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Otorhinolaryngologic Surgery Chapter 17 Anatomy of the Ear Outer ear Tympanic membrane Middle ear Umbo Auditory Ossicles Inner ear Labyrinth Organ of Corti Basilar Membrane Anatomy of the Ear Types of Hearing Loss Conduction-type deafness Sensorineural deafness Central deafness Mixed-type deafness Functional deafness Congenital deafness Neonatal deafness Pathology of the Outer Ear Auditory canal obstruction Otitis Externa Excess cerumen Swimmer’s Ear Perforated/Ruptured Tympanic Membrane. Pathology of the Middle Ear Otitis Media Very common acute inflammation. May cause severe ear pain. If untreated, could lead to permanent hearing loss. Otosclerosis Hereditary disease causing bony growth over the stapes. Prevents normal sound vibrations. Pathology of the Middle Ear Mastoiditis Complication of acute otitis media. Untreated infection causes destruction of the mastoid bone. Cholesteatoma Benign cyst or tumor that fills the mastoid cavity. Causes weakness of the face due to damage of the facial nerve (7th cranial nerve.) Pathology of the Inner Ear Meniere’s syndrome Causes fluctuating hearing loss, vertigo, and feeling of fullness in the ear. Dilatation of the endolymphatic spaces and failure to reabsorb the endolymphatic fluid. Medical and surgical treatment. Diagnostic Procedures of the Ear Tuning forks Audiometry (Hearing test) Otoscope CT Scan/MRI Tympanogram Electronystagmogram (ENG) Preoperative Considerations Microscope considerations O.R. table reversed. Supine position with head turned to the side. Turban head drapes. “Dry” preps. Room Set up Instrumentation Instrumentation for Ear Surgery Instrumentation Instrumentation for Ear Surgery Instrumentation Instrumentation for Ear Surgery Surgical Procedures of the Ear Myringotomy Myringoplasty/Tympanoplasty Mastoidectomy Stapedectomy Cochlear Implants Surgical Procedures of the Ear Anatomy of the Nose and Sinuses External nose Internal nose Conchae Paranasal sinuses Frontal Ethmoid Sphenoid Maxillary Anatomy of the Nose and Sinuses Anatomy of the Nose and Sinuses Anatomy of the Nose and Sinuses Pathology of the Nose and Sinuses Rhinitis/Sinusitis Rhinorrhea Inflammation caused by cold or allergies. May become chronic and cause permanent changes in the tissues. Polyps Small growths causing obstructions, in the nasal passageway. Pathology of the Nose and Sinuses Hypertrophied Turbinates Deviated Septum Septal Perforation Epistaxis Diagnostic Procedures of the Nose Direct vision Nasal Speculum Mirror exam Radiography CT Scan Angiography Instrumentation Instrumentation for Nasal Surgery Aufright Retractor Wilde Drsg Fcp Vienna Speculum Surgical Procedures of the Nose Submucous Resection (SMR/Septoplasty) Polypectomy Antrostomy Caldwell-Luc Ethmoidectomy Sinus endoscopy Anatomy of Upper Aerodigestive Tract Pharynx Nasopharynx Eustachian tube Pharyngeal tonsils Oropharynx Palatine tonsils Lingual tonsils Laryngopharynx Anatomy of Upper Aerodigestive Tract Larynx Trachea Glottis/Epiglottis Carina Esophagus Anatomy of Upper Aerodigestive Tract Anatomy of Upper Aerodigestive Tract Anatomy of Upper Aerodigestive Tract Anatomy of Upper Aerodigestive Tract Anatomy of Upper Aerodigestive Tract Anatomy of Upper Aerodigestive Tract Pathology of the Upper Aerodigestive Tract Pharyngitis Tonsillitis Abcess Sleep Apnea Vocal Cord pathology Laryngitis Nodules/Granulomas Neoplasms Anatomy of Upper Aerodigestive Tract Anatomy of Upper Aerodigestive Tract Pathology of the Esophagus Ulcerations Zenker’s Diverticulum Instrumentation Instrumentation for Upper Aerodigestive Tract Surgical Procedures of the Upper Aerodigestive Tract Tonsillectomy Uvulopalatopharyngoplasty (UPPP) Panendoscopy Radical Neck Dissection Otorhinolaryngologic Surgery QUESTIONS