Exam 18: Otorhinolaryngologic Surgery

During the preoperative assessment for a patient scheduled for nasal surgery using a local anesthetic that includes epinephrine,what important consideration,relevant to epinephrine use,should be explored?

When microlaryngoscopy is performed to remove polyps or nodules from the vocal cords,what important postoperative instruction must the nurse give the patient during discharge teaching?

The surgical microscope is often used to provide illumination and magnification for complex procedures to the ear,laryngeal surgery,or reconstructive free flap procedures following neck surgery.A common eyepiece magnification for an otologic microscope is ´12.5,and the usual objective (lens)is __- mm focal length (f).A ___- mm lens is used for laryngeal surgery.

Several types of diagnostic imaging studies visualize structures by producing serial sections through different anatomic planes,highlighting specific structures or tissue densities.Examples of these imaging diagnostics would be:

Type I thyroplasty is a form of phonosurgery for the treatment of unilateral vocal cord paralysis,which may be caused by trauma,neoplasms,paralysis from thyroidectomy or after extensive aortic and mediastinal vascular surgery,and mechanical and central nervous system dysfunctions.During the preoperative assessment,the perioperative nurse should inform the patient about postoperative voice care,which includes:

Benign or small malignant tumors of the oral cavity may be excised without a neck dissection,though in the presence of diagnosed or highly suspicious metastatic disease,a selective neck dissection may be performed in an effort to control a cancerous growth in the upper jugular lymphatic chain of the neck.Typically,endotracheal anesthesia is used and a pharyngeal pack of moist gauze may be inserted in the mouth.The perioperative nurse must be prepared for which additional procedure when head and neck surgery is performed?

The nasal turbinates increase the turbulence of the airflow through the nose to humidify the air.The turbinates also serve another function to the accessory sinuses by:

During otolaryngologic procedures using local anesthetic,the perioperative nurse plans the environment of care as a quiet,warm,and functional domain of healing and comfort.An important consideration with most otolaryngologic patients identifies their specific _ needs.

Lasers assist in vaporization of scar tissue,granulomas,and cholesteatomas without damaging surrounding tissue and may be used for select otolaryngologic procedures.Lasers can be secured to the operating microscope and laser energy delivered to the tissue by means of a:

A chain of three small articulated bones extends across the middle ear cavity and conducts vibrations from the tympanic membrane across the middle ear into the oval window and the fluid-filled inner ear.What are the names of those three small articulating bones?

Functional endoscopic sinus surgery (FESS)provides a more physiologic type of drainage by reducing trauma to normal tissues.FESS involves the endoscopic resection of inflammatory and anatomic defects of the sinuses.Select the appropriate indications for FESS.

Uvulopalatopharyngoplasty (UPPP)is performed primarily to relieve obstructive sleep apnea (OSA)and snoring.Select two common indications for UPPP surgery.

Oral malignancies can be linked to specific carcinogens,the most important one being tobacco.Benign or malignant lesions of the tongue,floor of the mouth,alveolar ridge,buccal mucosa,or tonsillar area are excised depending on the extensiveness of disease,involvement of surrounding vessels and nerves,and candidacy for surgery.Benign or small malignant tumors of the oral cavity may be excised without a neck dissection.What indicator would prompt the surgeon to perform a neck dissection for benign or small malignant tumors?

Both ears provide stereophonic hearing that gives us very specific hearing capabilities.Binaural hearing makes it possible for:

The cricoid cartilage is a complete cartilaginous ring that resembles a signet ring;it rests beneath the thyroid cartilage and supports the airway.What membrane,attached to the midline of the upper thyroid cartilage,protects the larynx during swallowing?

What is the purpose of using an intravenous injection of a radiopaque contrast dye during select imaging diagnostic studies?

A nasal polypectomy is the removal of polyps from the nasal cavity.Nasal polyps are benign,grapelike clusters of mucous membrane and connective tissue.When the polyps become large,they obstruct the free passage of air,make breathing difficult,and cause a change in speech quality.Nasal polypectomies are typically performed endoscopically with the use of microdebriders,which remove the polyps by their mechanism of ___ the polyp and suctioning the tissue.

Marci Williams,a 62-year-old woman,had a tympanoplasty 6 weeks ago and has been cleared by her otorhinolaryngologist to undergo a restorative dental procedure in which light anesthesia will be used.The dental procedure was uneventful,but Marci experienced ear pain,nausea and vomiting,and hearing loss in the former operative ear after the dental procedure.What could have been a probable cause of Marci's untoward recovery and hearing loss?

Depending on the surgical defect,head and neck surgical procedures to remove malignant tumors may also involve reconstructive procedures.The wound may be closed primarily,or local flaps and split-thickness skin grafts or full-thickness skin grafts may be used to restore function as well as cover defects.An important role of the perioperative nurse in the ongoing assessment of graft integrity includes which assessment tool?

The salivary glands produce saliva,which serves to moisten the mouth and initiate: