Otorhinolaryngologic
____________ surgery ranges from simple procedures such as a myringotomy to complex procedures such as laryngectomy.
tuning fork
The ________ ________ is a small two-pronged metal device that emits a clear tone of a fixed pitch when tapped.
diagnostic tool
The tuning fork is used as a ______ _______ to perform an initial assessment of a patient's level of hearing, and may be used intraoperatively on a patient under local anesthesia to determine improvement in his or her condition.
Audiometry
___________ is a more sophisticated method of testing a patient's hearing. The audiometer is a machine capable of emitting a tone at several different pitches and volumes. the results are normally in graft form
otoscope
The _________ is a handheld, lighted instrument used to view the external auditory canal
speculum
A _________ is inserted in the patient's ear by placing gentle traction on the pinna to straighten the canal.
Computed tomography (CT
________ _________ scans, also known as computed axial tomography (CAT) scans, and magnetic resonance imaging (MRI) are two specialized noninvasive methods of viewing the inside of the body.
MRI
_____ more accurately defines the soft tissues.
tympanogram
A ____________measures the vibrations of the eardrum by placing a probe against the tympanic membrane.
Electronystagmography (ENG)
_______________ is an exam that tests the balance mechanism in the inner ear. Cool, then warm liquid is introduced into the ear canal. The sudden temperature changes stimulate rapid eye movements that, when recorded, indicate the functioning of the balanc
microscope
When expecting a ___________to be used, the oculars and controls should be adjusted in advance according to the surgeon's preference. Specially designed sterile drapes or sterile handles may be used.
argon
The ______ laser is especially useful in the middle ear for stapedectomy and stapedotomy procedures.
speculum holder
A ________ ________ may be used to free the surgeon's hands. The speculum holder attaches to the rail at the side of the operating table for stability.
nerve stimulator
A _______ _______ should be available for identification of the facial and vestibulocochlear nerves.
Powered
________ instruments, such as a rotating drill (osteon, ototome), may be used
burs
A variety of ______ (cutting and diamond or polishing) should be available for selection by the surgeon.
continuous
A ________ irrigation system may be needed in addition to the power equipment for cooling the tissue and removal of debris.
reversed
Often, for ear procedures, the operating table is _________. The patient's head is placed at the foot of the table, allowing space under the foot portion of the table to accommodate the seated team members' legs and to allow for equipment placement
Nitrous oxide
_______ _______ causes expansion of the middle ear and can cause dislocation of a tympanic membrane graft. _______ _______ use is therefore restricted during reconstructive ear surgery.
ear dressing
The ______ _____ could be a very simple dressing, such as a cotton ball inserted in the external ear canal; or quite complex, such as a mastoid (Shea or a modification thereof) dressing.
mastoid dressing
A _______ _______ consists of antibiotic ointment, a nonadherent pad, fluffed gauze, and gauze that are wrapped around the patient's entire head.
autografts
__________ (from the same person)
allografts
_________ (from the same species)
xenografts
_________ (from animals),
temporalis fascia
The most commonly used autograft for tympanoplasty is the ________ _______ because it is easily accessible and provides a thick, well-vascularized graft that easily epithelializes.
tympanic membrane
The ______ ______ is the separation between the outer and middle ear
outer epithelial layer
It consists of three layers: _______ _______ ______, fibrous connective tissue middle layer, and the mucous membrane inner layer.
Tympanic mem.
What is concave, disk-shaped; pearly gray in color, translucent, and with a shiny appearance?
annulus.
the fibrous ring surrounding the tympanic membrane is the ______
pars tensa
The major portion of the membrane is fibrous tissue called the _______ ________
Otitis media
_______ ________ is a very common acute inflammation of the middle ear, usually caused by blockage of the eustachian tube causing an accumulation of fluid that normally drains into the nasopharynx.
pars flaccida
The superior portion is called the _____ ______ because it lacks the central fibrous connective tissue.
umbo
The ________ is the point of maximum concavity.
middle ear
The ______ ______ (tympanic cavity) is an air-filled chamber located within the temporal bone.
openings
There are two _______ in the wall of the middle ear: tympanic antrum that opens into the mastoid sinus and eustachian tube that connects the middle ear to the nasopharynx.
malleus
________ (hammer) Belongs in the inner ear
incus
_______ (anvil) Belongs in the inner ear
stapes
_______ (stirrups) Belongs in the inner ear
Tympanoplasty
___________ is performed to treat a variety of conditions affecting the tympanic membrane and the ossicular chain.
Type I
The damage is limited to the tympanic membrane. All contents of the middle ear are intact. A soft tissue graft is used to replace or repair the damaged eardrum.
Type II
The destructive process extends beyond the damaged tympanic membrane to include the malleus. The entire malleus or the diseased portion is removed. The tympanic membrane graft is placed directly against the remaining portion of the malleus or the incus.
