Otorhinolaryngologic surgery

cochlear implants are made of ____ components; the ____ and the ____

2; external; internal

otitis externa

AKA swimmers ear Inflammation of the external ear canal. Extends distally to the pinna and proximally to the tympanic membrane Chronic or Acute Acute may be bacterial - Pseudomonas aeruginosa and Staphylococcus aureus the most common pathogens Chronic - caused by allergies or underlying inflammatory dermatologic conditions, and is treated by addressing the underlying causes

sensorineural deafness

AKA: Nerve deafness. Involves the cochlea and acoustic nerve - damage to the inner ear (head trauma, loud noises, genetics, and diseases such as mumps, meningitis, multiple sclerosis) Permanent hearing loss. Limited treatment. Cochlear implants provide progress and hope for patients

hemostatic agents

Absorbable gelatin Absorbable collagen Microfibrillar collagen Oxidized cellulose Cautery & laser

cholesteatoma

Benign cyst or tumor that fills the mastoid cavity & erodes the mastoid air cells Can damage the ossicles of the ear Epithelial cells that normally shed through the Eustachian tube are unable to migrate out of the middle ear due to a blockage - can form a cholesteatoma

congenital deafness

Born deaf. May be due to genetics or factors present in-utero or at time of birth

Mixed-type deafness

Combination of sensorineural and conductive deafness. Damage to both outer or middle and inner ear. Birth defects, diseases, infections, masses can lead to mixed type. Severity of loss can range from mild to profound.

central deafness

Disorders of the brainstem or brain are generally responsible for central hearing loss.. Affects a person's ability to filter out competing auditory signals (Problems "hearing" when multiple conversations are going; inability to read or study with the radio or TV turned on; missing the first part of someone's sentence due to additional sound in the background). Typically classified as a learning disability rather than a hearing disorder.

The three main regions of the ear are

External Middle Inner

views of the paranasal sinuses

Frontal - located within the frontal bone behind the eyebrows Ethmoid - located between the eyes Sphenoid - located directly behind the nose Maxillary - located below the eyes and lateral to the nasal cavity Function is to produce the mucus that lines the nose

Sinus endoscopy

Functional Endoscopic Sinus Surgery (FESS). Performed to correct abnormalities related to the sinuses. The goal of a FESS is to reestablish normal breathing and the ability to be cleared from the sinuses. Critical: Presence of yellow orbital fat will appear on monitor if the orbit has been accidentally entered. It will need to be immediately addressed. Once a FESS has been performed, a second FESS becomes more difficult because the anatomical landmarks may be destroyed.

instruments for nasal procedures

Headlight Separate mayo stand for prep/local Protection of the eyes Hemostasis Packing Endoscopic surgery needs Sinus instruments

Functional deafness

Hearing loss without a corresponding pathology, rather with a psychological or emotional problem.

nasopharynx

Houses Pharyngeal tonsils. Mass of lymphatic tissue. When they are enlarged, they are referred to as adenoids. (Tonsils provide protection against pathogens entering the nose

oropharynx

Houses the palatine (faucial) and lingual tonsils. Palatine tonsils are the masses of lymphoid tissues commonly referred to as tonsils. They are located on the edge of the tissue that descends from the soft palate to the base of the tongue. Lingual tonsils located on the posterior surface of the tongue near the base.

myringotomy

Incision into the ear drum (tympanic membrane) in order to allow the accumulated fluid to drain Infection caused by otitis media may require a myringotomy to remove the accumulate fluid Will require the use of PE tubes

mastoiditits

Inflammation of the mastoid bone - usually a complication of otitis media It is usually a result of an extension of the inflammation of the middle ear infection into the mastoid air cells. Children with mastoiditis have a history of ear infections that continuously reoccur. May be caused by various bacteria Mastoiditis that extends beyond the mastoid sinus can lead to meningitis or encephalitis

otitis media (OM)

Inflammation of the middle ear Eustachian tubes become blocked with fluid Pus and bacteria can pool behind the eardrum - leading to infection - causing pressure and pain Common in children because their Eustachian tube is shorter and narrower than an adults, and can easily become clogged

pharyngitis

Inflammation of the pharyngeal tonsils is known as Adenoiditis Recurrent adenotitis can lead to hypertrophic tissue - which can lead to nasal obstruction and hearing impairment

sphenoidectomy

Involves creating an opening by removing the front wall of the sinus. Allows the sinus to drain into the nasal passageway

Epiglottis

Located behind the tongue, at the top of the larynx. Seals off the windpipe during eating.

vocal cords

Located within the larynx - more commonly known as "the voice box". Larynx is located above the trachea (between the pharynx and the trachea

tracheotomy/tracheostomy

May be performed by many surgeons from various surgical specialties May be performed in the OR, ER, PACU, ICU, and in the field. Facilitate breathing and protect damage to other structures Prior to the start of a tracheotomy, the ST should have the tracheotomy tube on their mayo stand - or back table

Conduction-type deafness

Occurs when sound is not conducted efficiently through the outer ear canal to the middle ear (tympanic membrane & ossicles) Usually involves a reduction in sound level or the ability to hear faint sounds. Can be caused by colds, allergies, ear infections, benign tumors...Can be corrected medically or surgically

PE tubes

PE tubes = Pressure Equalizer Tubes Allow the ear to stay open and helps the fluid build-up to drain into the throat. Fall out on their own or are removed

the bony labyrinth contains a fluid called...

