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CORLN Exam Syllabus & Study Guide

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NCBOHN CERTIFIED OTORHINOLARYNGOLOGY REGISTERED NURSE (CORLN) COMPLETE EXAMINATION TOPICS AND TERMINOLOGIES ============================================================ I. CONDITIONS — 25% OF THE EXAMINATION ============================================================ A. OTOLOGIC AND NEUROTOLOGIC CONDITIONS 1. Normal Ear Anatomy and Physiology - External ear - Auricle and pinna - External auditory canal - Cerumen and ceruminous glands - Tympanic membrane - Middle ear cavity - Ossicles: malleus, incus, stapes - Eustachian tube - Oval window and round window - Inner ear - Cochlea - Organ of Corti - Basilar membrane - Hair cells - Vestibule - Semicircular canals - Utricle and saccule - Vestibulocochlear nerve (cranial nerve VIII) - Facial nerve (cranial nerve VII) - Auditory conduction - Sound transmission - Air conduction and bone conduction - Vestibular function and balance - Central and peripheral auditory pathways 2. Auditory Disorders - Conductive hearing loss - Sensorineural hearing loss - Mixed hearing loss - Presbycusis - Congenital hearing loss - Acquired hearing loss - Unilateral and bilateral hearing loss - Sudden sensorineural hearing loss - Noise-induced hearing loss - Otosclerosis - Tinnitus - Cerumen impaction - Tympanic membrane perforation - Ossicular chain disruption - Auditory processing and communication difficulties - Hearing impairment and functional limitations 3. Vestibular Disorders - Meniere's syndrome or disease - Benign paroxysmal positional vertigo (BPPV) - Vestibular neuronitis - Vestibular neuritis - Labyrinthitis - Vertigo - Dizziness - Disequilibrium - Nystagmus - Motion sensitivity - Vestibular hypofunction - Balance impairment - Fall risk associated with vestibular dysfunction 4. Facial Nerve Disorders - Bell's palsy - Facial nerve paralysis - Facial nerve paresis - Facial nerve injury - Facial neuroma - Facial nerve schwannoma - Facial weakness - Incomplete eyelid closure - Corneal exposure risk - Facial nerve dysfunction following ear or head and neck surgery 5. Inflammatory and Infectious Ear Disorders - Otitis externa - Acute otitis externa - Chronic otitis externa - Malignant otitis externa - Otitis media - Acute otitis media - Chronic otitis media - Otitis media with effusion - Recurrent otitis media - Mastoiditis - Cholesteatoma - Tympanosclerosis - Autoimmune inner ear disease - Ear canal inflammation - Middle ear infection - Eustachian tube dysfunction - Tympanic membrane retraction - Ear drainage and otorrhea 6. Ear Tumors, Toxins and Trauma - Acoustic neuroma - Vestibular schwannoma - Glomus tumor - Paraganglioma - Temporal bone fracture - Cerebrospinal fluid leak - Otorrhea associated with trauma - Barotrauma - Ear foreign bodies - Ear canal injury - Auricular trauma - Ear and temporal bone carcinoma - Ototoxicity - Ototoxic medications - Aminoglycoside-associated ototoxicity - Cisplatin-associated ototoxicity - Medication-related hearing impairment - Traumatic hearing loss - Perilymphatic fistula - Other otologic neoplasms B. NASAL, PARANASAL, FACIAL AND ORBITAL CONDITIONS 1. Normal Anatomy and Physiology - External nose - Nasal vestibule - Nasal septum - Nasal cavity - Nasal turbinates and conchae - Inferior, middle and superior meatuses - Paranasal sinuses - Maxillary sinuses - Frontal sinuses - Ethmoid sinuses - Sphenoid sinuses - Osteomeatal complex - Nasal mucosa - Mucociliary clearance - Olfactory epithelium - Olfactory nerve - Nasolacrimal drainage system - Relationship between the nose, sinuses and orbit 2. Nasal and Sinus Disorders - Rhinorrhea - Rhinitis - Allergic rhinitis - Nonallergic rhinitis - Infectious rhinitis - Acute sinusitis - Chronic sinusitis - Acute rhinosinusitis - Chronic rhinosinusitis - Recurrent acute rhinosinusitis - Nasal polyposis - Nasal obstruction - Deviated nasal septum - Inferior turbinate hypertrophy - Epistaxis - Anterior epistaxis - Posterior epistaxis - Nasal crusting - Anosmia - Hyposmia - Parosmia - Nasal congestion - Sinus pressure and facial pain - Chronic sinus inflammation - Fungal rhinosinusitis - Sinus infection complications - Orbital complications of sinusitis - Intracranial complications of sinusitis 3. Nasal and Paranasal Tumors - Hemangioma - Fibroma - Nasal cavity carcinoma - Paranasal sinus carcinoma - Basal cell carcinoma - Squamous cell carcinoma - Benign nasal tumors - Malignant sinonasal tumors - Nasopharyngeal tumors - Tumor-related nasal obstruction - Facial swelling associated with tumors 4. Nasal, Facial and Orbital Trauma - Nasal fracture - Facial fractures - Septal hematoma - Nasal lacerations - Facial soft tissue injuries - Orbital trauma - Orbital complications - Nasal foreign bodies - Facial burns - Traumatic epistaxis - Cerebrospinal fluid rhinorrhea - Anterior skull base injury 5. Congenital and Other Nasal Conditions - Cleft lip - Choanal atresia - Congenital nasal obstruction - Congenital craniofacial abnormalities - Nasal developmental abnormalities - Sinonasal infections - Other congenital and acquired nasal disorders C. ORAL AND NASOPHARYNGEAL CONDITIONS 1. Normal Anatomy and Physiology - Oral cavity - Lips - Tongue - Floor of the mouth - Hard palate - Soft palate - Uvula - Buccal mucosa - Gingiva - Teeth and oral structures - Oropharynx - Nasopharynx - Palatine tonsils - Lingual tonsils - Adenoids - Waldeyer's ring - Pharyngeal muscles - Swallowing mechanism - Oral and pharyngeal phases of swallowing 2. Inflammatory and Infectious Disorders - Pharyngitis - Acute pharyngitis - Chronic pharyngitis - Tonsillitis - Acute tonsillitis - Recurrent tonsillitis - Adenoiditis - Adenotonsillar hypertrophy - Peritonsillar abscess - Oral infections - Oropharyngeal infections - Mucosal inflammation - Oral ulceration - Infectious lesions of the oral cavity 3. Oral and Pharyngeal Malignancies - Tongue carcinoma - Oral tongue cancer - Floor of mouth carcinoma - Oral cavity squamous cell carcinoma - Nasopharyngeal carcinoma - Oropharyngeal carcinoma - Human papillomavirus (HPV)-associated oropharyngeal cancer - Oral leukoplakia - Erythroplakia - Premalignant oral lesions - Cervical lymph node metastases - Regional lymphatic spread - Tumor-related dysphagia - Tumor-related speech impairment 4. Sleep-Related and Obstructive Disorders - Obstructive sleep apnea (OSA) - Adenotonsillar obstruction - Upper airway obstruction - Sleep-disordered breathing - Snoring - Hypoxemia associated with sleep apnea - Airway obstruction caused by enlarged tonsils or adenoids 5. Congenital, Traumatic and Other Disorders - Cleft palate - Cleft lip and palate - Congenital palatal abnormalities - Oral foreign bodies - Pharyngeal foreign bodies - Oral burns - Pharyngeal burns - Oral lacerations - Pharyngeal trauma - Airway compromise associated with oral trauma - Other oral and nasopharyngeal disorders D. LARYNGEAL AND HYPOPHARYNGEAL CONDITIONS 1. Normal Anatomy and Physiology - Larynx - Supraglottis - Glottis - Subglottis - Epiglottis - Arytenoid cartilages - Thyroid cartilage - Cricoid cartilage - Vocal folds - True vocal cords - False vocal cords - Laryngeal muscles - Recurrent laryngeal nerve - Superior laryngeal nerve - Phonation - Voice production - Airway protection - Cough reflex - Laryngeal sensation - Hypopharynx - Piriform sinuses - Postcricoid region 2. Laryngeal Infections - Epiglottitis - Acute epiglottitis - Croup - Laryngotracheitis - Acute laryngitis - Chronic laryngitis - Laryngeal tuberculosis - Infectious laryngeal inflammation - Laryngeal edema - Upper airway infection - Airway compromise due to inflammation 3. Laryngeal Symptoms and Functional Disorders - Stridor - Inspiratory stridor - Expiratory stridor - Hoarseness - Dysphonia - Aphonia - Vocal fatigue - Chronic cough - Dysphagia - Odynophagia - Aspiration - Voice changes - Airway narrowing - Vocal fold immobility 4. Laryngeal Tumors and Lesions - Laryngeal carcinoma - Squamous cell carcinoma of the larynx - Vocal cord polyps - Vocal fold nodules - Laryngeal papillomas - Recurrent respiratory papillomatosis - Benign laryngeal lesions - Malignant laryngeal lesions - Kaposi's sarcoma - Vocal fold leukoplakia - Precancerous laryngeal lesions - Tumor-related dysphonia - Tumor-related airway obstruction 5. Vocal Fold and Congenital Disorders - Vocal cord paralysis - Unilateral vocal fold paralysis - Bilateral vocal fold paralysis - Vocal fold paresis - Laryngomalacia - Congenital laryngeal abnormalities - Laryngeal stenosis - Vocal fold scarring - Other laryngeal conditions 6. Laryngeal Trauma - Laryngeal fracture - Blunt laryngeal trauma - Penetrating laryngeal trauma - Laryngeal edema following injury - Airway obstruction following trauma - Voice changes following trauma - Associated cervical injuries E. TRACHEAL AND ESOPHAGEAL CONDITIONS 1. Normal Anatomy and Physiology - Trachea - Tracheal cartilage - Tracheal mucosa - Carina - Main bronchi - Upper airway anatomy - Cervical esophagus - Esophageal mucosa - Upper esophageal sphincter - Swallowing and esophageal transit - Relationship between the trachea and esophagus 2. Tracheal Disorders - Tracheitis - Tracheal stenosis - Subglottic stenosis - Acquired tracheal stenosis - Post-intubation stenosis - Tracheal obstruction - Tracheomalacia - Tracheal inflammation - Tracheal injury - Tracheal foreign bodies - Airway narrowing - Respiratory distress related to tracheal disease 3. Esophageal Disorders - Cervical esophageal carcinoma - Esophageal obstruction - Dysphagia - Odynophagia - Zenker's diverticulum - Pharyngoesophageal diverticulum - Tracheoesophageal fistula - Congenital tracheoesophageal fistula - Acquired tracheoesophageal fistula - Aspiration associated with swallowing disorders - Esophageal foreign bodies - Cervical esophageal injury 4. Tracheal and Esophageal Trauma - Airway burns - Esophageal burns - Thermal injury - Chemical injury - Inhalation injury - Foreign body aspiration - Esophageal foreign body impaction - Traumatic airway injury - Postprocedural tracheal injury - Associated airway and swallowing complications F. SALIVARY GLAND CONDITIONS 1. Normal Anatomy and Physiology - Parotid glands - Submandibular glands - Sublingual glands - Minor salivary glands - Salivary ducts - Stensen's duct - Wharton's duct - Saliva production - Salivary secretion - Lubrication and oral mucosal protection - Saliva's role in swallowing and digestion 2. Salivary Disorders - Sialadenitis - Acute sialadenitis - Chronic sialadenitis - Parotitis - Bacterial parotitis - Viral parotitis - Sialolithiasis - Salivary duct obstruction - Salivary gland swelling - Drooling - Sialorrhea - Xerostomia - Reduced salivary secretion - Salivary gland infection - Salivary gland inflammation 3. Salivary Gland Tumors - Benign mixed tumor - Pleomorphic adenoma - Benign salivary gland neoplasms - Malignant salivary gland neoplasms - Parotid tumors - Submandibular gland tumors - Salivary gland masses - Facial nerve involvement in parotid disease G. NECK CONDITIONS 1. Normal Anatomy and Physiology - Cervical anatomy - Cervical lymph nodes - Lymphatic drainage of the head and neck - Thyroid gland - Parathyroid glands - Thyroid cartilage - Cricoid cartilage - Cervical fascia - Deep neck spaces - Neck muscles - Major cervical vessels - Cervical nerves - Congenital neck structures 2. Neck Disorders - Cervical adenopathy - Cervical lymphadenopathy - Reactive lymph nodes - Persistent neck mass - Thyroid disease - Thyroid nodules - Thyroid enlargement - Goiter - Thyroid malignancy - Thyroglossal duct cyst - Branchial cleft cyst - Deep neck infections - Retropharyngeal abscess - Parapharyngeal