Chapter 26 - Surgery of the Ear, Nose, Pharynx, and Larynx

Cerumen

A substance produced by the cerumen glands of the ear (i.e., earwax)

Cholesteatoma

A benign tumor of the middle ear caused by the shedding of keratin

Effusion

Fluid in the middle ear

Epistaxis

Bleeding arising from the nasal cavity

Evert

To turn outward or inside out

Hypertrophy

Enlargement of an organ or tissue

Ossicles

The bones of the middle ear that conduct sound (i.e., the malleus, incus, and stapes)

Ototoxic

A substance that can injure the ear

Packing

A method of applying a dressing to a body cavity. In nasal procedures, 1/4- or 1/2-inch gauze strips are inserted into the nasal cavity to absorb drainage, control bleeding, or expose the mucosa to topical medication. "Packing" a wound may refer to any dressing that is introduced into an anatomical space or cavity.

Papilloma

A benign epithelial tumor characterized by a branching or lobular tumor (also called a papillary tumor)

Paranasal sinuses

Air cells surrounding or on the periphery of the nasal cavities. These are the maxillary, ethmoid, sphenoid, and frontal sinuses

Paresis

Paralysis of a structure

Perforation

A defect in the tympanic membrane caused by trauma or infection

Phonation

Vibration of the vocal cords during speaking or vocalization

Polyp

Excessive proliferation of the mucosal epithelium

Sensorineural hearing loss

Hearing impairment arising from the cochlea, auditory nerve, or central nervous system

TM

The tympanic membrane

Transcanal

Surgical access through the external auditory canal (EAC)

Transsphenoidal

Literally, "across or through the sphenoid bone." Surgery of the pituitary gland may be performed by approaching it through the sphenoid bone

Tympanostomy tube

A tube that is placed in a myringotomy to produce aeration of the middle ear

A benign tumor of the middle ear caused by shedding of keratin in chronic otitis media

Cholesteatoma

Defect that can be caused by a blast injury or penetrating foreign body in the ear

Perforation

Enlargement of the tonsils that may prevent swallowing

Hypertrophy

A benign epithelial tumor characterized by a branching or lobular shape

Papilloma

Fluid in the middle ear

Effusion

Bleeding arising from the nasal cavity

Epistaxis

Vibration of the vocal cords during speaking or vocalization

Phonation

The most common cause of a break in the ossicle chain, which erodes the ossicles

Cholesteatoma

Paralysis of a structure, such as vocal cord paresis

Paresis

Excessive proliferation of mucosal epithelium

Polyp

Hearing impairment arising from the cochlea, auditory nerve, or central nervous system

Sensorineural hearing loss

Abnormal thickening of the bone in the middle and inner ear

Otosclerosis

A surgical opening is made in the tympanic membrane to release fluid

Myringotomy

Close a small, nonhealing hole in the tympanic membrane

Myringoplasty

Surgical removal of a cholesteatoma and mastoid bone, with or without reconstruction

Tympanoplasty

Removal of diseased bone, the mastoid air cells, and the soft tissue lining the air cell of the mastoid

Mastoidectomy/tympanomastoidectomy

The reconstruction of the ossicles to restore conduction to the oval window, performed to treat profound hearing loss related to sclerosis of the stapes

Stapedectomy/ossicular reconstruction

Is used to transmit external sound directly to the VIII cranial nerve, to treat sensineural hearing loss

Cochlear implant

Is performed to treat disease of the paranasal sinus, nasal cavity, and skull base and to improve nasal airflow

Endoscopic sinus surgery (ESS)

Maxillary sinus is exposed by making an incision in the gingivalbuccal sulcus (the junction of the gum and upper lip)

Caldwell-luc

Removal of the bony turbinate to increase airflow through the nose

Turbinectomy/turbinate reduction

Surgical manipulation of the septum to return it to the correct anatomical position or to gain access to the sphenoid sinus for removal of a pituitary tumor

Septoplasty

Is performed to reshape the external nose for aesthetic or functional purposes

Rhinoplasty

Is performed to reduce ear, nose, and throat infection, and improve the airway

Tonsillectomy

Surgical removal of the adenoids

Adenoidectomy

Performed to reduce and tighten oropharyngeal tissue to improve obstructive sleep apnea

UPPP

Endoscopic assessment of the larynx

Laryngoscopy

Is performed in the emergency department, ICU or operating room to create an airway for the patient

Tracheostomy/tracheotomy

Performed to enable jaw movement

Temporomandibular joint arthroplasty

Removal of the larynx usually with wide excision and skin grafting

Laryngectomy

Performed to treat malignant tumors; removal of all cervical lymph nodes and surrounding structures including the spinal accessory nerve, internal jugular vein, and sternocleidomastoid muscle

