topics (Days 1-7)
• Practice 50 MCQs (mixed ear + nose)

• Benign nasal tumours: juvenile nasopharyngeal angiofibroma (JNA), inverted papilloma (Schneiderian papilloma, sinonasal type, 10% malignant transformation, HPV 6/11), osteoma (frontal sinus most common - Gardner's syndrome)
• JNA: adolescent males, Holman-Miller sign on angiography, CT/MRI features, Fisch classification, preoperative embolisation, surgical approaches (transpalatal, midfacial degloving, FESS, infratemporal fossa)
• Malignant sinonasal tumours: squamous cell carcinoma (most common), adenocarcinoma (woodworkers, ethmoid sinus), adenoid cystic carcinoma (perineural invasion), olfactory neuroblastoma/esthesioneuroblastoma (Kadish staging), sinonasal undifferentiated carcinoma (SNUC), melanoma
• T staging (AJCC) of maxillary and ethmoid sinuses
• Surgical approaches: Caldwell-Luc, lateral rhinotomy, Weber-Ferguson incision, total maxillectomy (Öhngren's line)

• Week 2 rapid revision
• JNA classification and management flowchart

Day 13 - Monday 27 July | Throat: Pharyngeal Anatomy & Tonsils/Adenoids

• Pharyngeal anatomy: nasopharynx, oropharynx, hypopharynx (laryngopharynx)
• Waldeyer's ring: lingual tonsil, palatine tonsils, adenoids, tubal tonsils, pharyngeal tonsil
• Killian's dehiscence (pharyngeal pouch/Zenker's diverticulum): anatomy, Killian-Jamieson area
• Tonsil anatomy: capsule, crypts, blood supply (tonsillar branch of facial artery - main, ascending pharyngeal, ascending palatine, descending palatine, dorsal lingual arteries), nerve supply (glossopharyngeal - IX)
• Tonsillitis: acute, recurrent, peritonsillar abscess (quinsy), parapharyngeal abscess, retropharyngeal abscess
• Peritonsillar abscess: clinical features, aspiration vs incision and drainage, interval tonsillectomy
• Indications for tonsillectomy: Paradise criteria (≥7/yr, ≥5/yr ×2 yrs, ≥3/yr ×3 yrs), obstructive sleep apnoea, peritonsillar abscess, suspected malignancy
• Complications of tonsillectomy: primary haemorrhage (<24 hrs), secondary haemorrhage (5-10 days - commonly streptococcal), reactionary haemorrhage (within 24 hrs)
• Adenoidectomy: indications, contraindications (submucosal cleft palate), complications (VPI)

• MCQs on pharynx and tonsils
• Retropharyngeal vs parapharyngeal space infections
• Peritonsillar abscess management

• Paradise criteria memorisation
• Blood supply of tonsil chart

Day 14 - Tuesday 28 July | Laryngeal Anatomy, Voice & Dysphagia

• Laryngeal anatomy: cartilages (thyroid, cricoid, epiglottis, arytenoids, corniculate, cuneiform, triticeal), ligaments (thyro-hyoid membrane, quadrangular membrane, conus elasticus/cricovocal membrane), joints (cricoarytenoid - synovial, cricothyroid - synovial)
• Laryngeal muscles: intrinsic (PCA - posterior cricoarytenoid = only abductor) and extrinsic
• Glottis, subglottis, supraglottis anatomical boundaries
• Blood supply: superior and inferior laryngeal arteries
• Nerve supply: SLN (internal branch - sensory, external branch - cricothyroid motor), RLN (all other intrinsic muscles), vagus (X)
• Vocal fold layers: epithelium, superficial lamina propria (Reinke's space), intermediate LP, deep LP, vocalis muscle
• Dysphonia: organic vs functional, hoarseness evaluation, laryngoscopy, videostroboscopy
• Vocal fold nodules, polyps, cysts, Reinke's oedema (Bogart-Bacall syndrome)
• Laryngeal papillomatosis (RRP): HPV 6/11, adult vs juvenile types, treatment (microdebrider, KTP laser, cidofovir, bevacizumab, HPV vaccination)
• Dysphagia: classification, evaluation (modified barium swallow, FEES - fiberoptic endoscopic evaluation of swallowing), Zenker's diverticulum (cricopharyngeal achalasia), treatment (endoscopic stapling vs open approach)

• MCQs on larynx and pharynx
• Videostroboscopy findings in common voice disorders
• Swallowing phases: oral preparatory, oral, pharyngeal, oesophageal

• Intrinsic laryngeal muscles and their actions chart
• RLN injury consequences: unilateral vs bilateral

WEEK 3 (29 July - 4 August 2026): LARYNGOLOGY, HEAD & NECK

Day 15 - Wednesday 29 July | Laryngeal Carcinoma

• Epidemiology: most common laryngeal cancer = glottic SCC, M>F, smoking and alcohol
• Anatomy of laryngeal subsites and their barriers to spread (quadrangular membrane, conus elasticus)
• Glottic carcinoma: early lymph node spread (NO - due to poor lymphatics of glottis), T staging
• Supraglottic carcinoma: early LN spread (bilateral), transglottic spread, T staging
• Subglottic carcinoma: rare, early spread to tracheal and paratracheal nodes
• AJCC TNM staging (8th edition) for laryngeal SCC
• Treatment of early (T1/T2) glottic Ca: radiotherapy vs transoral laser microsurgery (TLM)
• Treatment of advanced laryngeal Ca: total laryngectomy (TL), partial laryngectomy options, organ preservation protocols (RTOG 91-11 trial, chemoradiation)
• Supraglottic laryngectomy, vertical partial laryngectomy, near-total laryngectomy
• Surgical rehabilitation after TL: tracheoesophageal voice (Blom-Singer valve), electrolarynx, oesophageal speech
• Tracheostomy: types, indications, surgical technique, complications (innominate artery erosion, tracheomalacia, tracheo-oesophageal fistula, stomal stenosis)

• MCQs on laryngeal cancer
• Staging revision using AJCC criteria
• Comparison: open vs endoscopic partial laryngectomy

• Organ preservation trials (RTOG 91-11, VA Laryngeal Cancer Study)
• Voice rehabilitation after laryngectomy

Day 16 - Thursday 30 July | Neck Dissection & Neck Masses

• Triangles of neck: anterior (carotid, muscular, submental, submandibular) and posterior triangles
• Lymph node levels of neck (I-VII: Memorial Sloan Kettering classification)
• Types of neck dissection: radical (RND), modified radical (MRND Types I, II, III), selective (SND: supraomohyoid = I-III, lateral = II-IV, central = VI, posterolateral = II-V)
• Indications for neck dissection: elective (N0 neck with >20% risk), therapeutic (N+)
• Sentinel lymph node biopsy in head and neck cancer
• Unknown primary with neck metastasis: work-up algorithm, PET-CT, tonsillectomy, tongue base biopsy, panendoscopy
• Differential diagnosis of neck masses: age-based, location-based (midline vs lateral)
• Branchial cyst (2nd branchial arch): Bailey's classification, presentation, treatment
• Thyroglossal duct cyst: moves with swallowing and tongue protrusion, Sistrunk operation
• Lymphoma: Hodgkin's vs Non-Hodgkin's, Reed-Sternberg cells, Ann Arbor staging
• Carotid body tumour (paraganglioma): Shamblin classification, "lyre sign" on angiography

• MCQs on neck dissection and masses
• Management algorithm for lateral neck mass
• Levels of neck dissection revision

• Branchial anomalies (cyst, sinus, fistula) - 1st through 4th cleft/pouch
• Carotid body tumour vs glomus jugulare vs glomus tympanicum