abscess - Cervical cellulitis - Neck trauma - Congenital neck masses - Cervical lymphatic malformations - Neck hemangioma - Rhabdomyosarcoma - Other benign and malignant neck masses 3. Neck Tumors and Related Conditions - Primary neck tumors - Metastatic cervical lymph nodes - Head and neck cancer metastases - Thyroid carcinoma - Lymphatic malformations - Congenital cystic masses - Vascular neck lesions - Neck mass evaluation - Tumor-related airway compromise - Tumor-related swallowing impairment H. ALLERGY - Allergic rhinitis - Seasonal allergies - Perennial allergies - Environmental allergens - Allergen exposure - Nasal allergic inflammation - Sneezing - Rhinorrhea - Nasal congestion - Postnasal drainage - Allergic mucosal edema - Allergy-related sinus symptoms - Allergic reactions affecting the upper airway - Allergy assessment and diagnostic terminology I. PATHOPHYSIOLOGY - Inflammation - Infection - Edema - Obstruction - Tissue injury - Ischemia - Hemorrhage - Neurologic dysfunction - Degeneration - Neoplasia - Benign and malignant growth - Congenital abnormalities - Immune-mediated disease - Autoimmune disease - Abnormal wound healing - Impaired mucociliary clearance - Airway compromise - Hearing impairment - Vestibular dysfunction - Swallowing dysfunction - Speech and voice impairment - Lymphatic spread of malignancy - Complications of untreated disease J. EPIDEMIOLOGY - Incidence and prevalence - Risk factors for ENT disorders - Age-related disease patterns - Congenital versus acquired disorders - Environmental exposures - Occupational noise exposure - Tobacco use - Alcohol use - HPV-associated disease - Infection-related risk factors - Genetic and familial risk factors - Cancer risk factors - Disease prevention - Population health patterns - Screening and early detection ============================================================ II. ASSESSMENT — 25% OF THE EXAMINATION ============================================================ A. HEALTH HISTORY - Chief complaint - History of present illness - Symptom onset and duration - Symptom severity - Symptom frequency - Symptom progression - Previous ENT disorders - Previous ENT surgery - Hearing history - History of tinnitus - History of vertigo - History of recurrent ear infections - Nasal and sinus history - History of epistaxis - Allergy history - Sleep history - Snoring and sleep apnea symptoms - Voice changes - Swallowing difficulties - Aspiration history - Neck mass history - Cancer history - Family history - Medication history - Ototoxic medication exposure - Tobacco and alcohol history - Occupational exposure - Noise exposure - Communication needs - Nutritional history - Pain history - Psychosocial history - Functional limitations - Relevant medical and surgical history B. PHYSICAL EXAMINATION 1. Ear Examination - Inspection of the auricle - External auditory canal examination - Otoscopy - Tympanic membrane assessment - Cerumen assessment - Ear drainage assessment - Tympanic membrane perforation - Middle ear abnormalities - Mastoid examination - Hearing screening - Bedside hearing assessment - Balance assessment - Ear-related cranial nerve examination 2. Nasal Examination - External nose inspection - Nasal patency - Nasal mucosal assessment - Nasal septum examination - Turbinate assessment - Nasal discharge - Nasal polyps - Nasal obstruction - Epistaxis assessment - Sinus tenderness - Facial swelling - Olfactory symptoms - Signs of infection or trauma 3. Oral Cavity Examination - Lip inspection - Oral mucosa assessment - Tongue examination - Floor of mouth examination - Hard and soft palate examination - Tonsil assessment - Uvula position - Oropharyngeal examination - Oral lesions - Ulceration - Bleeding - Oral masses - Dentition and oral hygiene - Mucosal dryness - Swallowing-related abnormalities - Signs of malignancy 4. Cranial Nerve Examination - Cranial nerve I: olfactory nerve - Cranial nerve II: optic nerve when relevant to associated disease - Cranial nerve V: trigeminal nerve - Cranial nerve VII: facial nerve - Cranial nerve VIII: vestibulocochlear nerve - Cranial nerve IX: glossopharyngeal nerve - Cranial nerve X: vagus nerve - Cranial nerve XI: accessory nerve - Cranial nerve XII: hypoglossal nerve - Facial movement - Facial symmetry - Hearing and balance - Palatal movement - Gag reflex when clinically indicated - Voice and phonation - Tongue movement - Shoulder elevation - Sensory and motor deficits 5. Skin Examination - Skin integrity - Surgical incisions - Wound healing - Bruising - Ecchymosis - Erythema - Edema - Skin lesions - Signs of infection - Tissue perfusion - Radiation-related skin changes - Flap and graft assessment - Skin changes associated with malignancy 6. Neck Examination - Neck inspection - Palpation of cervical lymph nodes - Cervical lymphadenopathy - Thyroid palpation - Thyroid enlargement - Neck masses - Neck tenderness - Neck mobility - Tracheal position - Airway patency - Cervical swelling - Signs of deep neck infection - Laryngeal movement - Postoperative neck examination - Wound and drain assessment C. GENERAL DIAGNOSTIC TESTS 1. Radiographic and Imaging Studies - Videofluoroscopy - Computed tomography (CT) - Magnetic resonance imaging (MRI) - CT of the temporal bone - CT of the paranasal sinuses - CT of the neck - MRI of the internal auditory canals - MRI of head and neck structures - Contrast-enhanced imaging - Imaging of neck masses - Imaging for head and neck tumors - Imaging for trauma - Imaging for sinus disease - Imaging for suspected complications 2. Ultrasound - Thyroid ultrasound - Cervical lymph node ultrasound - Neck mass ultrasound - Salivary gland ultrasound - Ultrasound-guided fine-needle aspiration - Evaluation of superficial neck lesions 3. Endoscopic Procedures - Nasal endoscopy - Flexible nasopharyngoscopy - Flexible laryngoscopy - Direct laryngoscopy - Bronchoscopy when indicated - Esophagoscopy - Panendoscopy - Endoscopic examination of the upper airway - Endoscopic biopsy - Visualization of mucosal lesions - Assessment of airway obstruction - Assessment of vocal fold movement 4. Laboratory Tests - Complete blood count (CBC) - White blood cell count - Hemoglobin and hematocrit - Inflammatory markers - Microbiological cultures - Culture and sensitivity - Blood chemistry - Thyroid function tests - Tissue pathology - Cytology - Biopsy and histopathology - Tumor-related laboratory investigations when indicated - Preoperative laboratory evaluation 5. Positron Emission Tomography - Positron emission tomography (PET) - PET/CT - Metabolic imaging - Evaluation of selected head and neck malignancies - Assessment of suspected metastatic disease - Evaluation of treatment response when indicated 6. Other Diagnostic Studies - Fine-needle aspiration - Core needle biopsy - Excisional biopsy - Incisional biopsy - Swallowing assessment - Sleep studies - Polysomnography - Pulmonary assessment when airway disease warrants it - Pathology and cytology review D. EAR DIAGNOSTIC TESTS 1. Basic Ear Tests - Pure-tone audiometry - Audiogram interpretation - Air conduction thresholds - Bone conduction thresholds - Conductive hearing loss patterns - Sensorineural hearing loss patterns - Mixed hearing loss patterns - Speech audiometry - Speech reception threshold - Word recognition score - Tympanometry - Acoustic reflex testing - Auditory brainstem response (ABR) - Auditory brainstem evoked response - Tuning fork testing - Weber test - Rinne test - Hearing screening - Interpretation of hearing test results 2. Specialized Ear and Vestibular Tests - Romberg test - Electronystagmography (ENG) - Vestibular testing - Nerve stimulation - Facial nerve testing - Schirmer's test when evaluating associated facial nerve dysfunction - Vestibular function assessment - Nystagmus evaluation - Balance testing - Positional testing - Dix-Hallpike maneuver - Head impulse test - Vestibulo-ocular reflex assessment - Video head impulse testing - Caloric testing - Other specialized diagnostic studies as clinically indicated E. COMMUNICATION SKILLS - Verbal communication - Written communication - Sign language - Alternative communication devices - Hearing impairment communication strategies - Communication boards - Picture charts - Speech-generating devices - Augmentative and alternative communication (AAC) - Communication following laryngectomy - Electrolarynx communication - Tracheoesophageal speech - Esophageal speech - Nonverbal communication - Patient-centered communication - Communication with patients who cannot speak - Communication with patients who cannot read or write - Interpreter use - Health literacy - Documentation of communication needs F. PSYCHOSOCIAL ASSESSMENT - Anxiety - Fear - Depression - Social isolation - Communication-related distress - Body image concerns - Altered self-esteem - Adjustment to hearing loss - Adjustment to voice loss - Adjustment following laryngectomy - Coping mechanisms - Family support - Caregiver needs - Cultural considerations - Quality of life - Functional independence - Rehabilitation readiness - Emotional response to cancer diagnosis - Supportive counseling and referral ============================================================ III. INTERVENTIONS — 40% OF THE EXAMINATION ============================================================ A. PRETREATMENT CARE 1. Patient and Family Education - Explanation of the diagnosis - Treatment options - Informed consent support - Preoperative teaching - Postoperative expectations - Medication instructions - Fasting instructions - Infection prevention - Pain management education - Airway safety education - Tracheostomy education - Laryngectomy education - Hearing device education - Swallowing precautions - Nutrition instructions - Wound care instructions - Follow-up planning - Recognition of warning signs - Discharge planning - Family and caregiver preparation 2. Physical Preparation - Baseline assessment - Preoperative nursing assessment - Airway assessment - Hearing assessment - Nutritional assessment - Skin assessment - Medication reconciliation - Allergy verification - Assessment of bleeding risk - Review of diagnostic results - Verification of procedure and site - Surgical safety checklist - Preparation for anesthesia - Positioning - Venous thromboembolism prevention as indicated - Preparation for postoperative monitoring - Baseline communication assessment B. TREATMENT 1. Nonsurgical Treatment a. Medications - Antibiotics - Antiviral agents when indicated - Antifungal agents when indicated - Analgesics - Anti-inflammatory medications - Corticosteroids - Antihistamines - Intranasal corticosteroids - Decongestants - Saline nasal preparations - Topical ear medications - Otic antibiotic preparations - Vestibular suppressants - Antiemetics - Medications for vertigo - Medications for allergic disease - Thyroid-related medications when indicated - Salivary secretion management medications - Medication safety - Drug interactions - Adverse drug reactions - Ototoxicity monitoring - Medication reconciliation - Patient adherence and education b. Radiation Therapy - External beam radiation therapy - Treatment planning - Radiation-related mucositis - Xerostomia - Dysphagia - Dermatitis - Taste changes - Nutritional complications - Fatigue - Tissue fibrosis - Late radiation effects - Radiation safety and patient education c. Chemotherapy - Chemotherapy administration precautions - Antineoplastic medication safety - Myelosuppression - Neutropenia - Thrombocytopenia - Anemia - Nausea and vomiting - Mucositis - Infection risk - Nutritional complications - Extravasation precautions - Treatment-related fatigue - Ototoxicity associated with selected agents - Patient education and monitoring d. Nutritional Treatment - Nutritional screening - Nutritional assessment - Oral nutrition - Texture-modified diets - High-calorie and high-protein nutrition - Enteral nutrition - Nasogastric feeding - Gastrostomy feeding - Hydration - Aspiration precautions - Feeding assistance - Nutritional support during cancer treatment - Management of malnutrition - Dietitian referral e. Other Nonsurgical Treatments - Observation and monitoring - Local treatment - Allergy management - Hearing rehabilitation - Vestibular rehabilitation - Voice therapy - Swallowing therapy - Conservative treatment of selected disorders - Symptom management - Multidisciplinary care 2. Surgical Treatment a. Instrumentation and Equipment - Otoscopes - Nasal specula - Endoscopes - Laryngoscopes - Operating microscopes - Suction equipment - Electrosurgical instruments - Surgical drills - Ear microsurgical instruments - Sinus surgery instruments - Tracheostomy equipment - Airway management equipment - Endotracheal tubes - Tracheostomy tubes - Cuffed and cuffless tubes - Inner cannulas - Speaking valves - Surgical drains - Hemostatic equipment - Specimen collection and labeling - Sterile field management - Instrument counts - Equipment checks - Surgical positioning and safety b. Otorhinolaryngology Procedures - Myringotomy - Tympanostomy tube placement - Ventilation tubes - Tonsillectomy - Adenoidectomy - Tonsillectomy and adenoidectomy - Stapedectomy - Stapedotomy - Tympanoplasty - Mastoidectomy - Tympanoplasty with mastoidectomy - Ossicular chain reconstruction - Cochlear implantation - Bone-anchored hearing aid placement - Nasal surgery - Septoplasty - Turbinate reduction - Rhinoplasty - Endoscopic sinus surgery - Functional endoscopic sinus surgery (FESS) - Nasal polypectomy - Nasal cauterization - Parotidectomy - Salivary gland surgery - Ear reconstruction - Other otologic and rhinologic procedures c. Head and Neck Surgery - Composite resection - Oral cavity resection - Mandibulectomy - Neck dissection - Cervical lymph node dissection - Maxillectomy - Tumor excision - Head and neck cancer surgery - Airway procedures - Panendoscopy - Tracheostomy - Laryngectomy - Supraglottic laryngectomy - Hemilaryngectomy - Partial laryngectomy - Total laryngectomy - Neck mass excision - Branchial cleft cyst excision - Thyroidectomy - Parathyroid surgery - Salivary gland surgery - Reconstructive procedures d. Plastic and Reconstructive Surgery - Cleft palate repair - Cleft lip repair - Flap reconstruction - Free flap reconstruction - Pedicled flaps - Skin grafts - Tissue grafts - Rhytidectomy - Blepharoplasty - Vocal fold surgery - Facial reconstruction - Reconstruction after tumor resection - Reconstruction following trauma - Wound closure - Graft and flap monitoring - Reconstructive surgical complications e. Trauma Procedures and Management - Le Fort fractures - Temporal bone fractures - Facial fractures - Mandibular fractures - Midface trauma - Nasal fractures - Soft tissue wounds - Burns - Laryngeal trauma - Airway injuries - Hemorrhage control - Wound assessment - Wound closure - Trauma stabilization - Post-trauma airway monitoring - Emergency surgical airway procedures C. POST-TREATMENT MANAGEMENT 1. Airway Management - Airway patency - Respiratory assessment - Respiratory distress - Stridor - Oxygen therapy - Airway obstruction - Airway edema - Suctioning - Tracheostomy care - Tracheostomy tube patency - Inner cannula care - Cuff assessment - Humidification - Secretion management - Stoma assessment - Emergency tracheostomy equipment - Accidental decannulation - Tube obstruction - Tracheostomy bleeding - Laryngectomy airway management - Recognition of respiratory emergencies - Emergency escalation and response 2. Nutrition Management - Oral intake assessment - Swallowing safety - Dysphagia management - Aspiration prevention - Enteral feeding - Nasogastric tube feeding - Gastrostomy tube feeding - Feeding tolerance - Hydration monitoring - Nutritional supplementation - Weight monitoring - Malnutrition prevention - Nutrition after head and neck surgery - Nutrition after radiation therapy - Nutrition after laryngectomy 3. Pain Management - Pain assessment - Acute postoperative pain - Chronic pain - Analgesic administration - Multimodal pain management - Nonpharmacologic pain relief - Pain-related functional limitations - Monitoring medication effectiveness - Adverse effects of analgesics - Pain documentation - Patient education 4. Skin Integrity - Surgical wound assessment - Incision care - Wound dressing - Pressure injury prevention - Skin breakdown prevention - Drain site care - Stoma care - Radiation dermatitis management - Flap assessment - Graft assessment - Wound dehiscence - Wound healing - Signs of infection - Skin protection 5. Tissue Perfusion - Circulation assessment - Flap perfusion - Graft perfusion - Color and temperature assessment - Capillary refill where applicable - Edema assessment - Hematoma detection - Hemorrhage detection - Tissue ischemia - Venous congestion - Signs of compromised reconstruction - Prompt escalation of perfusion abnormalities 6. Safety - Patient identification - Fall prevention - Aspiration precautions - Airway safety - Medication safety - Safe patient positioning - Surgical safety - Emergency preparedness - Equipment checks - Safe mobilization - Communication safety - Infection prevention - Recognition of deterioration - Incident reporting 7. Infection Control - Hand hygiene - Standard precautions - Transmission-based precautions - Aseptic technique - Sterile technique - Surgical site infection prevention - Wound care - Device-associated infection prevention - Tracheostomy infection prevention - Specimen handling - Antibiotic stewardship - Infection surveillance - Recognition of systemic infection - Fever and