Perilymph

Auditory Processing Disorder

Person can pick up sounds, words, etc., but their brain is unable ot process the sounds properly. The information becomes jumbled up or confused and misunderstood.

conditions of the upper aerodigestive tract

Pharyngitis Epiglottitis Tonsillitis Peritonsillar abscess Sleep apnea Laryngitis Polypoid corditis or vocal cord polyps Vocal cord nodules

tonsils

Produce lymphocytes. They contain 10 to 20 crypts that help trap bacteria

Caldwell-Luc

Radical type of Antrostomy. Performed when intranasal antrostomy does not provide adequate visualization. It is performed to remove diseased antral wall, evacuate sinus contents, and establish drainage through the nose. Contraindicated in pediatric patients prior to the descent of the permanent teeth

mastoidectomy; modified

Removal of diseased bone & some of the ossicles and the canal. Eardrum & some of the ossicles remain.

mastoidectomy; simple

Removal of diseased bone with preservation of ossicles, eardrum, & canal

mastoidectomy; radical

Removal of the canal wall along with ossicles & tympanic membrane

Ethmoidectomy

Removed infected tissue & bone in the ethmoid sinuses that block drainage. Located between eyes and bridge of nose. Key to treating most sinus infections. If the ethmoids are blocked, the infection can spread

Pharynx

Respiratory tract and digestive system Begins at internal nares and terminates posterior to the larynx at the level of the esophagus

Rinne test

This test compares the air conduction of sound to that of bone conduction; tuning fork i placed on the mastoid process posterior to the ear

myringotomy, tympanostomy

Type I involves just the tympanic membrane Type II: involves the tympanic membrane and the malleus Type III: Involves the tympanic membrane, the malleus, and the incus Type IV: All the ossicles are affected in addition to the perforated tympanum. The only remaining natural structure of the middle ear is the mobile footplate of the stapes Type V: Same as Type IV - but the footplate of the stapes is fixed. Disease can extend into the mastoid sinus - requiring a mastoidectomy.

uvulopalatopharyngoplasty

UPPP; UP3 Remove excess tissue in the throat to make the airway wider Performed to treat sleep apnea T&A will be performed if present Tracheotomy will be performed due to post-op swelling Tongue blade not used for post-op inspection so as to not disrupt the surgical site

laryngopharynx

Where both food and air pass. It can be found between the hyoid bone and the larynx and esophagus. It is a part of the pharynx.

Trachea

air pathway to lungs; prevent airway from collapsing but allow food to pass behind in the esophagus;AKA windpipe

the tip of the nose is known as the the opening is known as flared wings of the nostrils are known as

apex nares ala

the membranous labyrinth is responsible for

balance

the canals of the membranous labyrinth are lined with

cilia

the crista ampullaris is a _____, and detects

cluster of hair cells that controls dynamic equilibrium; motion

the cochlear branch of the vestibulocochlear nerve (VIII) is responsible for

conducting sound impulses (hearing) to the auditory complex of the temporal lobe of the brain

PE tubes are considered implants and must be what?

documented in the patients chart

the membranous labyrinth contains a fluid called...

endolymph

What nerve runs through the parotid gland?

facial nerve

otoscope

handheld, lighted instrument used to view the external auditory canal

the vestibular branch of the vestibulocochlear nerve (VIII) is responsible for

innervating the vestibular system of the inner ear and carriers information related to equilibrium to the cerebral cortex

which artery is the main blood supply to the nose

internal maxillary artery

audiometry

involves a machine that can emit tones at different pitches and volumes; used to asses a patients hearing

during a mastoidectomy it is crucial to

locate and identify the facial nerve

static equilibrium

maintians balance when stationary

tympanogram

measures the vibrations of the eardrum by placing a probe against the tympanic membrane

which tonsils are removed in a tonsilectomy

palatine

Name the 3 salivary glands

parotid sublingual submandibular

which tonsils are removed during an adenoidectomy

pharyngeal

stapendectomy/stapendotomy

removal of the fixed stapes; partial or complete replacement with a prosthesis; soft tissue grafting of the oval window; hole drilled in the foot plate of the stapes

cochlear implants are used to treat

sensorineural deafness

Epistasis

severe nose bleed

tuning fork test abnormal:

sound lateralizes to one ear

tuning fork test normal:

sound radiates equally to both ears

Inner ear consists of:

the cochlea, semicircular canals, and the internal auditory canal (meatus) the bony laybrinth, and the membranous labyrinth

The bony labyrinth contains perilymph and

the membranous labyrinth

the membranous labyrinth consists of -_____, ______, _____, and a fluid called

the utricle, saccule, and semi-circular ducts. endolymph

T&A

tonsilectomy, adenoidectomy