Day 17 - Friday 31 July | Salivary Gland Diseases

• Anatomy: parotid gland (Stensen's duct, facial nerve, Frey's syndrome after surgery), submandibular gland (Wharton's duct, lingual nerve, hypoglossal nerve), sublingual gland
• Physiology: parotid (serous), submandibular (mixed serous/mucous), sublingual (mucous)
• Parotid tumours: benign (pleomorphic adenoma - most common, Warthin's tumour/cystadenolymphoma, oncocytoma), malignant (mucoepidermoid carcinoma - most common malignant, adenoid cystic carcinoma, acinic cell carcinoma, carcinoma ex-pleomorphic adenoma)
• Pleomorphic adenoma: risk of malignant transformation (~5-10%), spillage during surgery, pseudopodia, satellite nodules, treatment = superficial parotidectomy
• Adenoid cystic carcinoma: perineural invasion (facial pain, facial nerve palsy), cribriform pattern, skip lesions, distant metastases (lung), poor prognosis despite slow growth
• Frey's syndrome (auriculotemporal nerve injury, aberrant regeneration): gustatory sweating, treatment = Botox
• Sjögren's syndrome: primary vs secondary, SSA/Ro and SSB/La antibodies, schirmer test, focus score, anti-SSA/SSB, lymphoma risk
• Sialadenitis: acute (Staphylococcus aureus), chronic, salivary calculi (sialolithiasis - 80% in Wharton's duct), sialendoscopy
• Mumps parotitis, radiation-induced xerostomia

• MCQs on salivary glands
• Facial nerve monitoring in parotidectomy
• WHO classification of salivary gland tumours

• "10s" rule of salivary gland tumours
• Revision: parotid tumour management algorithm

Day 18 - Saturday 1 August | Thyroid & Parathyroid Surgery in ENT

• Surgical anatomy of thyroid: relations (RLN, SLN, parathyroids, strap muscles)
• Thyroid cancer: papillary (most common, psammoma bodies, Orphan Annie nuclei, ground glass nuclei), follicular (vascular invasion, capsular invasion, haematogenous spread), medullary (RET proto-oncogene, MEN 2A/2B, calcitonin, amyloid stroma), anaplastic (most aggressive, worst prognosis)
• TNM staging for thyroid cancer (AJCC 8th edition)
• Indications for thyroidectomy: total thyroidectomy vs hemithyroidectomy + isthmectomy
• RLN injury: unilateral (hoarseness, BOL vocal cord) vs bilateral (bilateral adductor palsy - stridor, requires tracheostomy)
• Hypocalcaemia post-thyroidectomy: Chvostek's sign, Trousseau's sign, management
• Parathyroid glands: superior (from 4th pouch) vs inferior (from 3rd pouch = with thymus)
• Primary hyperparathyroidism: adenoma (85%), hyperplasia (15%), carcinoma (1%), sestamibi scan, 4D-CT, parathyroidectomy

• MCQs on thyroid and parathyroid
• Bethesda system for thyroid cytology (FNA categories I-VI)
• Minimally invasive video-assisted thyroidectomy (MIVAT)

• Bethesda categories and management decisions
• Week 3 progress check

Day 19 - Sunday 2 August | Revision Day + Oral Cavity & Oropharyngeal Cancer

• Rapid revision of Weeks 2-3 topics
• 50 mixed MCQs

• Oral cavity cancer: SCC (most common), floor of mouth (most common site for occult N+), tongue, hard palate, buccal mucosa
• Risk factors: tobacco, alcohol, betel nut chewing (oral submucous fibrosis), HPV
• Pre-malignant lesions: leukoplakia (Pindborg classification), erythroplakia (highest malignant potential), oral submucous fibrosis
• Oropharyngeal SCC: HPV-positive (HPV16, p16+) vs HPV-negative; HPV+ = better prognosis, younger, non-smoker
• TNM staging: oral cavity vs oropharynx (separate staging for HPV+ vs HPV- oropharynx)
• Elective neck dissection: N0 oral tongue carcinoma with >20% risk → selective SND (I-III)
• Reconstruction: local flaps, regional flaps (pectoralis major myocutaneous flap - PMMC), free flaps (radial forearm, anterolateral thigh, fibula for mandibular reconstruction)

