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Questions and Answers
What is the primary purpose of a myringotomy?
What is the primary purpose of a myringotomy?
- To implant a prosthesis in the stapes
- To create a passage for fluid drainage in the ear (correct)
- To surgically repair the tympanic membrane
- To remove the mastoid air cells
Which of the following surgeries is most commonly associated with the treatment of cholesteatoma?
Which of the following surgeries is most commonly associated with the treatment of cholesteatoma?
- Functional Endoscopic Sinus Surgery
- Tympanoplasty
- Mastoidectomy (correct)
- Cochlear implantation
What potential complication is highly associated with mastoidectomy procedures?
What potential complication is highly associated with mastoidectomy procedures?
- Risk of postoperative infection
- Risk of sensory hearing loss
- Risk of damage to the facial nerve (correct)
- Risk of tympanic membrane perforation
What is typically applied postoperatively to the external auditory canal after tympanoplasty?
What is typically applied postoperatively to the external auditory canal after tympanoplasty?
What technique is commonly used during Functional Endoscopic Sinus Surgery for better visualization?
What technique is commonly used during Functional Endoscopic Sinus Surgery for better visualization?
What is the primary role of the basilar membrane in the cochlea?
What is the primary role of the basilar membrane in the cochlea?
Which structures make up the nasal septum?
Which structures make up the nasal septum?
What component in the ear detects angular acceleration and sends impulses to the vestibular branch of the acoustic nerve?
What component in the ear detects angular acceleration and sends impulses to the vestibular branch of the acoustic nerve?
Which of the following best describes the function of the epiglottis in the larynx?
Which of the following best describes the function of the epiglottis in the larynx?
Which sinus is located anterior to the rest and is often involved in sinusitis?
Which sinus is located anterior to the rest and is often involved in sinusitis?
What is the role of the rich blood supply in the nasal septum?
What is the role of the rich blood supply in the nasal septum?
Which part of the throat communicates with both the esophagus and the larynx?
Which part of the throat communicates with both the esophagus and the larynx?
What bones contribute to the structure of the nasal cavity?
What bones contribute to the structure of the nasal cavity?
What is the primary purpose of assessing a patient’s respiratory status pre-operatively?
What is the primary purpose of assessing a patient’s respiratory status pre-operatively?
Which muscle group is located posteriorly to the trachea?
Which muscle group is located posteriorly to the trachea?
What is an essential consideration for patients undergoing surgeries involving the face or neck?
What is an essential consideration for patients undergoing surgeries involving the face or neck?
What type of anaesthesia may be used for tracheostomy procedures lasting less than two hours?
What type of anaesthesia may be used for tracheostomy procedures lasting less than two hours?
When is hair removal required in head and neck surgeries?
When is hair removal required in head and neck surgeries?
What action should be taken when performing rhinologic surgeries regarding the nasal cavity?
What action should be taken when performing rhinologic surgeries regarding the nasal cavity?
Why is lidocaine applied topically to the larynx during laryngeal surgery?
Why is lidocaine applied topically to the larynx during laryngeal surgery?
Which of the following statements about patient reassurance during surgery is true?
Which of the following statements about patient reassurance during surgery is true?
What is a common implementation after a biopsy of the larynx?
What is a common implementation after a biopsy of the larynx?
What is the primary reason for avoiding chlorhexidine in otorhinolaryngology procedures?
What is the primary reason for avoiding chlorhexidine in otorhinolaryngology procedures?
Which specific instrument is typically used for myringotomy in otologic surgery?
Which specific instrument is typically used for myringotomy in otologic surgery?
What positioning device is commonly used for patients undergoing head and neck surgeries?
What positioning device is commonly used for patients undergoing head and neck surgeries?
Which of the following is NOT typically included in the instruments required for rhinosurgery?
Which of the following is NOT typically included in the instruments required for rhinosurgery?
Which solution is recommended for use as a prep solution in otorhinolaryngology procedures?
Which solution is recommended for use as a prep solution in otorhinolaryngology procedures?
What is the role of the perioperative nurse in ensuring patient safety?
What is the role of the perioperative nurse in ensuring patient safety?
Which instrument is essential for visualizing the nasal passages during rhinosurgery?
Which instrument is essential for visualizing the nasal passages during rhinosurgery?
Which of the following best describes the timing for clipping hair before surgery?
Which of the following best describes the timing for clipping hair before surgery?
For maximum visualization during neck surgeries, which of the following instruments is least likely to be used?
For maximum visualization during neck surgeries, which of the following instruments is least likely to be used?
Which aspect of patient positioning is influenced by surgeon preferences?
Which aspect of patient positioning is influenced by surgeon preferences?
What is the purpose of using a sterile nerve stimulator during head and neck surgeries?
What is the purpose of using a sterile nerve stimulator during head and neck surgeries?
Which of the following instruments is NOT typically included in the minor instrument set for ENT surgeries?
