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2026 Statistics

Key Facts: Título em Otorrinolaringologia Exam

80 Items

Four-option MCQs on the official ABORL-CCF Prova Teórica

Edital Oficial ABORL-CCF / AMB

3 Hours

Duration of the Prova Teórica morning session

Edital Oficial ABORL-CCF / AMB

R$ 1.700,00

Registration fee for affiliated ABORL-CCF / AMB members (R$ 3.900 for non-members)

Edital Oficial ABORL-CCF

7.0 / 10.0

Minimum final passing score benchmark (70%)

Regulamento Oficial ABORL-CCF / AMB

RQE Otorrinolaringologia

Specialist credential conferred with CFM upon passing

Conselho Federal de Medicina (CFM) / AMB

Annual

Official examination frequency conducted by ABORL-CCF

Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial

The ABORL-CCF Título de Especialista is the prestigious Brazilian board certification examination in Otorhinolaryngology and Cervico-Facial Surgery. It assesses diagnostic acumen, surgical anatomy, audiometric and radiological interpretation, and guideline-directed medical therapy across all ENT subspecialties.

Sample Título em Otorrinolaringologia Practice Questions

Try these sample questions to test your Título em Otorrinolaringologia exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 34-year-old woman presents with progressive bilateral hearing loss, more pronounced in the left ear, and low-pitched tinnitus for the past two years. She notes that her hearing noticeably deteriorated during her recent pregnancy. Otoscopic examination is normal, with a faint pinkish vascular hue visible over the promontory through a translucent tympanic membrane (Schwartze sign). Pure-tone audiometry demonstrates a bilateral conductive hearing loss with an air-bone gap of 35 dB in the speech frequencies and a distinct dip in bone-conduction thresholds at 2000 Hz (Carhart notch). Tympanometry reveals type As curves bilaterally with absent acoustic stapedial reflexes. What is the definitive pathophysiological mechanism and primary surgical treatment of choice for this condition?

A.Incus necrosis from chronic Eustachian tube dysfunction treated with partial ossicular replacement prosthesis (PORP)

B.Abnormal fibro-osseous remodeling of the otic capsule causing stapedio-vestibular ankylosis treated with stapedotomy

C.Endolymphatic hydrops of the cochlear duct treated with endolymphatic sac decompression

D.Autoimmune resorption of the malleus handle treated with total ossicular replacement prosthesis (TORP)

Explanation: Otosclerosis is an autosomal dominant bone dysplasia characterized by disordered resorption and neo-ossification of the otic capsule, most commonly at the fissula ante fenestram, leading to stapes footplate fixation. The Carhart notch (a mechanical artifact characterized by a 10–15 dB bone-conduction elevation specifically at 2000 Hz) and type As tympanometry are classic. Stapedotomy with piston prosthesis placement is the definitive surgical procedure to restore ossicular mobility.

2A 42-year-old man presents with chronic, foul-smelling, purulent left otorrhea refractory to topical fluoroquinolones, along with progressive hearing loss. Otoscopy reveals a retraction pocket in the pars flaccida containing keratin debris and erosion of the lateral epitympanic wall (scutum). High-resolution temporal bone CT demonstrates soft tissue filling the Prussak space with blunting of the scutum and partial erosion of the incus long process. Which of the following is the most appropriate surgical management according to ABORL-CCF otology consensus?

A.Myringotomy with grommet ventilation tube insertion and topical antibiotic drops

B.Tympanomastoidectomy with complete cholesteatoma eradication and ossicular reconstruction

C.Endolymphatic mastoid shunt surgery combined with systemic steroid therapy

D.Laser myringoplasty with autologous fascia temporalis under local anesthesia

Explanation: Acquired primary cholesteatoma arising from the pars flaccida (Prussak space) is a destructive, bone-eroding squamous epithelial lesion that requires surgical eradication via tympanomastoidectomy (canal wall up or canal wall down depending on anatomy and disease extent) to prevent intracranial or intratemporal complications.

