OSCE Notes of Rhinology cases

Station 1:


10 years old boy came with a reddish granular mass in the right nasal cavity - 4 years

He gave h/o bleeding from the mass

What could be the probable lesion ?

Name the causative organism ?

How is this disease transmitted ?

Name the drug which can be used in this condition to prevent recurrence of the same after surgery


This is caused by Rhinosporidium seeberi ( ? Probably a fungus)

It is transmitted by taking bath in common ponds along with cattle

Dapsone is the drug which is used to prevent recurrence following surgical removal

Station 2:

Name the life cycle of Rhinosporidium seeberi

1. Trophozoite (Juvenile sporangium) about 6 - 100 Microns in diameter

2. Intermediate sporangium - about 100 - 150 microns in diameter

3. Mature sporangium - about 400 microns in diameter

4. Infective unit - Electron dense body (spore) It is about the size of a R.B.C

Station 3:

Enumerate the common sites affected by rhinosporidiosis

1. Nose

2. Nasopharynx

3. Tonsil

4. Eye (Lacrimal sac & duct)

Station 4:

30 years old female patient came with


Nasal block - 3 years

Bleeding from nose - 2 years

Loss of sensation of smell - 3 years

Fetid smelling greenish crusts - both nasal cavity



Name the probable diagnosis

Name the organisms associated with this disorder

Name a surgical procedure used in the treatment of this disorder

1. Atrophic rhinitis

2. Coccobacillus, Bacillus mucosus, Coccobacillus foetidus ozaenae, Diphtheroid bacilli and Klebsiella ozenae

3. Modified Young's operation

Station 5:

Name the constituents of Kemecitine antiozena solution

Kemecetine antiozaena solution - is prepared with chloramphenicol 90mg, oestradiol dipropionate 0.64mg, vitamin D2 900 IU and propylene glycol in 1 ml of saline

Station 6:

15 years old boy came with c/o blocking sensation left nose 3 years

Discharge from left nose - 3 years

Diagnostic endoscopy showed:


What could be the possible diagnosis ?

Why is the mass presenting at the choana ?

Probable diagnosis is antrochoanal polyp.

It presents posteriorly due to following reasons:

1. The inspiratory air current is more powerful than the expiratory current

2. The natural curvature of the floor of nasal cavity is curving posteriorly, hence gravity pulls the polyp posteriorly

3. The cilia beats towards the choana

4. The polyp exits out of maxillary antrum through the accessory ostium which is placed posteriorly

Station 7:


What is this line called ?

What is its use ?

It is known as the Ohngren's line. It is an imaginary line drawn from the medial canthus to the angle of the mandible.

Structures above this line are called suprastructures and below this line are called infrastructure.

Malignant lesions involving the suprastructures carry worse prognosis in comparison with those of infrastructure

Station 8:


This patient came with c/o swelling over left forehead - 15 years duration

Swelling over left orbit - 20 years duration

Enumerate the clinical findings

What could be the possible diagnosis ?

1. Soft boggy swelling over left forehead.

2. Proptosis with left eye pushed downwards and outwards

3. Ocular movements full / vision normal

Possible diagnosis : Frontoethmoidal mucocele left side

Station 9:


What type of fracture is this ?

Name one synonym for this type of fracture

What is the status of palate in this patient ?

It is a Lefort I type of fracture

It is also known as Guerin's fracture

Palate in these patients float into the oral cavity

Station 10


Name the structure illustrated with an asterix.

How do you differentiate this structure from the frontal process of maxilla?

It is the uncinate process. It is a boomerang shaped bone, sagittally oriented.
It is mobile as compared to the frontal process of maxilla, which is immobile.

Station 11


Comment on this histopathology slide.

This slide shows double walled sporangia containing spores.

Surrounding stroma shows dense collection of inflammatory cells.

Probable diagnosis - Rhinosporidiosis

Station 12

Name any 4 nasal complaints of sinonasal malignancy.

1. Foul smelling nasal discharge
2. Stuffiness of the nose / nasal obstruction
3. Bleeding from the nose
4. Obvious swelling over the cheek if the tumor has breached the anterior wall of maxilla / mass in the nasal cavity

Station 13:

Comment on this video.

What could be the rhinological causes of this condition?

This patient is having total ophthalmoplegia of right eye. The right eye appears frozen, while the left one is mobile.

Infections involving nose and paranasal sinuses could cause this condition. Commonly fungal infections of nose and
paranasal sinuses cause this condition.

Station 14 :

What is Bernhard Fraenkel triad?

What it indicates?

Bernhard Fraenkel triad include:

1. Fetor
2. Crusting of nasal mucosa
3. Atrophy of nasal mucosa

It is present in patients with atrophic rhinitis.

Station 15:
Given below is a DNE picture of a patient.
Clinical details:
Age of the patient 18
Sex - M
C/o Bilateral nasal obstruction since childhood.
Comment on the DNE picture.
What could be the probable diagnosis?
What syndromes you would like to rule out in this patient?


Probable diagnosis - Choanal atresia.
Syndromes to be ruled out:
Treacher Collins

Unless otherwise stated, the content of this page is licensed under Creative Commons Attribution-ShareAlike 3.0 License