• TNM staging comparison: oral cavity vs oropharynx
• Oral cancer surgical approaches

Day 20 - Monday 3 August | Hypopharyngeal & Oesophageal Pathology

• Hypopharynx: piriform sinus (most common site for hypopharyngeal SCC), posterior pharyngeal wall, postcricoid area (associated with Paterson-Brown-Kelly/Plummer-Vinson syndrome = iron deficiency anaemia + dysphagia in middle-aged women)
• Hypopharyngeal SCC: poorest prognosis, presentation (late, dysphagia, neck LN), investigations, treatment (chemoradiation vs surgery)
• Total pharyngolaryngoesophagectomy with gastric pull-up or free jejunal interposition
• Laryngopharyngeal reflux (LPR): symptoms (globus, chronic cough, dysphonia), RSI and RFS scoring, treatment (PPI, dietary, alginate)
• Globus pharyngeus (globus hystericus): investigation, management
• Foreign bodies in aerodigestive tract: common sites of impaction (tonsil, base of tongue, vallecula, piriform fossa, cricopharynx), rigid vs flexible oesophagoscopy, plain X-ray (coins, fish bones)

• MCQs on hypopharynx and oesophagus
• Plummer-Vinson syndrome - complete syndrome, management
• Zenker's diverticulum: surgical options in detail

• Hypopharyngeal cancer staging and management summary
• Foreign body aerodigestive emergencies

Day 21 - Tuesday 4 August | Paediatric ENT - Part 1

• Congenital ear abnormalities: microtia (Nagata classification), atresia (Jahrsdoerfer grading), ossicular anomalies, preauricular sinus/pit
• Cholesteatoma in children: congenital (white mass anteromedial to malleus with intact TM) vs acquired
• Paediatric hearing loss: congenital causes (TORCH infections, CMV = most common congenital viral SNHL, hereditary - connexin 26/GJB2 mutation = most common hereditary SNHL in developed countries)
• Otoscopy in children: positioning, normal variants (normal TM mobility)
• Paediatric obstructive sleep apnoea (OSA): OSAS in children, polysomnography, adenotonsillectomy as first-line treatment, CPAP
• Neonatal hearing screening: UNHS (Universal Newborn Hearing Screening), OAE → ABR pathway
• Hearing aids for children: timing (as early as 4-6 weeks), bone-anchored hearing aids (BAHA), cochlear implants
• Cochlear implantation: criteria (bilateral profound SNHL, no benefit from HAs, no contraindications), electrode types, candidacy, outcomes

• MCQs on paediatric ENT
• Connexin 26 (GJB2) mutation pattern of inheritance
• Cochlear implant CI: programming, mapping, rehabilitation

• Jahrsdoerfer grading for atresia repair candidacy
• GJB2 (Connexin 26) and hereditary hearing loss

WEEK 4 (5 - 14 August 2026): PAEDIATRIC ENT, SKULL BASE & FINAL REVISION

Day 22 - Wednesday 5 August | Paediatric ENT - Part 2 & Airway

• Paediatric airway emergencies: croup (laryngotracheobronchitis - parainfluenza, steeple sign, nebulised adrenaline, dexamethasone), epiglottitis (H. influenzae type B, "thumb sign" on X-ray, emergency airway)
• Croup vs epiglottitis vs tracheitis comparison table
• Subglottic stenosis (SGS): Cotton-Myer grading (I <50%, II 51-70%, III 71-99%, IV 100%), congenital vs acquired (post-intubation most common)
• Surgical management of SGS: anterior cricoid split, laryngotracheoplasty, cricotracheal resection
• Choanal atresia: CHARGE syndrome (Coloboma, Heart defects, Atresia choanae, Retardation, Genital anomalies, Ear anomalies), bony (90%) vs membranous (10%), emergency management with oral airway, definitive treatment = endoscopic transnasal repair
• Laryngomalacia: most common cause of stridor in neonates, inspiratory stridor, supraglottoplasty
• Subglottic haemangioma: PHACE syndrome association, propranolol (first-line)
• Tracheostomy in children: differences from adults, decannulation protocol