3A 52-year-old woman presents to the emergency room with severe episodic vertigo lasting 30 to 45 seconds triggered whenever she turns her head to the right while in bed or looks up to reach a high shelf. There is no associated tinnitus, hearing loss, or spontaneous nystagmus. A right Dix-Hallpike maneuver induces a 5-second latent onset of mixed torsional (counterclockwise, top pole beating toward the down ear) and upbeating nystagmus with intense vertigo lasting 25 seconds, which fatigues upon repeated testing. What is the most appropriate next step in management?

A.Prescribe oral betahistine 24 mg twice daily and recommend strict bed rest for 5 days

B.Perform an immediate right-sided Epley canalith repositioning maneuver

C.Administer intravenous methylprednisolone 1 g for acute vestibular neuritis

D.Perform a Lempert (360-degree barbecue roll) repositioning maneuver

Explanation: The clinical vignette describes classic posterior semicircular canal Benign Paroxysmal Positional Vertigo (BPPV) canalolithiasis. The diagnostic hallmark on the Dix-Hallpike test is torsional upbeating nystagmus with latency, duration under 60 seconds, and fatigability. The first-line, definitive treatment is the Epley canalith repositioning maneuver (or Semont liberatory maneuver).

4A 48-year-old male with a 4-year history of episodic true spinning vertigo lasting 2 to 4 hours, accompanied by fluctuating left-sided low-frequency hearing loss, roaring tinnitus, and ipsilateral aural fullness, presents for evaluation. Electrocochleography demonstrates an elevated Summating Potential to Action Potential ratio (SP/AP > 0.45). According to international and ABORL-CCF diagnostic criteria, which first-line medical maintenance strategy is recommended to reduce episode frequency and preserve hearing in this disorder?

A.Dietary sodium restriction (<2 g/day), caffeine/alcohol avoidance, and thiazide diuretic or betahistine maintenance therapy

B.Prophylactic long-term daily intratympanic gentamicin injections

C.High-dose lifelong oral carbamazepine or pregabalin

D.Immediate surgical translabyrinthine vestibular nerve section

Explanation: The patient meets definitive criteria for Ménière disease (idiopathic endolymphatic hydrops). First-line conservative management consists of lifestyle and dietary modification (sodium restriction ≤1.5–2.0 g/day, limiting caffeine and alcohol) along with betahistine or a mild diuretic (such as hydrochlorothiazide/triamterene) to reduce endolymphatic pressure and prevent vertigo attacks.

5A 38-year-old man presents with sudden hearing loss in his right ear upon waking 24 hours ago. He denies prior otologic surgery or trauma. Otoscopy is entirely normal bilaterally. Pure-tone audiometry confirms an acute right sensorineural hearing loss of 55 dB across 500 Hz, 1000 Hz, and 2000 Hz with a normal left ear. Speech discrimination in the right ear is 48%. According to national and international sudden sensorineural hearing loss (SSNHL) guidelines, which intervention is the cornerstone of initial emergency management within the early therapeutic window?

A.Immediate oral high-dose corticosteroid therapy (e.g., Prednisone 1 mg/kg/day for 10–14 days with taper)

B.Immediate exploratory tympanotomy for suspected perilymphatic fistula

C.Prescription of oral acyclovir 800 mg 5 times daily alone without corticosteroids

D.Observation for 4 weeks with repeat audiogram, as spontaneous recovery rates exceed 90%

Explanation: Sudden sensorineural hearing loss (SSNHL) is defined as a decrease in hearing of ≥30 dB over at least 3 contiguous audiometric frequencies developing within 72 hours. High-dose systemic corticosteroid therapy (prednisone 1 mg/kg/day, maximum 60 mg/day, tapered over 10–14 days) initiated as early as possible within the first 14 days is the proven standard of care. Intratympanic dexamethasone can be used as primary or salvage therapy.