Which of the following instruments is NOT typically included in the minor instrument set for ENT surgeries?
In what position should a microscope be stored when not in use during surgical procedures?
In what position should a microscope be stored when not in use during surgical procedures?
What is a key consideration when using power drills during surgeries?
What is a key consideration when using power drills during surgeries?
Which surgical technique is primarily used for most otologic procedures?
Which surgical technique is primarily used for most otologic procedures?
What is the main purpose of using forced-air warming blankets during surgery?
What is the main purpose of using forced-air warming blankets during surgery?
What is a common requirement for using lasers such as CO2 or Nd:YAG in surgeries?
What is a common requirement for using lasers such as CO2 or Nd:YAG in surgeries?
What type of equipment must the OR be prepared with for head and neck surgeries?
What type of equipment must the OR be prepared with for head and neck surgeries?
What should be continuously monitored during surgery to ensure patient safety?
What should be continuously monitored during surgery to ensure patient safety?
Which instrument is specifically designed to grasp the tonsils during surgical procedures?
Which instrument is specifically designed to grasp the tonsils during surgical procedures?
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Study Notes
Cochlea and Vestibular Labyrinth
- Basilar membrane in the cochlea contains hair cells that convert mechanical vibration into electrochemical impulses.
- The vestibular labyrinth is composed of the utricle, saccule, and three semicircular canals, crucial for detecting angular acceleration during movement.
- Semicircular canals trigger impulses through the vestibular branch of the acoustic nerve (8th cranial nerve).
Anatomy of the Nose
- The nose is a prominent facial feature, susceptible to trauma and consists of skin supported by cartilage and bone.
- Two external nares serve as air passages to the nasal cavity, which humidifies and filters air before it reaches the lungs.
- Alar cartilages shape the nose's tip and nostrils; the columella separates the nares.
- Nasal cavity divided into right and left parts by the nasal septum, composed of nasal cartilage, the perpendicular plate of the ethmoid bone, and the vomer bone.
- Rich blood supply in the septum warms and moistens air, while mucus traps dust and small particles.
- Nasal sinuses (frontal, ethmoid, sphenoid, maxillary) communicate with the nasal cavity via the meatus.
Throat Structure
- The throat includes the oral cavity, pharynx, and larynx, facilitating both digestion and respiration.
- The oral cavity is composed of the mouth, salivary glands, and structures like cheeks, hard palate, tongue, teeth, and lips.
- Pharynx connects to multiple cavities, serving as a passageway from the nose to the larynx and esophagus.
- Larynx acts as an airway, containing the epiglottis that prevents aspiration and the vocal cords (supraglottis, glottis, subglottis).
Perioperative Nursing Considerations
- Pre-operative respiratory assessment involves evaluating breathing quality, smoking history, and nutritional status.
- Facial structures must be assessed for symmetry, color, lesions, and patient pain levels.
- Surgical considerations may affect body image and can lead to long-term issues like hearing loss or facial numbness.
Anaesthesia Considerations
- Local anaesthetic with neurolept is used for minor procedures; patients must remain immobile.
- General anaesthesia may be necessary based on patient health and surgical requirements.
- For rhinologic surgeries, nasal packing with vasoconstrictor-soaked patties is common.
Surgical Prep and Positioning
- Hair removal for surgeries is performed only if it obstructs the surgical field, preferably using clippers.
- Surgical site disinfectant commonly used is povidone-iodine unless allergic; chlorhexidine is avoided due to ototoxicity.
- Position patients according to surgical needs; supine position with should rolls is standard for head and neck surgeries.
Instrumentation and Counting
- Otorhinolaryngology surgeries require specific instruments for delicate handling.
- Key instruments for otologic surgeries include myringotomy knives and middle ear tools.
- Rhinologic surgeries utilize tools like sinus scopes and alar retractors.
- Comprehensive instrument counting is necessary before and after surgeries to ensure all tools are accounted for.
Equipment Requirements
- Operating rooms must be equipped with cautery tools, suction, and monitoring systems.
- Surgical microscopes provide illumination and magnification, while power drills assist in ear surgeries.
- CO2, KTP, Er:YAG, and Nd:YAG lasers are utilized for delicate procedures without damaging surrounding tissue.
- Continuous patient temperature monitoring with warming blankets prevents hypothermia during surgeries.
Surgical Interventions
- Otologic procedures often performed via the ear canal or behind the ear, including:
- Myringotomy involves incising the tympanic membrane and placing a tube.
- Mastoidectomy, with types categorized by approaches and related risks.
- Tympanoplasty for tympanic membrane repair, utilizing grafts from various ear parts.
- Cochlear Implantation involves inserting a device into the cochlea for sensory hearing loss.
Rhinologic Surgery Details
- Functional Endoscopic Sinus Surgery (FESS) employs an endoscope to address sinus issues, ensuring drainage by resecting tissue.
- Local infiltration aids in surgery, and the postoperative care includes nasal packing, typically with moustache dressings.
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