postoperative infection assessment 8. Body Image - Changes in facial appearance - Changes following neck dissection - Altered appearance after reconstruction - Changes following laryngectomy - Stoma-related concerns - Scarring - Disfigurement - Self-esteem - Social adjustment - Counseling and support - Rehabilitation planning 9. Psychosocial Care - Anxiety management - Emotional support - Coping with cancer - Adjustment to altered speech - Adjustment to hearing loss - Adjustment to swallowing difficulties - Family support - Caregiver education - Support groups - Communication support - Quality of life - Referral for psychological services - Social and rehabilitation services 10. Metabolic Management - Fluid balance - Electrolyte balance - Hydration status - Nutritional status - Blood glucose monitoring when indicated - Thyroid function monitoring after relevant surgery - Metabolic changes associated with illness - Nutritional consequences of treatment - Monitoring for dehydration - Recognition of metabolic complications D. REHABILITATION 1. Activities of Daily Living - Personal hygiene - Oral hygiene - Dressing and grooming - Safe mobility - Feeding assistance - Independence assessment - Functional recovery - Energy conservation - Adaptation to physical limitations - Caregiver assistance - Discharge readiness 2. Speech Therapy - Speech assessment - Voice rehabilitation - Dysphonia management - Aphonia management - Speech following laryngectomy - Tracheoesophageal speech - Esophageal speech - Electrolarynx use - Communication strategies - Speech-language pathology referral - Communication device training 3. Swallowing and Feeding Therapy - Swallowing assessment - Dysphagia rehabilitation - Aspiration prevention - Compensatory swallowing techniques - Texture modification - Feeding posture - Swallowing exercises - Enteral feeding support - Oral intake progression - Speech-language pathology collaboration - Nutritional rehabilitation 4. Hearing Rehabilitation - Hearing aid use - Hearing aid care - Cochlear implant care - Bone-anchored hearing devices - Auditory rehabilitation - Hearing conservation - Communication strategies - Assistive listening devices - Audiology referral - Patient and family education 5. Vestibular Rehabilitation - Balance exercises - Gaze stabilization - Vestibular compensation - Fall prevention - Positional vertigo management - Vestibular therapy referral - Mobility assessment - Home safety - Functional balance training 6. Physical Rehabilitation - Mobility restoration - Range of motion - Neck and shoulder rehabilitation - Rehabilitation after neck dissection - Functional assessment - Activities of daily living - Exercise tolerance - Postoperative mobility - Physical therapy referral - Recovery planning 7. Maxillofacial Rehabilitation - Facial reconstruction recovery - Oral function rehabilitation - Jaw mobility - Speech rehabilitation - Swallowing rehabilitation - Prosthetic rehabilitation when indicated - Facial appearance adaptation - Dental and oral rehabilitation - Interdisciplinary follow-up E. COMPLICATIONS 1. Sensorineural Deficits - Sensorineural hearing loss - Facial nerve dysfunction - Vestibular dysfunction - Cranial nerve deficits - Voice dysfunction - Swallowing impairment - Sensory deficits - Neurologic complications - Functional impairment after surgery 2. Airway Obstruction - Upper airway obstruction - Postoperative airway edema - Hematoma-related obstruction - Secretions and mucus plugging - Tracheostomy tube obstruction - Accidental decannulation - Laryngeal edema - Stridor - Respiratory distress - Aspiration-related respiratory compromise - Emergency airway response 3. Hemorrhage - Post-tonsillectomy hemorrhage - Postoperative bleeding - Nasal hemorrhage - Epistaxis - Neck hematoma - Surgical wound bleeding - Hemorrhage after thyroid surgery - Hemodynamic instability - Signs of hypovolemia - Emergency bleeding management 4. Wound Breakdown - Wound dehiscence - Delayed healing - Fistula formation - Flap failure - Graft failure - Tissue necrosis - Wound drainage - Surgical site complications - Impaired healing - Wound assessment and escalation 5. Infection - Surgical site infection - Wound infection - Deep neck infection - Postoperative infection - Abscess formation - Sepsis recognition - Fever - Purulent drainage - Infection associated with tracheostomy - Infection prevention and management 6. Other Complications - Aspiration - Dysphagia - Dehydration - Malnutrition - Xerostomia - Mucositis - Pain - Speech impairment - Altered taste - Lymphedema - Cranial nerve injury - Thyroid dysfunction following thyroid surgery - Hypocalcemia following relevant thyroid or parathyroid surgery - Cerebrospinal fluid leak - Vestibular symptoms - Medication adverse effects - Complications of radiation and chemotherapy ============================================================ IV. PROFESSIONAL ISSUES — 10% OF THE EXAMINATION ============================================================ A. EDUCATION 1. Patient and Family Education - Disease process education - Treatment options - Medication administration - Medication adherence - Postoperative care - Airway emergency instructions - Tracheostomy care - Laryngectomy care - Wound care - Hearing conservation - Hearing device care - Nasal and sinus care - Swallowing precautions - Nutrition and hydration - Infection prevention - Pain management - Warning signs and complications - Follow-up appointments - Discharge instructions - Caregiver training - Health literacy - Teach-back method - Evaluation of learning outcomes 2. Staff Education - Specialty nursing education - Clinical competency - Orientation - Continuing education - Airway emergency training - Tracheostomy emergency training - Infection control - Patient safety - Equipment use - Medication safety - Clinical protocols - Interdisciplinary