6A 56-year-old man presents with slowly progressive unilateral right-sided hearing loss and persistent high-frequency tinnitus over the past 18 months. Pure-tone audiometry shows asymmetric sensorineural hearing loss in the right ear with a pure-tone average of 40 dB, but speech discrimination score (SDS) is markedly reduced at 28% (word recognition disproportionately poorer than pure-tone loss). Auditory Brainstem Response (ABR) demonstrates a prolonged wave I–V interpeak latency and an interaural wave V latency difference >0.4 ms. Contrast-enhanced MRI reveals an intensely enhancing 1.8 cm lesion centered in the right internal auditory canal extending into the cerebellopontine angle without brainstem compression (Koos Grade II). What is the most likely diagnosis?

A.Meningioma of the petrous apex

B.Vestibular Schwannoma (Acoustic Neuroma)

C.Epidermoid cyst of the cerebellopontine angle

D.Glomus jugulare paraganglioma

Explanation: Vestibular schwannoma (acoustic neuroma) typically arises from the inferior or superior vestibular nerve in the internal auditory canal. Its hallmark presentation is progressive unilateral/asymmetric SNHL with disproportionately impaired speech discrimination (rollover phenomenon) and retrocochlear ABR delay. Contrast-enhanced T1 MRI showing an intensely enhancing mass widening the internal auditory canal confirms the diagnosis.

7A 74-year-old diabetic male presents with intense, deep-seated right otalgia worsening at night, purulent otorrhea, and right facial weakness (House-Brackmann Grade IV). Otoscopy reveals granulation tissue at the bony-cartilaginous junction of the external auditory canal floor. Laboratory workup reveals an ESR of 98 mm/hr and elevated CRP. A technetium-99m bone scan demonstrates intense osteoblastic activity in the right temporal bone and skull base. Which pathogen is most commonly responsible, and what is the first-line medical therapy?

A.Staphylococcus aureus; treated with oral cephalexin for 10 days

B.Pseudomonas aeruginosa; treated with intravenous/oral antipseudomonal fluoroquinolones (e.g., ciprofloxacin) for a prolonged course (6–12 weeks)

C.Aspergillus fumigatus; treated with topical clotrimazole ear drops alone

D.Streptococcus pneumoniae; treated with high-dose oral amoxicillin for 14 days

Explanation: Malignant (necrotizing) otitis externa is an aggressive, skull base osteomyelitis occurring almost exclusively in elderly diabetic or immunocompromised patients. Pseudomonas aeruginosa is the causative agent in >95% of cases. The classic finding is granulation tissue at the bony-cartilaginous junction (fissures of Santorini) with cranial nerve involvement (CN VII most frequent). Treatment requires prolonged systemic antipseudomonal therapy (such as ciprofloxacin or ceftazidime) for 6–12 weeks monitored by gallium-67 or SPECT scans.

8During a routine pre-cochlear implant electrophysiological evaluation of an infant, Auditory Brainstem Response (ABR / BERA) clicks are delivered. If the recording shows normal latency and morphology for Wave I, but prolonged absolute latency and interpeak intervals for Waves III and V, which anatomical segment of the auditory pathway is implicated in this conduction delay?

A.Distal portion of the cochlear nerve (cranial nerve VIII)

B.Brainstem auditory pathway between the cochlear nucleus / superior olivary complex and inferior colliculus

C.Medial geniculate body of the thalamus

D.Primary auditory cortex in the superior temporal gyrus (Heschl gyrus)

Explanation: In ABR wave generator anatomy: Wave I originates from the distal cochlear nerve (CN VIII), Wave II from the proximal cochlear nerve / cochlear nucleus, Wave III from the superior olivary complex in the lower pons, Wave IV from the lateral lemniscus, and Wave V from the inferior colliculus in the upper midbrain. Prolongation of Waves III–V or I–V indicates a pontine or retrocochlear brainstem transmission delay.

