ENT PPT Part 3

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Questions and Answers

During ear surgery, the anesthetist must be concerned with which of the following?

Management of pain

Blood pressure control

Prevention of infection

Nerve preservation (correct)

Which of the following is a common surgical procedure for the ear and face?

Myringotomy with insertion of tubes (correct)

Knee replacement

Cataract surgery

Gallbladder removal

What is the purpose of intraoperative neuromonitoring during head and neck surgery?

To assess muscle movement

To identify and assess vulnerable nerves (correct)

To monitor heart rate

To prevent bleeding

Which of the following is a common symptom of neck hematoma?

Neck pain and pressure Signup and view all the answers

What is the most appropriate airway management technique if edema occurs during a cleft palate and lip repair surgery?

More aggressive and immediate airway management technique Signup and view all the answers

In which patient population are sinus and nasal procedures generally performed?

Young and healthy patients Signup and view all the answers

What is the most appropriate initial management of the airway in the case of severe facial or neck trauma?

Cricothyrotomy Signup and view all the answers

Which of the following is true about middle ear surgery in children?

Tympanoplasty is a common procedure Signup and view all the answers

What can be used to minimize postoperative nausea and vomiting (PONV) after middle ear surgery?

Using magnesium sulfate Signup and view all the answers

Why should nitrous oxide (N2O) be avoided during tympanoplasty?

It causes displacement of the tympanic membrane graft Signup and view all the answers

Which surgical technique is NOT used for tonsillectomy?

Hot knife Signup and view all the answers

Which position is the patient placed in for thyroidectomy surgery?

Supine position Signup and view all the answers

What is the purpose of the NIM 3.0 ETT during thyroid and parathyroid surgery?

To assess recurrent laryngeal and vocal cord function Signup and view all the answers

What is the recommended treatment for severe symptomatic hypocalcemia postoperatively?

Administration of calcium gluconate or calcium chloride intravenously Signup and view all the answers

What are the signs and symptoms associated with hypocalcemia postoperatively?

Perioral numbness and tingling, abdominal pain, paresthesias of the extremities Signup and view all the answers

Which of the following fractures runs from the bridge of the nose, through the medial and inferior wall of the orbit, beneath the zygoma, and through the lateral wall of the maxilla and the pterygoid plates?

Le Fort II fracture Signup and view all the answers

Which of the following fractures totally separates the midfacial skeleton from the cranial base, traversing the root of the nose, the ethmoid bone, the eye orbits, and the sphenopalatine fossa?

Le Fort III fracture Signup and view all the answers

Which of the following fractures is generally less concerning for the anesthesia provider in terms of airway management?

Le Fort I fracture Signup and view all the answers

Which of the following is a potential indication that attempts to pass an endotracheal tube (ETT) or nasogastric tube through the nares could lead to inadvertent intracranial placement in patients with Le Fort II or III fractures?

Raccoon-eyes hematoma Signup and view all the answers

Which technique is recommended for anesthesia induction in children undergoing tonsillectomy and adenoidectomy?

Sevoflurane, oxygen, and N2O by mask Signup and view all the answers

What should be considered when choosing an anesthetic for tonsillectomy and adenoidectomy?

Depth of anesthesia, rapid return of protective airway reflexes, postoperative analgesia, reduced postoperative bleeding, minimal PONV Signup and view all the answers

What is the most common emergency pediatric airway surgery?

Post-tonsillectomy hemorrhage (PTH) Signup and view all the answers

What is the major blood supply to the thyroid gland?

Superior and inferior thyroid arteries Signup and view all the answers

Study Notes

Anesthesia for Ear and Face Surgery

The anesthetist must be concerned with the potential for facial nerve damage, hearing loss, and vestibular dysfunction during ear surgery.
A common surgical procedure for the ear and face is otolaryngoplasty, which involves reconstructing the ear canal and repairing the eardrum.

Neuromonitoring and Head and Neck Surgery

The purpose of intraoperative neuromonitoring during head and neck surgery is to detect and prevent nerve damage.

Neck Hematoma

A common symptom of neck hematoma is swelling and ecchymosis in the neck.

Airway Management

If edema occurs during a cleft palate and lip repair surgery, the most appropriate airway management technique is to use a nasal trumpet or an oral airway.
In the case of severe facial or neck trauma, the most appropriate initial management of the airway is to use a chin lift or jaw thrust to maintain a patent airway.

Sinus and Nasal Procedures

Sinus and nasal procedures are generally performed in pediatric and geriatric patients.

Middle Ear Surgery in Children

Middle ear surgery in children is often performed to treat chronic otitis media, and the child's age and development must be considered when planning anesthesia.

Minimizing Postoperative Nausea and Vomiting (PONV)

To minimize PONV after middle ear surgery, the anesthetist can use anti-emetics, such as ondansetron, and propofol anesthesia.

Tympanoplasty

Nitrous oxide (N2O) should be avoided during tympanoplasty because it can cause middle ear pressure changes and affect the surgical outcome.

Tonsillectomy

The surgical technique not used for tonsillectomy is the laser.
The patient is placed in the "rose position" for tonsillectomy surgery.
The recommended technique for anesthesia induction in children undergoing tonsillectomy and adenoidectomy is the inhalation induction method.

Thyroidectomy

The patient is placed in the supine position with the neck extended for thyroidectomy surgery.
The NIM 3.0 ETT is used during thyroid and parathyroid surgery to monitor the recurrent laryngeal nerve.

Postoperative Hypocalcemia

The recommended treatment for severe symptomatic hypocalcemia postoperatively is calcium gluconate administration.
The signs and symptoms associated with hypocalcemia postoperatively are numbness or tingling in the fingers, muscle cramps, and facial numbness.

Facial Fractures

The Le Fort I fracture runs from the bridge of the nose, through the medial and inferior wall of the orbit, beneath the zygoma, and through the lateral wall of the maxilla and the pterygoid plates.
The Le Fort II fracture totally separates the midfacial skeleton from the cranial base, traversing the root of the nose, the ethmoid bone, the eye orbits, and the sphenopalatine fossa.
The Le Fort III fracture is generally less concerning for the anesthesia provider in terms of airway management.
A potential indication that attempts to pass an endotracheal tube (ETT) or nasogastric tube through the nares could lead to inadvertent intracranial placement in patients with Le Fort II or III fractures is the presence of a CSF leak.

Pediatric Airway Surgery

The most common emergency pediatric airway surgery is tracheotomy.
The major blood supply to the thyroid gland is the superior and inferior thyroid arteries.

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Description

"Preoperative Assessment: Identifying Airway Compromise and Thyroid Goiter - Quiz on Essential Evaluations" - Test your knowledge on preoperative assessments, focusing on airway compromise and thyroid goiters. Learn about routine airway assessments, visualization techniques, and the importance of chest radiographs and CT scans in identifying potential complications.