Aural atresia regional conference

surgical approaches to frontal sinus ppt

Vaibhav Lahane

1. The document discusses the embryology and anatomy of the frontal sinus and frontal recess. It develops from ethmoidal cells that pneumatize into the frontal bone. 2. It describes different surgical approaches to access and drain the frontal sinus including external approaches and various types of endoscopic frontal sinusotomies. 3. Type 1 and 2 endoscopic procedures involve draining the frontal sinus via the frontal recess and removing obstructions. Type 3 is a more extensive procedure that creates a common chamber between the frontal sinus and nasal cavity via an intranasal modified Lothrop procedure.

Mucosal folds and ventilation of middle ear

AlkaKapil

The document discusses the anatomy and embryology of the middle ear spaces and mucosal folds. 1. The middle ear develops from the tubotympanic recess which buds into sacs including the saccus anticus, medius, superior and posterior. Remnants of mesenchyme become ligaments and blood vessels. 2. The middle ear is divided into several compartments by mucosal folds including the protympanum, mesotympanum, epitympanum, hypotympanum, and retrotympanum. 3. The epitympanum or attic is further divided by mucosal folds into the upper unit above

Ossiculoplasty

Ajay Manickam

This document discusses ossiculoplasty procedures for reconstructing the ossicular chain in the middle ear. It describes the history of different prosthetic materials used, including wires, homografts, and plastics. An ideal prosthesis is said to be durable, biocompatible, and easy to manipulate. Current prostheses discussed include plastipore covered in cartilage to prevent extrusion, ceramic implants which have higher extrusion rates, and hydroxylapatite which can directly contact the tympanic membrane. Surgical techniques are explained for different ossicular discontinuities classified by Austin and Wullstein. Key factors for success are described as infection control, tissue health, and eustachian tube function.

Empty Nose Syndrome (ENS) is a condition characterized by paradoxical nasal obstruction despite a widely patent nasal airway. It often results from nasal surgery involving resection of the turbinates. Diagnosis involves identifying a history of turbinate surgery and appropriate symptoms like dryness and improvement with a "cotton test" where cotton is placed in areas of deficit. Treatment planning involves using CT imaging and endoscopy to identify defects and testing placement of cotton or saline to identify locations for grafting. Surgical repair techniques involve implanting tissue like acellular dermis or autogenous tissue into locations identified as beneficial by the cotton test, such as the septum, lateral wall, or expanding the existing inferior turbinate. The

Phonosurgery

Vaibhav Lahane

This document discusses phonosurgery techniques including vocal fold injection and laryngeal framework surgery. It provides details on the intrinsic laryngeal musculature and the expansion of phonosurgery over the last 50 years to primarily improve or restore the voice. Type I thyroplasty for vocal fold medialization is described in detail, including indications, surgical technique of making a window in the thyroid cartilage and placing different types of implants, advantages, complications, and pitfalls. The goal of type I thyroplasty is to improve voice and prevent aspiration by medializing the vocal fold to mimic the function of the thyroarytenoid muscle.

OME-Otitis Media with effusion in children

Razal M

Otitis media with effusion (OME), also known as glue ear, is a chronic accumulation of fluid in the middle ear caused by eustachian tube dysfunction and inflammation of the middle ear mucosa. It is characterized by thick, viscous fluid in the middle ear without signs of infection. OME is commonly seen in young children, especially during winter months when upper respiratory infections are more prevalent. Treatment involves initial diagnosis by otoscopy and tympanometry, with surgical intervention of myringotomy with ventilation tube insertion if the effusion persists for more than 3 months. Adenoidectomy may provide additional benefit in resolving OME by removing a source of chronic infection in the nasopharynx.

Inverted papilloma

Mohammed Nishad N

1. Inverted papilloma is a benign epithelial tumor originating from the Schneiderian membrane of the nasal cavity and paranasal sinuses. 2. It most commonly affects males ages 30-50 and presents as a unilateral nasal mass, obstruction, and bleeding. 3. Treatment involves surgical resection, typically an endoscopic medial maxillectomy to remove the entire lateral nasal wall and clear the tumor attachment site.