9A 28-year-old motorcyclist is brought to the trauma center following a collision. He has blood pooling in his right external ear canal, right-sided peripheral facial paralysis (House-Brackmann VI), severe vertigo with spontaneous nystagmus beating to the left, and profound right sensorineural hearing loss. High-resolution temporal bone CT demonstrates a fracture line running perpendicular to the long axis of the petrous pyramid, crossing the internal auditory canal and the otic capsule (cochlea and vestibule). What type of temporal bone fracture is present, and what is the primary risk factor regarding facial nerve outcome?

A.Longitudinal (otic capsule-sparing) fracture; 15% incidence of facial nerve palsy with excellent spontaneous recovery

B.Transverse (otic capsule-violating) fracture; 50% incidence of facial nerve injury frequently involving severe nerve transection or crush requiring urgent surgical exploration

C.Isolated squamosal fracture; 0% incidence of inner ear or facial nerve injury

D.Anterior mandibular condyle avulsion fracture without skull base communication

Explanation: Transverse fractures of the temporal bone (often resulting from frontal or occipital impacts) run perpendicular to the petrous ridge and violate the otic capsule, causing profound SNHL, severe vestibular destruction, and a high rate (~50%) of facial nerve paralysis due to direct laceration or severe compression in the labyrinthine/geniculate region. Immediate onset complete facial palsy in otic capsule-violating fractures often warrants surgical exploration.

10A 6-year-old boy is evaluated for bilateral conductive hearing loss and academic difficulties. Otoscopy reveals intact, dull, retracted tympanic membranes with an amber-yellowish fluid level and impaired mobility on pneumatic otoscopy. Pure-tone audiometry demonstrates a 25 dB air-bone gap bilaterally. What tympanometric profile according to the Jerger classification is expected in this patient?

A.Type A curve (normal peak compliance at 0 daPa)

B.Type As curve (normal pressure with reduced peak compliance <0.3 cm³)

C.Type B curve (flat tracing with no identifiable compliance peak and normal ear canal volume)

D.Type C curve (significant negative peak pressure <-100 daPa with normal compliance amplitude)

Explanation: Otitis media with effusion (OME) presents characteristically with a Jerger Type B (flat) tympanogram due to fluid in the middle ear cavity impeding tympanic membrane compliance, while the ear canal volume remains normal (distinguishing it from a perforation or patent tympanostomy tube, which produces a flat curve with large canal volume).

About the Título em Otorrinolaringologia Exam

The Título de Especialista em Otorrinolaringologia e Cirurgia Cérvico-Facial is the official board certification for otorhinolaryngologists in Brazil, awarded by the Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial (ABORL-CCF) in partnership with the Associação Médica Brasileira (AMB) and registered with the Conselho Federal de Medicina (CFM). The examination evaluates comprehensive expertise across otology, neurotology, audiology, rhinology, paranasal sinus surgery, laryngology, voice and swallowing, head and neck surgical oncology, pediatric otorhinolaryngology, sleep medicine, facial trauma, and facial plastic and reconstructive surgery. Achieving this title is the definitive requirement for physicians in Brazil to register their specialized qualification (Registro de Qualificação de Especialista - RQE) in Otorrinolaringologia.

Assessment

Annual examination administered by the Comissão de Título de Especialista da ABORL-CCF in partnership with the AMB. The process runs in two stages: first an Análise Curricular assessing the candidate's training and professional record against the edital criteria, then the Prova Teórica — 80 four-option multiple-choice questions over 3 hours, scored out of 10 points. Candidates must confirm the current stages and weightings in the edital for their exam year.

