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