ENT reading for nasal procedures (730-748)

nose

facial feature that serves a the sense of smell and as the upper portion of the respiratory system

paired nasolacrimal ducts

enter the nasal cavity near the inferior meatus and are part of the tear drainage system

diagnostic procedures and tests used for the nose include

direct vision, mirror examination, and radiography

what is the most commonly and highly effective method of examining the interior of the nose?

direct visualization with illumination

what is mirror examination used for?

the nasopharynx, posterior nasal cavity, turbinates, posterior vomer bones, and outlet of the maxillary sinus, inserted into the oropharynx and directed upward

how is the mirror prepared for mirror examination?

warmed or treated with a commercial antifoam preperation

how many views make up the sinus series?

4 basic views

what are the 4 basic views?

caldwell, lateral, waters, and submental view

what is becoming the standard radiography for the nose?

CT scan

angiography

used to demonstrate blood flow, useful in determining the location of hemorrhage in case of traumatic injury or epistaxis

A

yankauer suction tip

B

#3 scalpel handle

C

#7 scalpel handle

D

freer mucosa septum knife

E

plastic surgery scissors (curved or sharp point)

F

Joseph nasal scissors (straight or curved sharp point)

G

metzenbaum scissors (delicate pattern 5 ½ in)

H

metzenbaum scissors (delicate pattern 7 in)

I

fomon upper lateral scissors

J

knight nasal scissors

K

adson tissue forceps (with teeth angled)

L

gradfe tissue forceps

M

wilde dressing forceps

N

halted mosquito forceps (straight and curved)

O

backhaul towel clamp

P

Halsey needle holder

Q

Frazier suction tip

R

aufricht retractor

S

senn retractor

T

army navy retractor

U

Joseph single hook

V

Joseph double hook

W

baby allis forcep

X

farrel applicator

Y

Vienna nasal speculum

Z

killian septum speculum

AA

bottle septum speculum

BB

maltz nasal rasp

CC

cottle rasp

DD

mckenty septum elevator

EE

Jansen-middleton septum forceps

why might the head of the OR bed be slightly elevated during nasal procedures?

reduce bleeding and prevent edema

A

freer septum elevator

B

Takahashi cutting forceps

poly snare

nasal anatomy rasp

what can be inserted into the patients eyes and why?

ointment to provide moisture

what dressings are used following nasal procedures?

packed with gauze, may be impregnanted with ointment (antibiotic or vaseline), internal and external splints, mustache style dressing

are procedures performed through the nose considered sterile?

no, but best possible sterile technique should be used

closed reduction of a nasal fracture

involves setting the nose back to normal position soon after the nose is broken, typically performed a few days after the break to allow for swelling to subside

sub mucous resection (SMR)

indicates that the mucous membrane lining the nasal cavity will be insides and the underlying perichondrium or periosteum lifted, underlying structures will be removed to restore normal breathing

septoplasty

most often performed to straighten a deviated nasal septum, also for perforated septum or due to trauma

what surgical approach is used for a septoplasty?

submucosal approach

what is a septoplasty often done in conjunction with?

rhinoplasty

what are the 3 types of turbinectomiesy performed?

inferior, microdebrider, and laser

nasal valves

the narrowest points within the nasal passageway, when they are narrow or weak it can cause nasal obstruction

what is another name for nasal obstruction due to weak nasal valves?

nasal valve collapse

what can be used to support the structure of the nasal valve?

cartilage graft and dissolvable sutures

where can incisions be made for reconstruction of the nasal valve?

incision inside the nostril or placed across the columella

antrostomy

performed to treat sinusitis or remove recurrent polyps that originate within the maxillary sinus

intranasal antrostomy

an opening into the maxillary sinus through the nasoantral wall of the maxilla just below the inferior turbinate, incision made over the inferior turbinate

what can be performed if greater exposure is needed for an antrostomy or intranasal antrostomy?

caldwell luv procedure

examples of nasal procedures include

closed nasal reduction, sub mucous resection, septoplasty, turbinectomy, nasal valve reconstruction, polypectomy, choanal atresia repair, functional endoscopic sinus surgery (FESS), intranasal antrostomy, caldwell-luc