Time Limit

3 hours for the Prova Teórica

Passing Score

Defined each year in the official ABORL-CCF/AMB Edital, which combines the Prova Teórica score (maximum 10 points) with the Análise Curricular

Exam Fee

R$ 1.700,00 (sócios adimplentes da ABORL-CCF e/ou AMB) / R$ 3.900,00 (não sócios) (Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial (ABORL-CCF) — Associação Médica Brasileira (AMB))

Título em Otorrinolaringologia Exam Content Outline

25%

Otologia e Otoneurologia

Chronic otitis media (cholesteatomatous and non-cholesteatomatous), otosclerosis, stapedotomy, temporal bone trauma, sudden sensorineural hearing loss, Ménière disease, benign paroxysmal positional vertigo (BPPV), vestibular schwannoma, audiometry, tympanometry, auditory brainstem response (ABR/BERA), and cochlear implants.

20%

Rinologia e Seios Paranasais

EPOS 2020 guidelines on chronic rhinosinusitis with/without polyps, Type 2 inflammation and biologics, functional endoscopic sinus surgery (FESS) surgical anatomy and safety landmarks, epistaxis management, allergic rhinitis, inverted papilloma, and CSF rhinorrhea / endoscopic skull base reconstruction.

15%

Laringologia, Voz e Foniatria

Benign vocal fold lesions (nodules, polyps, cysts, Reinke edema), stroboscopy, recurrent respiratory papillomatosis, vocal fold paralysis and thyroplasty, spasmodic dysphonia, laryngopharyngeal reflux disease, and laryngeal cancer staging and management.

15%

Cirurgia de Cabeça e Pescoço

Salivary gland neoplasms (pleomorphic adenoma, Warthin, mucoepidermoid, adenoid cystic), parotidectomy, thyroid nodules and Bethesda classification, HPV-associated and smoking-related HNSCC, neck dissection levels (I-VI), and deep neck space infections (Ludwig angina, parapharyngeal space).

15%

Otorrinolaringologia Pediátrica e Medicina do Sono

Pediatric OSA, adenotonsillar hypertrophy (Brodsky), post-tonsillectomy care, congenital airway stridor (laryngomalacia, subglottic stenosis Cotton-Myer), choanal atresia, adult OSA polysomnography (AHI), DISE (VOTE classification), and sleep apnea surgical procedures.

10%

Cirurgia Plástica Facial e Trauma Crânio-Maxilo-Facial

Rhinoplasty anatomy (nasal valve, tip dynamics, structural grafting), facial fractures (Le Fort I-III, ZMC, orbital blowout), facial nerve injury and Bell palsy, House-Brackmann grading (I-VI), and local facial reconstruction flaps.

How to Pass the Título em Otorrinolaringologia Exam

What You Need to Know

Passing score: Defined each year in the official ABORL-CCF/AMB Edital, which combines the Prova Teórica score (maximum 10 points) with the Análise Curricular
Assessment: Annual examination administered by the Comissão de Título de Especialista da ABORL-CCF in partnership with the AMB. The process runs in two stages: first an Análise Curricular assessing the candidate's training and professional record against the edital criteria, then the Prova Teórica — 80 four-option multiple-choice questions over 3 hours, scored out of 10 points. Candidates must confirm the current stages and weightings in the edital for their exam year.
Time limit: 3 hours for the Prova Teórica
Exam fee: R$ 1.700,00 (sócios adimplentes da ABORL-CCF e/ou AMB) / R$ 3.900,00 (não sócios)

Keys to Passing

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Título em Otorrinolaringologia Study Tips from Top Performers

1Master Temporal Bone & Middle Ear Anatomy: Know the course of the facial nerve (labyrinthine, tympanic, mastoid segments), landmarks for stapedotomy, Trautmann triangle, sinus tympani, and the differences between mucosal chronic otitis media and cholesteatoma.

2Internalize EPOS 2020 Guidelines & FESS Landmarks: Memorize the criteria for chronic rhinosinusitis with nasal polyps (CRSwNP), indications for biologic therapies (dupilumab, omalizumab), Keros classification of the olfactory fossa depth, and the relationship between the lamina papyracea and anterior ethmoidal artery.

