Oral cavity, throat, and neck surgery

polysomnography

diagnose sleep apnea

multiple sleep latency test (MSLT)

measures the amount of time it takes to fall asleep

uvulopalatopharyngoplasty (UPPP)

redundant tissue of the fossa, tonsils and portion of soft palate including the uvula

what is the goal of UPPP procedure?

intractable snoring, obstructive sleep apnea, usually occurs in males, often overweight

choanal atresia

esophageal atresia is a congenital anomaly of the esophagus, develops between 3rd and 6th week of fetal life, a bony membranous occlusion blocks the passageway between the nose and pharynx

parotidectomy

excision of parotid gland (superficial=benign, deep=cancer)

what structures need to be identified and preserved during a parotidectomy?

facial nerve and its branches (travels directly through gland), auricular nerve, superficial temporal artery and vein, external jugular vein, and external carotid artery

excision of submandibular gland

performed to remove gland (right or left), hypoglossal and facial lingual nerve must be preserved

thyroglossal duct cystectomy

most common congenital cyst found in neck, cystic pouch is connected to hyoid bone

tracheostomy (tracheotomy)

opening made into trachea with insertion of a cannula to facilitate breathing, can be temporary or permanent, used for emergency treatment of upper respiratory tract obstruction (obturator MUST go with patient to PACU)

laryngectomy

performed for neoplasms or cancer involving extrinsic larynx and hypopharynx, located between trachea and pharynx, vocal cords are here, air passageway, voice box for sound and speech

partial laryngectomy (HEMI)

excise portion of larynx and done for superficial tumor

total laryngectomy

excision of larynx, hyoid bone, portion of strap muscles which attach to larynx, and possibly epiglottis

laryngoscopy

direct visual exam of interior of larynx, using a rigid laryngoscope (exam for diagnosis, retrieve foreign body, and obtain specimen)

micro-laryngoscopy

microscope used to more precisely visualize (minor surgery on larynx, removal of polyps, nodules on vocal cords, can use in conjunction with CO2)

radical neck dissection

resection of cancerous tumor and surrounding structures, only done if there is reasonable chance of controlling the cancer (sternocleidomastoid muscle, internal jugular vein, submandibular gland, lymph chains, hyoid bone, 11 CN severed)

modified neck dissection

removal of neck contents excluding the sternocleidomastoid muscle, internal jugular vein, and 11 cranial nerve, removes tumor and lymph nodes suspected of cancer but allows patient minimal defect and impaired shoulder function

temporomandibular joint procedures (TMJ)

synovial joint found between the condyles of the mandible and temporal bone, has 2 classifications: myogenous and arthrogeneous

myogenous

muscle related, usually from jaw clenching

arthrogeneous

joint related, caused by malocclusion of the teeth

what is TMJ arthroscopy typically recommended for patients with what?

persistent jaw pain, no response to other treatments, joint diseases, scar tissue or adhesions, and displaced or damaged joint discs

transoral robotic surgery (TORS)

treats conditions such as head and neck cancers, oropharynx, hypo pharynx, larynx, oral cavity, obstructive sleep apnea, benign tumors and cysts, and lingual tonsillitis

lingual tonsillitis

inflammation of the tonsils at the base of the tongue

bronchoscopy

purpose is to diagnose lung conditions (persistent cough, shortness or breath, coughing up blood), evaluate abnormalities (tumors or infections), and treat airway issues (blockages, tissue samples, or place stents)

flexible bronchoscope

a bendable tube used more frequently because it can navigate the airways more easily, typically used for diagnostic purposes and minor treatments

rigid bronchoscope

a firm tube used for more complex procedures, such as removing large objects or treating significant bleeding