Ossiculoplasty

The document discusses the middle ear transformer mechanism and ossiculoplasty surgery. It covers: 1) The middle ear transforms sound via 3 mechanisms - the catenary lever of the ear drum, ossicular lever ratio, and hydraulic lever area ratio. 2) Ossiculoplasty surgically repairs the ossicular chain to restore conduction. Materials used include autografts, allografts, and synthetic grafts. 3) Techniques depend on the ossicular status and include using prostheses, autografts, or reattaching existing ossicles. The goal is optimal sound transmission.

EMBRYOLOGY AND MALFORMATION OF EAR

Manish Kumar

The document discusses congenital anomalies of the external ear. It begins by describing the normal development of the ear in utero from weeks 6 to month 5. It then discusses various types of anomalies including microtia (underdeveloped ear), macrotia (overly large ear), and anomalies of the external acoustic meatus such as atresia (blockage of the ear canal). It provides details on the classification, causes, and reconstructive options for microtia. It also discusses other rare anomalies such as anotia (complete absence of the ear), dysplastic ears, low-set ears, ear tags, and ear canal anomalies. Syndromes commonly associated with ear anomalies like Treacher Collins and Goldenhar syndrome are

Surgical approach to middle ear,mastoid mamoon

Mamoon Ameen

The three main surgical approaches to the middle ear are transcanal, endaural, and postaural. The appropriate approach depends on factors like the planned extent of surgery and anatomical findings. Transcanal is commonly used for tympanoplasty and is less traumatic than postaural, but has limited access to mastoid cells. Endaural is best for infants due to easy graft access and visibility of epitympanum, but difficult for mastoid procedures. Postaural provides full mastoid exposure and is used for extensive procedures like radical mastoidectomy.

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Mucosal folds of the middle ear

Dʀ Smruti Ranjan Samal

The document discusses the mucosal folds of the middle ear, which develop as the primitive tympanic cavity expands into the middle ear cleft between 3-7 months of fetal development. This forms four primary sacs that enlarge and replace the mesenchyme, with their walls becoming the mucosal lining of the middle ear. Mucosal folds are the planes of contact between neighboring sacs and carry ligaments and blood vessels to the ossicles. There are 10 important mucosal folds described, including the anterior and posterior malleal folds, lateral malleal ligamental fold, and tensor tympani fold. The folds divide the epitympanum (attic) and orient the progression of

Endoscopic middle ear surgery

Divya Raana

Endoscopic middle ear surgery is an emerging technique that provides several advantages over traditional microscopic surgery, including a wider field of view allowing visualization of hidden areas. While the endoscope provides excellent maneuverability, the learning curve is steep and it requires adaptation to a one-handed technique. Experienced surgeons are using endoscopy for diagnostic evaluation, tympanoplasty, retraction pocket surgery, and minimally invasive approaches. Continued technological advances may further expand the applications of endoscopic ear surgery.

Stem cell therapy in ENT

SuryaR38

This document discusses stem cell therapy and its applications in ENT (ear, nose, throat). It defines different types of stem cells including embryonic stem cells, adult tissue specific stem cells, mesenchymal stem cells, and induced pluripotent stem cells. Some potential applications of stem cells in ENT discussed include using stem cells to regenerate injured vocal cords and treat defects in the middle ear or trachea. Stem cells may also help regenerate sensory hair cells and neurons in the cochlea for sensorineural hearing loss or support neural regeneration for injured peripheral nerves like the facial or recurrent laryngeal nerve.

Nasal polypi

1) Nasal polyps are sacs of swollen nasal tissue that can cause nasal obstruction. They were first described over 4000 years ago by ancient Egyptians and Greeks. 2) Theories on the causes of nasal polyps include allergy, cystic fibrosis, and vasomotor imbalance. Nasal polyps can be inflammatory, fungal, or malignant. 3) Clinical features include nasal obstruction, loss of smell, rhinorrhea, and headache. Examination shows smooth masses in the nose that can be pushed around but not into. Treatment involves medical management with steroids or surgery to remove polyps.

Balloon sinuplasty-slides-091216

Karl Daniel, M.D.