education - Competency assessment - Evidence-based practice updates B. PREVENTION AND DETECTION ACTIVITIES 1. Risk Factors a. Lifestyle - Tobacco use - Smoking - Smokeless tobacco - Alcohol consumption - Environmental exposures - Poor oral hygiene - Medication-related risks - Noise exposure - Risk reduction counseling b. Eating Habits - Nutritional deficiencies - Inadequate hydration - Poor nutritional status - Diet-related risk factors - Nutrition during cancer treatment - Prevention of malnutrition - Healthy eating education c. Noise Pollution - Occupational noise exposure - Recreational noise exposure - Noise-induced hearing loss - Hearing conservation - Hearing protection devices - Safe listening practices - Noise exposure assessment - Prevention of permanent hearing damage d. Occupational Exposure - Industrial noise - Chemical irritants - Airborne irritants - Occupational carcinogens - Workplace respiratory protection - Exposure history - Workplace risk reduction - Occupational health education e. Substance Abuse - Tobacco dependence - Alcohol misuse - Substance-related health risks - Screening and counseling - Referral for treatment - Risk reduction strategies f. Other Risk Factors - Age-related changes - Family history - Genetic predisposition - HPV infection - Chronic inflammation - Immunosuppression - Previous radiation exposure - Persistent mucosal lesions - Delayed evaluation of head and neck symptoms 2. Prevention and Detection Strategies a. Health Maintenance Programs - Hearing screening - Hearing conservation programs - Early detection of hearing loss - Oral health maintenance - Upper airway health education - Prevention of occupational hearing damage - Risk-based cancer screening and evaluation - Preventive care follow-up - Immunization education when relevant - Community health programs b. Educational Materials - Patient information leaflets - Discharge instructions - Medication instructions - Hearing protection information - Tracheostomy care instructions - Laryngectomy education - Cancer prevention materials - Swallowing safety instructions - Accessible and translated materials - Digital patient education resources c. Community Awareness - Hearing health awareness - Noise exposure prevention - Tobacco cessation awareness - Alcohol risk education - Head and neck cancer awareness - Recognition of persistent hoarseness - Recognition of persistent neck masses - Early evaluation of oral lesions - Community education - Referral and screening awareness C. ETHICS - Ethical principles - Autonomy - Beneficence - Nonmaleficence - Justice - Patient dignity - Respect for patient preferences - Informed decision-making - Confidentiality - Privacy - Professional boundaries - Ethical dilemmas - Advocacy - Cultural sensitivity - Respect for diverse beliefs - Ethical communication - End-of-life care - Ethical research participation - Appropriate delegation - Accountability - Conflict of interest - Professional integrity D. LEGAL CONCERNS 1. Documentation - Accurate clinical documentation - Complete nursing records - Timely documentation - Objective charting - Electronic health records - Documentation of assessment findings - Documentation of interventions - Documentation of patient education - Documentation of informed consent - Documentation of adverse events - Incident reporting - Legal significance of medical records - Correction of documentation errors - Record retention policies 2. Confidentiality - Patient privacy - Protected health information - Confidential medical records - Authorized disclosure - Privacy safeguards - Photography and recording consent - Secure electronic communication - Appropriate use of patient information - Prevention of unauthorized disclosure - Privacy violations 3. Patient Rights and Informed Consent - Patient autonomy - Right to information - Right to refuse treatment - Informed consent - Decision-making capacity - Shared decision-making - Explanation of risks and benefits - Consent for procedures - Consent for photography - Patient advocacy - Respect for treatment preferences - Disclosure of relevant information 4. Advance Directives - Advance care planning - Advance directives - Living wills - Healthcare proxy - Surrogate decision-maker - Goals of care - Code status - Resuscitation preferences - End-of-life decision-making - Respect for documented patient wishes 5. Other Legal and Regulatory Concepts - Scope of nursing practice - Standards of care - Professional negligence - Malpractice - Duty of care - Breach of duty - Causation and damages - Accountability - Delegation - Mandatory reporting where applicable - Regulatory compliance - Institutional policies - Legal responsibilities in patient safety E. PROFESSIONAL RELATIONSHIPS 1. Staff Relationships - Interprofessional collaboration - Team communication - Conflict resolution - Professional boundaries - Respectful communication - Delegation - Supervision - Consultation - Handoffs - Continuity of care - Interdisciplinary care planning - Collaborative problem-solving 2. Patient and Family Relationships - Therapeutic communication - Empathy - Active listening - Patient advocacy - Shared decision-making - Family engagement - Caregiver collaboration - Cultural competence - Respect for patient preferences - Support during difficult diagnoses - Communication about treatment outcomes - Trust and professional boundaries 3. Health Community Relationships - Collaboration with physicians - Collaboration with audiologists - Collaboration with speech-language pathologists - Collaboration with respiratory therapists - Collaboration with dietitians - Collaboration with physical therapists - Collaboration with social workers - Collaboration with oncology services - Collaboration with rehabilitation services - Community referral networks - Continuity between hospital and