II Lecture Chapter 17 Short Answer: Ear Surgery pp 379

which laser is useful in middle ear procedures (stapedectomy)

Argon laser

describe Meniere's disease

Meniere's disease is a disorder of the inner ear that can lead to dizzy spells (vertigo) and hearing loss. In most cases, Meniere's disease affects only one ear.

describe the types of ear dressings

simple: cotton ball inserted in the external ear canal complex: mastoid (shea or a modification thereof) dressing (mastoid-antibiotic ointment, a nonadherent pad, fluffed gauze, and gauze wrapped around the patient's head)

what are the reasons for reversing the operating table during ear surgery

the patient's head is placed at the foot of the table, allowing space under the foot portion of the table to accommodate the seated team members' legs and to allow for equipment placement

what may be used to hold implants in place or to fill the mastoid sinus? what is used to place it?

the receiver and electrodes may be kept in place with the use of a small piece of temporalis fascia Gelfoam sponge is used, which is cut into small pieces and placed with an alligator forceps. Gelfoam can be used dry or soaked in saline, epinephrine, or an antibiotic solution

what is the purpose of a myringotomy? where is the incision made?

to remove accumulated fluid and insertion of a pressure-equalizing (PE) tube to allow for additional drainage and to maintain pressure equalization incision is made in the inferior posterior portion of the tympanic membrane with a disposable myringotomy knife

what is a bony overgrowth surrounding the stapes that prevents vibrations of the ossicles? what procedure is done to remove it?

Otosclerosis occurs when there is a bony overgrowth of the stapes. Eventually the footplate of the stapes becomes fixed to the oval window, preventing the normal sound vibrations from entering the inner ear. This progressive disease is hereditary, affecting women more commonly than men and is diagnosed with the assistance of a tuning fork and audio-metric exams. Surgical treatment to consider for this disorder would be stapedotomy or stapedectomy.

what are the classifications for tympanoplasty, and how are they determined?

Type I: damage is limited to the tympanic membrane Type II: destructive process extends beyond the damaged tympanic membrane to include the malleus Type III: in addition to the damaged tympanic membrane, both the malleus and incus have been affected Type IV: all of the ossicles are affected, in addition to the perforated tympanum. only the middle ear is intact and mobile footplate of the stapes Type V: remaining footplate of stapes is fixed. all ossicles are completely removed

once the stapes footplate is removed, what can be used between the implant and the oval window

a fascia graft

hearing loss is measured in decibels. which nerve is affected in a patient with sensorineural deafness? what can be done to help this patient?

also called nerve deafness, involves the cochlea and acoustic nerve. treatment is limited; however, cochlear implants are providing some progress and hope for patients

what is the most common cause of otitis media (acute inflammation of the inner ear)

blockage of the eustachian tube causing an accumulation of fluid that normally drains into the nasopharynx, causing extreme pain and an inflamed tympanic membrane

what source of energy will be needed to operate the rotating drill

electrically or pneumatically (gas or compressed air)

why would you add an ototome to a tympanoplasty setup and complete a postauricular or retroauricular incision

if a mastoidectomy or a temporalis fascia muscle harvest is anticipated, the postauricular approach is performed

why might a stapedectomy be completed using a local anesthetic?

local anesthetic is preferred so surgeon may immediately assess hearing restoration using voice commands or a tuning fork

why is nitrous oxide restricted during reconstructive ear surgery

nitrous oxide causes expansion of the middle ear and can cause dislocation of a tympanic membrane graft

what could be wrong if the patient presents with an earache, headache, purulent discharge from the ear, hearing loss, dizziness, and weakness of the facial muscles due to damage of the seventh cranial nerve? what is used to remove it?

patient may be suffering from a cholesteatoma (a benign cyst or tumor that fills the mastoid cavity and erodes the mastoid air cells, also damaging the ossicles