• MCQs on paediatric airway
• CHARGE syndrome components
• Flexible nasolaryngoscopy in children

• Stridor in neonates: differential diagnosis by site
• Croup management algorithm

Day 23 - Thursday 6 August | Skull Base Surgery & Glomus Tumours

• Anterior skull base: anatomy, approaches (bifrontal craniotomy, endoscopic transnasal)
• Middle fossa approaches: middle cranial fossa approach for IAC, petrous apex lesions
• Posterior fossa approaches: translabyrinthine, retrosigmoid, transcochlear
• Acoustic neuroma (vestibular schwannoma): most common CP angle tumour, CNVIII (superior vestibular division), unilateral progressive SNHL + tinnitus, MRI gadolinium imaging
• Koos grading (Grades I-IV), surgical approaches based on grade and hearing status
• NF2 (bilateral acoustic neuromas): chromosome 22, merlin protein
• Other CP angle tumours: meningioma, epidermoid cyst, facial nerve schwannoma, cholesterol granuloma
• Glomus jugulare and glomus tympanicum (paragangliomas): Fisch classification, Glasscock-Jackson classification, pulsatile tinnitus, Aquino's sign (blanching on positive pressure = Brown's sign), surgical vs embolisation vs radiosurgery
• Petrous apex lesions: cholesterol granuloma, cholesteatoma, effusion, apical petrositis

• MCQs on skull base
• Translabyrinthine vs retrosigmoid vs middle fossa: indications
• NF2 management

• Comparison of approaches to vestibular schwannoma
• Glomus tumour classification tables

Day 24 - Friday 7 August | Otology Revision + Implantable Hearing Devices

• BAHA (bone-anchored hearing aids): indications (unilateral deafness, CHL or mixed loss, atresia), osseointegration, processor types (Osia, Attract, Connect)
• Middle ear implants: Vibrant Soundbridge, Carina
• Cochlear implants - detailed revision: electrode arrays, activation, mapping, outcomes
• Implantable hearing devices in children
• Auditory brainstem implant (ABI): NF2, cochlear aplasia
• Electrocochleography (ECoG): endolymphatic hydrops (SP/AP ratio >0.4)
• VEMP (vestibular evoked myogenic potentials): cervical VEMP (saccule/IVN), ocular VEMP (utricle/SVN)
• Intraoperative monitoring of facial nerve (EMG)
• Advanced cochlear imaging: CT, MRI pre-implant (cochlear aplasia, Mondini, large vestibular aqueduct syndrome/LVAS)

• Revision of audiological investigations: comprehensive run-through
• MCQs
• Large vestibular aqueduct syndrome: genetics (SLC26A4/Pendrin), Pendred syndrome

• Chart: audiological tests and their cochlear/retrocochlear specificity
• Implantable devices comparison

Day 25 - Saturday 8 August | Allergy, Immunology & Rhinology Advanced Topics

• Samter's triad deep revision: COX-1 inhibition, leukotriene overproduction, aspirin desensitisation
• Vasomotor rhinitis: neural hyperresponsiveness, treatment (ipratropium, capsaicin, vidian neurectomy)
• Sinonasal tumours revision (inverted papilloma - Krouse classification, surgical staging)
• Cerebrospinal fluid (CSF) rhinorrhoea: traumatic vs spontaneous (idiopathic intracranial hypertension), beta-2 transferrin (diagnostic), cisternography (CT, radionuclide), endoscopic repair, lumbar drain, grafts (fat, fascia lata, mucosa)
• Sinonasal granulomatous diseases: Wegener's (GPA) - saddle nose, c-ANCA/PR3, nasal crusting; Sarcoidosis - lupus pernio, Heerfordt syndrome, ACE levels; Rhinoscleroma (Klebsiella rhinoscleromatis), Rhinosporidiosis (Rhinosporidium seeberi - strawberry polyp)
• Fungal sinusitis: invasive (acute fulminant in immunocompromised - Mucor/Aspergillus, amphotericin B) vs non-invasive (saprophytic, mycetoma/fungal ball, AFRS = allergic fungal rhinosinusitis with eosinophilia, Charcot-Leyden crystals, Mucin, Bent-Kuhn criteria for AFRS)