Radical neck dissection

Removal of the tongue for treatment of cancer

Glossectomy

Often performed for the treatment of a neoplasm neoplasm of the salivary gland

Parotidectomy

Tuning fork test (Rinne and Weber tests)

Test bone conduction and sensorineural hearing function of cochlea

Audiological testing (hearing test)

Usually conducted by an audiologist; can include air conduction, bone conduction, and speech recognition tests

Electronystagmography (ENG) testing

Tests for nystagmus

Head-positioning tests

Test for benign paroxysmal positional vertigo (BPPV)

Balance testing

Tests stance, gait, and balance for signs of vertigo

Caloric testing

Tests for vertigo and nystagmus; warm or cool water is instilled into the external ear canal to determine whether those conditions are elecited

Auditory brainstem response (ABR)

Usually conducted by an audiologist or neurologist; measures the response of the brainstem to electrical stimulus as it relates to the ear

The knife used to make an opening into the eardrum is:

Myringotomy knife

Careful dissection around the Facial Nerve (CN VII) and its branches is essential in which of the following procedures?

Parotidectomy

With which of the following procedures should a patient be instructed to avoid blowing the nose, coughing, sneezing, swimming, and air travel?

Stapedectomy

Which of the following statements is true of cocaine hydrochloride?

It is used topically as an anesthetic and to decrease bleeding

A disease associated with bone conduction hearing loss whereby the stapes become fixed is:

Otosclerosis

Benign tumors that grow on a stalk and can be found on mucous membranes are called:

polyps

The surgical procedure performed to straighten a deviated septum in the nose is a/an:

 Submucous Resection

Immediately following surgery of the mouth or pharynx, before consciousness is regained, the patient is positioned:

in the lateral position with slight Trendelenburg

The surgical procedure done to correct sleep apnea (absence of breathing for periods during sleep) is:

uvulopalatopharyngoplasty

The laryngeal cartilage which serves as the first tracheal ring and completely encircles the trachea is the:

cricoid cartilage

The salivary glands located alongside the ear and drained by Stenson's duct into the mouth are:

parotid

A tracheotomy would precede which of the following surgical procedures?

Laryngectomy

Surgical hazards associated with a Thyroidectomy include all of the following except:

Damage to the Facial Nerve

Surgical contouring of the teeth sockets in preparation for dentures is:

Alveoloplasty

For which of the following fractures would Erich arch bars and 25-gauge wire be applied?

Maxillary fracture

The drill used for ear surgery is a/an:

Ototome

Basic instrumentation for a Myringotomy would include all of the following except:

Yankauer suction tip

The transparent, absorbable sponge used to support a graft in the ear is:

Gelfilm

The anesthetic agent NOT used during middle ear surgery after graft placement is:

nitrous oxide

The type of Tympanoplasty which involves malleus damage and a graft placed between the tympanic membrane and the incus is:

Type II

Tissue used for a graft over the tympanic membrane is the:

temporalis fascia

The nerve which may be injured during Mastoidectomy is the:

Facial Nerve

The major nerve supply to the nose is the :

Olfactory Nerve

The medication used during nasal surgery that shrinks mucous membranes and relieves pain is called:

cocaine HCl

The surgical procedure to open the maxillary sinus by way of the canine fossa for removal of the sinus contents is referred to as:

Caldwell-Luc

Salivary glands includes:

Parotid glands, submandibular glands, and sublingual glands.

A sampling of the lymph nodes in the neck region is referred to as a:

Scalene Node Biopsy

Tonsillar fossa bleeders encountered during Tonsillectomy are ligated with:

surgical gut

Preoperative testing which should be reported for the patient undergoing Tonsillectomy would be:

PTT - 7 minutes

The embryologic structure of the tongue/neck region that may remain open, form a cystic pouch, and become infected is the:

thyroglossal duct

To create a Tracheostomy, a transverse incision is created in the neck, just below that _____.

cricoid cartilage

The parotid glands are located:

Under and in front of each ear

The procedure resulting in the patient's permanent loss of the ability to speak normally is a:

Total Laryngectomy

The facial bone which makes up the bony structure of the outer aspect of cheek is the:

Zygoma

The midface fracture which results in a "moustache" fracture is classified as a:

Le Fort I fracture

A Malar fracture is a fracture primarily involving which of the following bones?

b. Zygoma

Which of the following instrucments would be used to remove nasal polps? 

Wilde Forceps 

At what age is cohlear implant contraindicated in the children?

Under 2 years old

Earwax is known as

Cerumen

The ________ transmits the vibrations of the tympanic membrane (TM) and other ossicles to the inner ear via oval window. 

Stapes