Type III
In addition to the damaged tympanic membrane, both the malleus and incus have been affected. The replacement tympanum is placed directly against the intact stapes, permitting the transmission of sound to the oval window.
Type IV
All of the ossicles are affected, in addition to the perforated tympanum. The only remaining natural structure of the middle ear is the intact and mobile footplate of the stapes. Only an air pocket remains as protection for the round window, as the graft
type V
This situation is similar to type IV, with one exception. The remaining footplate of the stapes is fixed. All ossicles are completely removed. A window is made into the horizontal semicircular canal and the tympanic graft seals off the middle ear and prov
mastoid
It is located posterior to the external acoustic meatus and lateral to the styloid process.
Cholesteatoma
__________ is a benign cyst or tumor that fills the mastoid cavity and erodes the mastoid air cells. This process can also damage the ossicles.
Otosclerosis
________ occurs when there is a bony overgrowth of the stapes. This progressive disease is hereditary, affecting women more than men.
oval window
Eventually the footplate of the stapes becomes fixed to the_______ _______, preventing the normal sound vibrations from entering the inner ear
inner ear
The _________, or labyrinth, consists of two main sections: bony and membranous labyrinth located in the temporal bon
Perilymph fluid
______ _______fills the spaces of the bony labyrinth. The bony labyrinth is also lined by a thin membrane that contains endolymph fluid. The three compartments of the bony labyrinth are the vestibule, semicircular canals, and cochlea
vestibule
The_________ separates the cochlea from the semicircular canals
principal organs
The _______ _______ of equilibrium are the vestibule and semicircular ducts. The vestibular branch of the vestibulocochlear nerve (cranial nerve VIII) carries the information related to equilibrium to the cerebral cortex.
Corti
The organs of _______ are contained within the cochlea, a coiled portion of the bony labyrinth. The organs of ______ consist of a series of hair cells that directly contact the fibers of the cochlear nerve, which is also a branch of the vestibulocochlear
Sensorineural deafness,
_______ ______ also called nerve deafness, involves the cochlea and acoustic nerve. Treatment is limited; however, cochlear implants are providing some progress and hope for patients.
nose
The ____ is a facial feature that serves as the organ for the sense of smell and as the upper portion of the respiratory system.
paranasal sinuses
The nose and ______ ______ are prone to suffer several types of pathological conditions, which will be reviewed as well as we present the procedures performed to treat the pathologies.
direct vision
The most common and highly effective method of examining the interior of the nose is _____ _____. Excellent illumination is imperative
nares
A nasal speculum may be used to spread the ______.
Angiography
_______ is used to demonstrate blood flow. This can be useful in determining the exact location of hemorrhage in case of traumatic injuries or epistaxis.
patient
Provisions to protect and prevent drying of the patient's eyes should be made. Protective eyewear should be available for the _______
submucous resection (SMR
As the name implies, _______ ________ _____ indicates that the mucous membrane lining the nasal cavity will be incised and the underlying perichondrium or periosteum lifted.
Septoplasty
______ is most often performed to straighten a deviated nasal septum . It is also used to repair a perforated septum or one damaged by trauma
severe
If the deviation is _______, the patient may experience difficulty breathing due to the obstruction. The patient may also suffer sinusitis because of ostium blockage, resulting in failure of the affected sinus to drain
nasal cavity
Each _____ ____ has a series of four bony projections called turbinates
middle
turbinates locations supreme, superior, _______, and inferior.
Hypertrophied
________ turbinates may occur as a result of chronic rhinitis
congenital defect
Choanal atresia is a ______ _____ caused by the failure of the nasopharyngeal septum to rupture during embryonic development.
series
A _____ of ducts called ostia lead to the paranasal sinuses, which are air cavities in the bone surrounding the nasal cavity.
Frontal sinuses
__________ _______are located within the frontal bone behind the eyebrows and may be one cavity or divided.
Ethmoid sinuses,
_______ ______ numbering 10 to 15, are located between the eyes and have a honeycomb appearance.
Sphenoid sinuses
______ _____Are located directly behind the nose at the center of the skull and may be one cavity or divided.
Maxillary sinuses
______ _______are located below the eyes and lateral to the nasal cavity.
FESS
_______ is performed as a diagnostic procedure and/or used to treat a variety of sinus disorders, anatomical defects, and inflammatory conditions such as chronic sinusitis.
Antrostomy
_________ is performed to treat sinusitis or remove recurrent polyps that originate within the maxillary sinus. Intranasal antrostomy is an opening into the maxillary sinus through the nasoantral wall of the maxilla just below the inferior turbinate.