• MCQs on rhinology advanced topics
• AFRS diagnosis and treatment (oral and topical steroids, antifungal adjuvants)
• CSF rhinorrhoea repair techniques

• Granulomatous diseases differential: table format
• Mucormycosis management protocol

Day 26 - Sunday 9 August | Full Revision Day 1: Ear + Nose

• Complete ear topics rapid revision
• Key facts: CSOM, otosclerosis, BPPV, Meniere's, facial nerve, vestibular schwannoma
• 75 ear MCQs (timed - 1 min each)

• Complete nose topics rapid revision
• Key facts: epistaxis, sinusitis, polyps, JNA, inverted papilloma
• 50 nose MCQs

• Focus on weak areas identified today
• Revision of staging systems (TNM, Chandler, Koos, Fisch)

Day 27 - Monday 10 August | Emergency ENT, Radiology & Investigations

• ENT emergencies: airway obstruction, anaphylaxis (adrenaline 0.5 mg IM), epiglottitis, Ludwig's angina (floor of mouth cellulitis), peritonsillar abscess, acute mastoiditis with complications
• Surgical cricothyroidotomy: anatomy (cricothyroid membrane), indications, technique
• Tracheostomy emergency: blocked tracheostomy, displaced tracheostomy
• Imaging in ENT: CT scan (temporal bone, sinuses, neck - views and findings), MRI (soft tissue, skull base, cochlear nerve aplasia), PET-CT (unknown primary, restaging)
• X-rays in ENT: lateral neck (retropharyngeal space, normal width <7mm at C2), Waters' view (sinuses), Towne's projection, Schüller's view (mastoid), Stenvens/Owen's view
• Audiological tests summary table: pure tone audiogram, impedance, OAE, ABR/BERA, ECoG, VEMP, caloric, HINTS
• Nasal endoscopy: landmarks, Lund-Kennedy endoscopy score

• MCQs on ENT radiology and investigations
• Practice interpreting audiograms and tympanograms
• CT temporal bone interpretation: ossicular discontinuity, cholesteatoma, otosclerosis

• Quick revision of all staging systems used in ENT
• Investigations chart: which test for which ENT condition

Day 28 - Tuesday 11 August | Head & Neck Oncology: Advanced Topics

• Molecular markers in H&N cancer: p16/HPV, EGFR, PD-L1, VEGF
• Immunotherapy in H&N cancer: pembrolizumab, nivolumab (anti-PD-1), cetuximab (anti-EGFR)
• Chemoradiation protocols: concurrent cisplatin + RT (3-weekly vs weekly regimens)
• Intensity-modulated radiotherapy (IMRT): parotid sparing, dose painting
• Reconstruction flaps in detail:
  • Local: nasolabial, forehead, palatal rotation
  • Regional: PMMC, SCM, deltopectoral, trapezius
  • Free flaps: radial forearm (thin, pliable - oral lining), fibula (bone + skin - mandible), ALT (anterolateral thigh - large defects), rectus abdominis, jejunum (circumferential pharyngeal defects)
• Sentinel lymph node biopsy: technique, indications in oral cancer
• Quality of life after H&N cancer treatment: swallowing, voice, cosmesis
• Osteoradionecrosis (ORN): pathophysiology, Marx classification, hyperbaric oxygen, sequestrectomy

• MCQs on H&N oncology
• Free flap anastomosis and monitoring
• ORN management

• Reconstruction algorithm: defect → flap choice
• Immunotherapy regimens in recurrent/metastatic HNSCC