- Balloon sinuplasty is a minimally invasive technique for treating sinusitis using balloon catheters to dilate sinus ostia rather than conventional endoscopic sinus surgery. - Studies show balloon sinuplasty improves symptoms in selected patients with chronic sinusitis and is safe, with minimal adverse effects. However, longer term data is still needed to define its optimal role and indications. - While initial data is promising for symptom relief and preservation of sinus anatomy compared to traditional FESS, balloon sinuplasty may not eliminate the need for conventional sinus surgery in all patients.

Petrous apex 360°

Murali Chand Nallamothu

This document describes various approaches to the petrous apex, including the middle cranial fossa transpetrous approach. It discusses the landmarks and surgical anatomy relevant to this approach, including exposing the internal auditory canal and petrous apex by drilling bone. It also mentions combining the frontotemporal orbitozygomatic approach with the Kawase approach to access the middle and posterior cranial fossae. Several references are provided with links to videos and papers on these techniques.

Sinus tympani prof dr bikash

Bikash Shrestha

The document discusses the anatomy of the sinus tympani, a cavity located in the posterior region of the tympanic cavity. It describes how the sinus tympani was first named and discussed in 1820. It defines the two portions of the retrotympanum based on the position of the facial nerve. It outlines different shapes that the sinus tympani can take, including classical, confluent, partitioned, and restricted, and different types - A, B, and C - based on its extension in relation to the facial nerve. The shapes and types of the sinus tympani can influence the surgical approach used for cholesteatoma surgery.

Anatomy of temporal bone

praneeth koduru

Intra operative monitoring facial nerve

This document discusses intraoperative neurophysiological monitoring during surgery. It describes monitoring brain and nerve pathways to reduce risks from surgery and protect the brain, nerves, and spinal cord. Specific techniques are covered, including electrical stimulation of pathways to identify changes from surgery and ensure integrity. Placement of recording electrodes and how they are used to monitor facial and other cranial nerves is also summarized.

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IPGMER

Endoscopic anatomy of nose ,paranasal sinus and anterior skull base

Rajat Jain

This document provides an overview of nasal endoscopic anatomy and the endoscopic examination technique. It describes the three passes used in endoscopy to examine the different anatomical structures of the nose and paranasal sinuses. The first pass examines the nasal septum, inferior turbinate, and posterior choana. The second pass examines the superior turbinate, sphenoethmoidal recess, and sphenoid ostium. The third pass examines the middle meatus, uncinate process, bulla ethmoidalis, and maxillary ostium. It also describes important anatomical structures like the turbinates, sinuses, arteries and variations that can be observed during nasal endoscopy.

Petrous cholesteatoma sample

85160

This document discusses two cases of petrous bone cholesteatoma. It provides background on petrous bone anatomy and classifications of petrous bone cholesteatoma. It also describes the surgical approaches and considerations for treatment of petrous bone cholesteatoma, which aim to completely remove the disease while preserving vital structures like the facial nerve. Two cases of petrous bone cholesteatoma are presented and the surgical treatments used in each case.

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Diseases of external ear

Saeed Ullah

This document provides an overview of diseases that can affect the external ear, including the pinna and external auditory canal. It discusses various congenital, traumatic, inflammatory, and neoplastic conditions. Congenital deformities include microtia and atresia of the ear canal. Common traumatic injuries are lacerations and hematomas. Inflammatory diseases include infections like otitis externa caused by bacteria, viruses, or fungi. Some examples of neoplastic conditions mentioned are squamous cell carcinoma and malignant melanoma. The document provides details on symptoms, causes, and treatment approaches for many of these external ear diseases.

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Razal M

Inverted papilloma

Mohammed Nishad N

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EMBRYOLOGY AND MALFORMATION OF EAR

Manish Kumar

Surgical approach to middle ear,mastoid mamoon

Mamoon Ameen

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Mucosal folds of the middle ear

Dʀ Smruti Ranjan Samal

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Divya Raana

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SuryaR38

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Karl Daniel, M.D.

