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Morbidity mortality in E.N.T. surgeries causes, diagnosis prevention

Common E.N.T. surgeries; 1- adenotonsillectomy 2- UPPP 3- septal

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Morbidity mortality in E.N.T. surgeries causes, diagnosis prevention

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    1. Morbidity &mortality in E.N.T. surgeries causes, diagnosis & prevention

    2. Common E.N.T. surgeries; 1- adenotonsillectomy 2- UPPP 3- septal & terbinate 4- FESSS 5- nasal tumors 6- ear surg. Grommet insertion , tympanoplasty, mastiod surg. 7- laryngeal ; D L for VC nodules, polyp , mass

    3. 8- Neck surg. Thyroid , thyrogossal cyst &fistula, branchial cyst &fistula, other neck masses

    4. Mortality in E.N.T. due to ; A- anesthetic causes B – surg. Causes A- anesthetic causes; 1- poor preoperative evaluation; chest; wheezy, asthma, heart; CHD,valvular lesion. HF abdomen; liver, spleen, LN. Neck; vs,LN,thyroid,short obese neck receding mandible, large tongue, trismus, stridor

    5. All cause difficult intubation so stylet , lary. Mask, tracheostomy &its alternatives jaundice …..> isoflurane cyanosis………O2 * invest. ; CBC,BT&CT,ESR, liver& kid. Function , PT,RBS

    6. Intraoperative causes; 1- idiosyncrasy of drugs 2- anaphylaxis 3- cardiac arrest *prevention; 1- venous line 2- monitoring of vital signs 3- drugs& equipments; adren.,atropine ,ephedrine, xylocaine, steroids &DC shock

    7. *Postoperative causes; usually due to respiratory obst. By secretion , bld. Clot ,pack ,vomiting , incomplete recovery &poor positioning of PT. *Diag. difficult resp. stridor , chocking &cough, irritability

    8. *prevention &TTT; 1- full recovery 2- proper positioning 3- clearance of secretions 4- adjust of pack 5- if resp. obstruction ….airway, intubation, consultation, tracheostomy or its alternatives

    9. B- surgical comp; I- adenotonsillectomy ; 1- Hge; due to; slipped ligature, rise of BP, incomplete removal of adenoid ,excessive curettage of adenoid , trauma by endotracheal. tube

    10. *C/P ; bleeding/mouth or nose, false hematemesis *TTT; 1- guard against airway obst. 2- coagulants 3- pack 4- antishock measures 5- consultation

    11. II- UPPP ; the same + respiratory obst. Due to palatal edema TTT; steroids , airway .

    12. III- septal &terbinate serg. respiratory obst. By secretion , bld. Clot ,pack , incomplete recovery &poor positioning of PT. *diag. difficult resp. stridor , chocking &cough, irritability

    13. *prevention &TTT; 1- full recovery 2- proper positioning 3- clearance of secreations 4- adjust of pack 5- if resp. obstruction ….airway, intubation, consultation,

    14. IV- FESS : the same + periorbital ecchomosis, edema & surg. Emphysema .orbt. Hge. Diag.; periorbital reddish or bluish swelling& crepitus, progressive proptosis&loss of vision TTT ; avoid nasal blowing , ice packs, haemostatic,

    15. Consultation lat. Or med. Canthotomy V- nasal tumors ; -Hge, edema . *prevention ; - close observation of vital signs - anti shock measures .

    16. VI- Ear surgery vestibular manifestations due to trauma to inner ear TTT ; primpiran VII- laryngeal surgery stridor , resp. obst. Due to edema, VC. Palsy,cricoarytenoid dislocation TTT; O2,steroids, intubation, tracheostomy

    17. VIII- Neck surgery - thyroidectomy , sistrunk op. - excision of neck swellings *complications ; 1- Hge, shock, respiratory obst. Due to Hge. in closed space, TTT; removal of stitches & evacuation of hematoma , anti shock measures

    18. 2- VC palsy ; due to injury of rec. laryngeal n. …….stridor &respiratory distress TTT ; - O2 , steroids - if bil…….. Intubation , tracheostomy or its alternatives

    19. Thank you

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