Day 29 - Wednesday 12 August | Full Revision Day 2: Throat + Head & Neck

• Larynx, pharynx, oropharynx, hypopharynx topics rapid revision
• Tonsil/adenoid, neck dissection, salivary gland revision
• 75 MCQs (mixed throat + H&N)

• Thyroid, parathyroid, skull base revision
• 50 MCQs

• Weak area consolidation
• All classification systems in one revision session

Day 30 - Thursday 13 August | Grand Revision Day: All Topics

• Speed revision across all topics: 10-minute summaries per topic
• High-yield one-liners and mnemonics review
• Classification systems masterlist:
  • Chandler (orbital complications), Cottle (DNS), Cotton-Myer (SGS), Koos (acoustic neuroma), Fisch/Glasscock-Jackson (glomus), Shamblin (carotid body), Bailey/Branchial cyst, Lund-Mackay (CT sinuses), Kadish (esthesioneuroblastoma), Jahrdoerfer (atresia), Holman-Miller (JNA), House-Brackmann (facial nerve), Ann Arbor (lymphoma)
• Previous PG exam question pattern analysis

• 100-question timed mock exam (all ENT topics)
• Self-analysis of performance

• Final consolidation of weak spots
• Scott-Brown's Key Points boxes review across all chapters

Day 31 - Friday 14 August | Final Revision + Exam Readiness

• Very last rapid revision: ear, nose, throat, head & neck one-liners
• All mnemonics review
• Final 50 MCQs

• Rest and relaxation
• Light reading of Scott-Brown's "Best Clinical Practice" summary boxes
• No new topics

• Logistics and preparation for exam day
• Confidence review of strongest topics

High-Yield Classification Systems Quick Reference

Scott-Brown's Most Tested Chapters (Focus These)

• Anatomy and physiology of hearing (Chs 1-3)
• Chronic otitis media and cholesteatoma (Chs 8-10)
• Otosclerosis and tympanosclerosis (Ch 11)
• Facial nerve disorders (Ch 14)
• BPPV and Meniere's disease (Chs 15-16)
• Vestibular schwannoma (Ch 18)
• Cochlear implants and BAHA (Chs 20-21)

• Applied anatomy (Chs 1-4)
• Allergic rhinitis (Ch 15)
• Chronic rhinosinusitis and FESS (Chs 18-20)
• Nasal polyps (Ch 22)
• Laryngeal carcinoma (Chs 35-38)
• Voice disorders (Chs 30-32)

• Head and neck cancer: oral cavity, oropharynx, larynx, hypopharynx (Chs 1-12)
• Neck dissection (Ch 15)
• Salivary gland tumours (Chs 18-20)
• Thyroid surgery (Chs 22-24)
• Skull base surgery (Chs 28-32)
• Paediatric airway (Chs 40-45)
• Cochlear implantation in children (Ch 50)

Key Mnemonics for PG Exam

• CHARGE = Coloboma, Heart defects, Atresia choanae, Retardation, Genital anomalies, Ear anomalies
• COWS = Cold Opposite, Warm Same (caloric test nystagmus direction)
• PCA = only Abductor of vocal folds (Posterior CricoArytenoid)
• Samter's Triad = Asthma + ASA sensitivity + Nasal polyps
• Plummer-Vinson = Iron deficiency anaemia + Post-cricoid web + Dysphagia (middle-aged women, pre-malignant)
• Paterson-Brown-Kelly = Same as Plummer-Vinson (UK terminology)
• Bezold's abscess = Tracks along sternocleidomastoid, below mastoid tip into neck
• Citelli's abscess = Into posterior digastric region
• HINTS = Head Impulse, Nystagmus, Test of Skew (differentiate central vs peripheral vertigo)
• Gradenigo's Triad = Petrous apicitis = VI nerve palsy + retro-orbital pain + otorrhoea
• Frey's syndrome = Post-parotidectomy gustatory sweating (auriculotemporal nerve)