Petrous apex 360°

Murali Chand Nallamothu

Sinus tympani prof dr bikash

Bikash Shrestha

Anatomy of temporal bone

praneeth koduru

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Rajat Jain

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What's hot (20)

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Sinus tympani prof dr bikash

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External auditory canal anatomy pathologies & management

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The document describes the anatomy and clinical features of the external auditory canal. It discusses the following key points: - The external auditory canal has both cartilaginous and bony portions, with the bony portion making up the medial two-thirds. It is lined by skin that grows obliquely to prevent blockage. - Aural atresia is the absence or closure of the external auditory canal. It can be congenital or acquired. Types include minor, moderate, and severe aplasia. Surgery aims to reconstruct the canal but has risks. - Acquired atresia is due to inflammation, trauma, burns or previous ear surgery. It can be solid from

Diseases of the external ear

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Oesophageal atresia

Fahad AlHulaibi

This document discusses esophageal atresia, a birth defect where the esophagus fails to develop properly, resulting in an abnormal connection or closure. It defines the condition, describes its epidemiology and embryology, classifications, associated anomalies, pathophysiology, diagnosis, and treatment. Esophageal atresia occurs in about 1 in 3000-4500 births and is diagnosed prenatally by ultrasound or after birth based on symptoms like choking during feeding. Treatment involves surgical repair of the esophagus.

Tumours of external and middle ear

Ramesh Parajuli

This document discusses tumours of the ear, including both benign and malignant types. It provides details on the epidemiology, risk factors, pathology, diagnosis and treatment of various tumours such as basal cell carcinoma, squamous cell carcinoma, melanoma, and others. Treatment options discussed include surgical excision with various techniques depending on tumour size and location, Mohs surgery, radiation therapy, and reconstruction after tumour removal. Staging criteria and classifications of temporal bone tumours are also presented.

Diseases of external ear

Rajendra Institute of Medical Sciences, Ranchi.

This document discusses diseases of the external ear. It begins by describing the anatomy of the external ear canal. It then categorizes conditions affecting the external ear into congenital, inflammatory, reactive, traumatic, and tumors. Under congenital conditions it discusses preauricular sinus, congenital ear swellings, fistulas and anomalies. It provides details on preauricular sinus including embryology, clinical features, management and associated syndromes. It also discusses other congenital conditions such as ear swellings, fistulas and atresia. The document further describes inflammatory conditions including erysipelas, perichondritis and malignant otitis externa. It also covers reactive, traumatic, and neoplastic conditions of the external

ear disorders

ligi xavier

This document discusses various ear disorders including infections of the external ear like otitis externa. It describes the anatomy of the ear and the causes, symptoms, diagnosis and treatment of acute and chronic otitis externa. It also covers otitis media, explaining the types like acute suppurative, non-suppurative and chronic suppurative otitis media. The causes, symptoms, investigations and management of different types of otitis media are outlined. Complications of chronic suppurative otitis media and differences between tubotympanic and atticoantral diseases are summarized as well. The pathology of otosclerosis is also briefly explained.

Otitis externa

Ahmed Almumtin

Otitis externa refers to infections of the external ear canal. It can be acute or chronic. Acute otitis externa is commonly known as swimmer's ear and is caused by bacterial or fungal infections due to water exposure. Chronic otitis externa is defined as lasting over 4 weeks and is often due to bacterial, fungal, or dermatological causes. Necrotizing external otitis is a potentially lethal infection seen in immunocompromised patients like diabetics. Treatment involves topical or oral antibiotics, cleaning of the ear canal, and surgery in severe cases. Proper diagnosis depends on history, exam, and sometimes imaging or labs.

Anatomy & embryology ext ear & middle ear

Shafeeq Mohammed

The document provides an overview of the anatomy and embryology of the external and middle ear. It describes how the external ear develops from the first and second pharyngeal arches. It then details the anatomy of the auricle, external acoustic canal, and tympanic membrane. For the middle ear, it discusses the embryological development and describes the structures of the middle ear cleft, tympanic cavity, ossicles, muscles, nerves and blood supply.