3Practice Systematic Audiometry & Electrophysiology: Rapidly interpret audiograms for air-bone gaps, Carhart notch (2000 Hz bone conduction dip in otosclerosis), speech recognition thresholds (SRT), tympanograms (Jerger types A, As, Ad, B, C), and ABR wave interpeak latencies (I-III, III-V, I-V).

4Correlate Head & Neck Oncology Guidelines: Review cervical lymph node drainage levels (I through VI), Bethesda System classification for thyroid fine-needle aspiration (FNA) with malignancy risks and surgical management, and salivary gland tumor histopathology (pleomorphic adenoma vs mucoepidermoid carcinoma vs adenoid cystic carcinoma).

5Systematize Pediatric Airway & Sleep Medicine: Memorize the Cotton-Myer subglottic stenosis grading scale, Brodsky tonsillar hypertrophy scale, laryngomalacia endoscopic findings (omega-shaped epiglottis, short aryepiglottic folds), and adult sleep endoscopy (DISE VOTE classification).

6Review Facial Plastics & Trauma Protocols: Understand Le Fort fracture patterns, zygomaticomaxillary complex (ZMC) tripod fractures, orbital blowout trapdoor fractures with entrapment in children, and House-Brackmann facial nerve palsy grading scale (I through VI).

Frequently Asked Questions

What is the Título de Especialista em Otorrinolaringologia (ABORL-CCF / AMB)?

The Título de Especialista em Otorrinolaringologia is the official medical specialty board certification awarded by the Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial (ABORL-CCF) in conjunction with the Associação Médica Brasileira (AMB). Passing this examination enables physicians to obtain their specialized qualification registration (Registro de Qualificação de Especialista - RQE) in Otorrinolaringologia with their Regional Medical Council (CRM) and the Federal Council of Medicine (CFM), legally authorizing them to practice and advertise as specialist otorhinolaryngologists in Brazil.

What are the eligibility requirements to sit for the ABORL-CCF board exam?

Candidates must be physicians with active registration in a Regional Medical Council (CRM) in Brazil and fulfill one of the following pathways: (1) Completion of a 3-year accredited Medical Residency Program (CNRM/MEC) in Otorhinolaryngology; (2) Completion of a 3-year specialization training program accredited by ABORL-CCF; or (3) Proof of at least 6 years of documented clinical and surgical practice in Otorhinolaryngology, meeting the specific curricular requirements defined in the annual Edital.

How is the ABORL-CCF specialty examination structured?

The exam consists of three core components: (1) Prova Teórica (Theoretical Exam), containing 80 four-option multiple-choice questions testing all domains of otorhinolaryngology; (2) Prova Prática (Practical Exam), featuring image, video, audiogram, and clinical scenario stations; and (3) Análise Curricular (Curricular Analysis), scoring academic output, residency completion, and scientific publications.

What is the passing score for the ABORL-CCF certification?

Candidates must achieve a minimum overall composite score of 7.0 on a 0 to 10 scale (or 70%), with specific eliminatory thresholds in the theoretical and practical exam components as detailed in the annual official notice (Edital).

Which clinical consensus and reference texts form the foundation of the exam?

Questions are referenced from major otolaryngology literature including the Tratado de Otorrinolaringologia e Cirurgia Cérvico-Facial (ABORL-CCF), Cummings Otolaryngology Head and Neck Surgery, Bailey's Head and Neck Surgery, EPOS 2020 (European Position Paper on Rhinosinusitis and Nasal Polyps), Bethesda System for Reporting Thyroid Cytopathology, and official consensus guidelines published in the Brazilian Journal of Otorhinolaryngology (BJORL).

Why is this OpenExamPrep practice bank presented in English?

This practice bank is an English-language MCQ study adaptation designed to support Brazilian residents, international fellows, and clinicians worldwide who wish to test their mastery of otolaryngology and cervico-facial surgery. All essential anatomical nomenclature, diagnostic criteria (e.g., House-Brackmann, EPOS 2020, Bethesda, Cotton-Myer, Brodsky), and Brazilian consensus principles are fully preserved inline.