The aim of this new section within the new look Otorhinolaryngologist is to look at common intercollegiate viva questions in all 4 sections and provide a model answer. It is not unusual to start a question with a clinical photograph or scan. Often in the viva situation there are not wrong or right answers but a body of opinion, the examiner is trying to ascertain whether you are familiar with these opinions and what YOU think. – I will try to illustrate some of these points in this question. Also the examiners sometimes want to know how you do it and why, so make sure you are happy with your own technique and if it is a new or different way make sure you have evidence to back it up.