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بسم الله الرحمن الرحيم

بسم الله الرحمن الرحيم. ENT Surgical Procedures. Ear Operations. Myrigotomy. Indications of myringotomy. AOM with bulging TM Relieve pain C & S To produce a clean cut incision which is more likely to heal spontaneously. Indications of myringotomy. AOM with bulging TM

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بسم الله الرحمن الرحيم

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  1. بسم الله الرحمن الرحيم

  2. ENT Surgical Procedures

  3. Ear Operations

  4. Myrigotomy

  5. Indications of myringotomy • AOM with bulging TM • Relieve pain • C & S • To produce a clean cut incision which is more likely to heal spontaneously

  6. Indications of myringotomy • AOM with bulging TM • Insertion of Ventilation tube (Grommet tube)

  7. Indications of Ventilation Tube Insertion • Otitis Media with Effusion • Repeated attacks of acute otitis media

  8. Complications of myringotomy • Injury to incudostapedial Joint • Bleeding (high dehiscent jugular bulb)

  9. Complications of Ventilation Tubes • Infection

  10. Complications of Ventilation Tubes • Infection • Blockage

  11. Complications of Ventilation Tubes • Infection • Blockage • Early extrusion

  12. Complications of Ventilation Tubes • Infection • Blockage • Early extrusion • Tympanoscleosis

  13. Complications of Ventilation Tubes • Infection • Blockage • Early extrusion • Tympanosclerosis • Persistent perforation

  14. Myringoplasty Tympanoplasty An operation performed to repair the tympanic cavity (TM and/or the ossicles) • An operation performed to repair the tympanic membrane

  15. Indications • Chronic infections (CSOM) • Trauma • Congenital (not common)

  16. Aims of Tympanoplasty and Myringoplasty • To close the perforation • To prevent re-infection • To improve hearing

  17. CORTICAL MASTOIDECTOMY An operation performed to covert the mastoid antrum and air cells into one cavity, without disturbing the existing middle ear content

  18. Aim • Drainage

  19. Indications of cortical mastoidectomy • Acute mastoiditis not responding to medical treatment • Mastoid abscess

  20. Technique of Cortical Mastoidectomy

  21. Radical & Modified Radical Mastoidectomy Radical An operation in which the mastoid antrum and middle ear and the external canal are converted into common cavity. The tympanic membrane, malleus and incus are removed leaving only the stapes in situ. Modified Radical An operation in which the mastoid antrum and middle ear and the external canal are converted into common cavity. The tympanic membrane and ossicles remnants are retained

  22. Indication • CSOM with Cholesteatoma (attico-antral or the unsafe type)

  23. Indication • CSOM with Cholesteatoma (attico-antral or the unsafe type)

  24. Aims of radical & modified radical mastoidectomy • Remove cholesteatoma to provide • Safety • Dry ear • Preserve hearing

  25. Complications of Tympanoplasty & Mastoidectomy • Facial nerve injury • Inner ear trauma • Other complications • Chorda tympani injury • Hemorrahge, infection etc

  26. The Pharynx

  27. Adenoidectomy

  28. Indication • Large and/or chronically infected adenoid causing symptoms or complications

  29. General Contraindications • Bleeding tendency • Recent URTI

  30. Local Contraindication Palatopharyngeal incompetence

  31. TONSILLECTOMY

  32. INDICATIONS • Obstructing tonsillar enlargement

  33. INDICATIONS • Obstructing tonsillar enlargement • Suspected malignancy

  34. INDICATIONS • Obstructing tonsillar enlargement • Suspected malignancy • Repeated attacks of tonsillitis • Chronic tonsillitis • One attack of quinsy (peritnosillar abscess)

  35. INDICATIONS • Obstructing tonsillar enlargement • Suspected malignancy • Repeated attacks of tonsillitis • Chronic tonsillitis • One attack of quinsy (peritnosillar abscess) • Others

  36. CONTRAINDICATIONS • Bleeding tendency • Recent URTI

  37. COMPLICATIONS • Hemorrhage • Primary • Reactionary • Secondary • Respiratory obstruction • Injury to near-by structures • Pulmonary and distant infections

  38. Primary Hemorrhage • Bleeding occurring during the surgery • Causes • Bleeding tendency • Acute infections • Bad technique • Management • General supportive measures • Diathermy, ligature or stitches • Packing

  39. Reactionary Hemorrhage • Bleeding occurring within the first 24 hours postoperative period • Causes • Bleeding tendency • Slipped ligature • Diagnosis • Rising pulse & dropping blood pressure • Rattle breathing • Blood trickling from the mouth • Frequent swallowing • Examination

  40. Reactionary Hemorrhage • Treatment • General supportive measures • Take patient back to OR • Control like reactionary hemorrhage

  41. Secondary hemorrhage • Occur 5-10 days posoperatively • Due to infection • Treated by antibiotics • May need diathermy or packing

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