Caldwell-Luc retractor
_____________ ______is a specialty retractor that may need to be sterilized prior to the case. Be sure this and all other necessary instruments are available.
anatomical
The pharynx, larynx, trachea, and esophagus all contribute to this complex __________region.
noted
Any patient assessment should include a full history given by the patient, if possible. Any medication allergies should be _______
physical exam
The ______ _____ should include special attention to the suspected target of the disorder, but should not be limited. Nearby lymph nodes should be palpated for any abnormalities.
gooseneck lamp.
Direct visualization is the most efficient method of examining the pharynx. The examiner uses direct lighting, which may be in the form of a flashlight, headlamp, or _______ _______
mirror
In addition to direct visualization, the use of a _______ can be employed to view the nasopharynx and laryngopharynx. The _______ should be treated with a commercial antifog preparation or warmed to prevent fogging.
Videostroboscopy
___________is used for precise analysis of endolaryngeal tissue during speech. The strobe equipment is introduced into the larynx via a flexible laryngoscope. The exact movement of the vocal mucosa can be studied and pathological changes easily noted.
Polysomnography
___________ is an examination used to diagnose sleep apnea and determine its severity. The test is used to record vital body functions such as heart rate, respiration, airflow, and blood oxygen levels during sleep, as well as brain activity, eye movement,
MSLT
_______measures the amount of time that it takes an individual to fall asleep. The average time is 10 to 20 minutes. Those who fall asleep in less than 5 minutes are considered to have some type of sleep disorder.
pharynx
_______is a tubular structure that serves the respiratory tract by receiving air from the nose and mouth, and the digestive system as a passageway for food and liquids
esophagus
The pharynx begins at the internal nares and terminates posterior to the larynx at the level of the_______
uvula
The oropharynx begins at the _______, communicates superiorly with the nasopharynx, and extends to the level of the hyoid bone. The anterior opening is the mouth
hypertrophic tissue
______ _______can cause snoring due to nasal obstruction or hearing impairment due to eustachian tube blockage. Antibiotics may be helpful, but surgical excision is often necessary.
palatine tonsils
_____ ______and adenoids are excised during a tonsillectomy and adenoidectomy (T&A) procedure.
lingual tonsils
______ ______are also at risk of becoming infected. Antibiotics and saline irrigations are recommended initial treatments. If the infection is recurrent, lingual tonsillectomy can be performed.
Saliva
________ is secreted by the three pairs of salivary glands that are situated outside the oral cavity: parotid, submandibular, and sublingual glands.
parotid gland
The ______ ______ is the largest of the three glands located on the lateral sides of the face anterior to the external ear.
Stensen's duct
The excretory duct is called ______ ______, and its orifice is on the inner surface of the cheek opposite the second molar tooth of the upper jaw.
Steno's duct
A common disorder is the formation of stones that block _____ ______. The number and type of stones can vary from one or two large stones to several small stones located in the gland itself or the duct. Surgery is performed to clear the ducts or, if too m
UPPP
_____is performed to treat patients who suffer from sleep apnea
Sleep apnea
______ _______ patients suffer numerous, brief interruptions in respiration during sleep, leaving the patient feeling sleepy during the day
Central sleep apnea
____ ____ _____is the less common type and occurs when the brain fails to signal the muscles controlling respiration.
larynx
_________is located between the pharynx and trachea
obstructive sleep apnea
______ _____ ______occurs when a problem with the upper respiratory tract prevents movement of air through the nose or mouth during respiration.
9
_____laryngeal cartilages and hyoid bone form its rigid framework. Muscles and ligaments connect the cartilages to one another. The larynx has ligamentous attachments to the hyoid bone.
arytenoid, corniculate, and cuneiform;
There are three pairs of cartilages of the larynx
thyroid, cricoids, and epiglottis
three individual cartilages of the larynx
thyroid
The largest and most superior of the single cartilages is the ______ cartilage. It consists of a pair of shield-like plates fused in the front, projecting forward to form what is commonly known as the Adam's apple.
cricoid
The _____ cartilage is the only cartilage in the upper respiratory tract to form a complete circle and is located at the base of the larynx. It is the most inferior of the laryngeal cartilages and attaches to the trachea.
epiglottis
The _________ is an elongated leaf-like structure. The base of the epiglottis is attached inferiorly to the thyroid cartilage; the posterior aspect is located in the laryngopharynx.
arytenoid
The _______ cartilages are the largest of the paired laryngeal cartilages. They are pyramid shaped and attach to the superior posterior edges of the cricoid cartilage. They also attach to the posterior ends of the vocal folds and move them during sound pr
cuneiform
The smaller ________ and corniculate cartilages attach to the arytenoids. The cuneiform is the attachment of the arytenoid cartilages to the epiglottis.
radical neck dissection with madibulectomy
Procedure is performed to treat metastatic squamous cell carcinoma; also performed in conjunction with mandibulectomy for metastatic cancer of the mouth and jaw.