outpatient care F. SAFETY - Patient identification - Medication safety - Infection prevention - Fall prevention - Airway safety - Tracheostomy emergency preparedness - Surgical safety - Safe equipment handling - Safe patient positioning - Specimen identification - Correct procedure verification - Emergency response - Recognition of clinical deterioration - Safe handoff communication - Incident reporting - Risk management - Quality improvement - Environmental safety - Patient education for home safety G. PROFESSIONAL DEVELOPMENT - Continuing nursing education - Specialty certification - Professional competency - Evidence-based practice - Clinical practice guidelines - Professional standards - Scope of practice - Competency maintenance - Reflective practice - Mentorship - Leadership - Professional accountability - Interdisciplinary learning - Clinical skill development - Professional organization participation - Ongoing evaluation of clinical knowledge - Quality improvement participation H. RESEARCH ISSUES - Research literacy - Evidence-based nursing practice - Research design - Quantitative research - Qualitative research - Clinical research - Literature review - Critical appraisal - Evidence hierarchy - Research ethics - Informed consent for research - Protection of research participants - Confidentiality of research data - Research validity - Reliability - Interpretation of clinical evidence - Application of research findings - Clinical practice guidelines - Quality improvement projects - Patient outcome evaluation - Dissemination of clinical knowledge ============================================================ ADDITIONAL CROSS-DOMAIN CLINICAL TERMINOLOGY SUPPLEMENTARY STUDY VOCABULARY ============================================================ The following terminology supports study of the official domains above. This is an expanded study aid, not a separate official NCBOHN content outline. A. COMMON SYMPTOMS AND CLINICAL FINDINGS - Otalgia: ear pain - Otorrhea: ear discharge - Tinnitus: perception of sound without an external source - Vertigo: sensation of movement or spinning - Nystagmus: involuntary rhythmic eye movement - Hearing loss: reduced auditory ability - Rhinorrhea: nasal discharge - Epistaxis: nosebleed - Anosmia: loss of smell - Hyposmia: reduced sense of smell - Dysphonia: impaired voice - Aphonia: absence of voice - Hoarseness: abnormal voice quality - Stridor: harsh, often high-pitched airway sound - Dysphagia: difficulty swallowing - Odynophagia: painful swallowing - Xerostomia: dry mouth - Sialorrhea: excessive saliva or drooling - Lymphadenopathy: abnormal lymph node enlargement - Dyspnea: difficulty breathing - Aspiration: entry of material into the airway - Rhinorrhagia: nasal bleeding - Otorrhagia: bleeding from the ear - Trismus: restricted mouth opening - Dysgeusia: altered taste - Facial paresis: partial facial muscle weakness - Facial paralysis: loss of facial muscle movement - Airway edema: swelling affecting the airway - Mucositis: inflammation of mucosal surfaces B. COMMON PROCEDURAL AND TREATMENT TERMS - Otoscopy: examination of the ear - Audiometry: measurement of hearing - Tympanometry: assessment of middle ear function - Myringotomy: incision in the tympanic membrane - Tympanostomy: creation of an opening for ventilation or drainage - Tympanoplasty: surgical repair of the tympanic membrane or middle ear - Mastoidectomy: removal of mastoid air cells or diseased mastoid tissue - Stapedectomy: surgical removal of the stapes - Cochlear implant: device that electrically stimulates the auditory nerve - Septoplasty: surgical correction of the nasal septum - Polypectomy: removal of a polyp - Sinusotomy: surgical opening of a sinus - Endoscopic sinus surgery: endoscopic treatment of sinus disease - Tonsillectomy: removal of the tonsils - Adenoidectomy: removal of the adenoids - Laryngoscopy: examination of the larynx - Bronchoscopy: examination of the lower airway - Esophagoscopy: examination of the esophagus - Tracheostomy: creation of an opening into the trachea - Laryngectomy: partial or total surgical removal of the larynx - Thyroidectomy: surgical removal of part or all of the thyroid - Parotidectomy: removal of part or all of the parotid gland - Neck dissection: removal of selected cervical lymphatic tissue - Maxillectomy: surgical removal of part or all of the maxilla - Mandibulectomy: surgical removal of part or all of the mandible - Debridement: removal of nonviable or contaminated tissue - Decannulation: removal of a tracheostomy tube - Aspiration precautions: measures to reduce entry of material into the airway - Enteral nutrition: delivery of nutrition through the gastrointestinal tract C. ABBREVIATIONS - ORL: Otorhinolaryngology - ENT: Ear, nose and throat - CORLN: Certified Otorhinolaryngology Registered Nurse - NCBOHN: National Certifying Board of Otorhinolaryngology and Head-Neck Nurses - SOHN: Society of Otorhinolaryngology and Head-Neck Nurses - PTC: Professional Testing Corporation - RN: Registered Nurse - CT: Computed tomography - MRI: Magnetic resonance imaging - PET: Positron emission tomography - PET/CT: Combined positron emission tomography and computed tomography - CBC: Complete blood count - ABR: Auditory brainstem response - ENG: Electronystagmography - BPPV: Benign paroxysmal positional vertigo - OSA: Obstructive sleep apnea - HPV: Human papillomavirus - FESS: Functional endoscopic sinus surgery - AAC: Augmentative and alternative communication - CSF: Cerebrospinal fluid - FNA: Fine-needle aspiration - ICU: Intensive care unit - PACU: Post-anesthesia care unit - NPO: Nothing by mouth - ADL: Activities of daily living - EHR: Electronic health record - QI: Quality improvement - EBP: Evidence-based practice - PPE: Personal protective equipment - ENT-NF: Ear, Nose, and Throat Nursing Foundation