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The document discusses airway assessment for anesthesia. It defines the upper and lower airways and provides details on relevant anatomy. Key points of airway assessment are identified including patient history, external examination focusing on dentition, head and neck mobility. Specific tests like Mallampati score, thyromental distance and range of motion are described. The document emphasizes the importance of thorough airway assessment prior to procedures to anticipate difficult intubation. Advanced assessment methods involving imaging and fiberoptics are also mentioned.

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A 22 year old male presented with left earache and discharge for 2 weeks. On examination, his left tympanic membrane was bulging and erythematous. He was diagnosed with acute otitis media. Treatment involves topical and oral antibiotics as well as analgesics to manage pain. Surgical drainage may be required if symptoms persist despite medical management. The nurse's role includes assessing pain, monitoring for complications, providing patient education, and ensuring a safe recovery.

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The document discusses otogenic brain abscesses, which occur when a middle ear infection spreads beyond the ear to nearby structures like the brain. Key points: - CT scans are crucial for accurately diagnosing brain abscesses and associated complications like meningitis or thrombosis. They also guide treatment and allow monitoring of resolution. - Common pathogens are anaerobic bacteria. Treatment involves IV antibiotics, steroids, and surgery like burr hole drainage or mastoidectomy depending on abscess location. - Residual abscesses may require repeat drainage. CT scans after treatment confirm full resolution before discharge to prevent recurrence of infection.

Airway assessment and pedictors of difficult airway....must know for anaesthe...

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This document discusses the importance of airway management expertise and outlines factors that can indicate a difficult airway. It notes that respiratory events are the second most common cause of injuries in anesthesia practice. Various anatomical measurements and assessments are described that can help predict a difficult airway, including Mallampati score, thyromental distance, neck mobility, and mandibular range of motion. Radiographic assessments like CT scans can also provide useful information. No single test is perfectly predictive, so anesthesiologists must always be prepared for an unanticipated difficult airway.

Diagnosis-of-ent-disorders-you-make-the-call.pptx

AshurajHerode1

This document discusses the diagnosis and management of various ear, nose, and throat (ENT) disorders in children. It presents several case examples of common ENT conditions like acute otitis media, mastoiditis, otitis media with effusion, and others. For each case, it describes the presenting symptoms, typical clinical and imaging findings, and recommended treatment approaches. The document also covers topics like hearing assessment techniques, nasal foreign bodies, branchial cleft cysts, sinusitis definitions and more. The goal is to help clinicians differentially diagnose and appropriately manage a variety of pediatric ENT conditions.

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This document discusses rigid endoscopic evaluation of conventional curettage adenoidectomy. It begins with an introduction stating that adenoidectomy is a common procedure in children and conventional curettage is commonly used. It then provides details on the anatomy and physiology of the adenoids, clinical presentation of adenoid hypertrophy, diagnosis, grading systems used, different surgical techniques including conventional curettage and various types of endoscopic adenoidectomy, post-operative care, and potential complications.

Nasopharyngeal Carcinoma

Sushrutha College of Nursing college of Nursing

The document discusses the anatomy, histology, epidemiology, clinical features, diagnosis, staging, and treatment of nasopharyngeal carcinoma (NPC). Key points include: - NPC originates from the epithelial lining of the nasopharynx. - It has a strong association with Epstein-Barr virus. - Risk factors include genetic predisposition and environmental exposures like salted fish consumption. - Common symptoms are cervical lymphadenopathy, epistaxis, ear symptoms, and neurological deficits. - Diagnosis involves biopsy and serological testing for EBV markers. - Staging systems consider tumor size, node involvement, and serological factors. - Primary treatment is radiotherapy,

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MohammadEissaAhmadi

This document discusses radiographic aids in diagnosing periodontal disease. It describes the normal appearance of interdental septa on radiographs and how periodontal disease appears radiographically. Periodontal disease is seen as fuzziness or breaks in the lamina dura, wedge-shaped radiolucencies across the crest, and progressively reduced height of the interdental septum. The document also discusses how different radiographic techniques can distort images and the limitations of radiography for assessing internal morphology, depth of bone destruction, or abscesses in soft tissue.

Airway management in for seadtion

moutasem al mashour

This document provides an overview of airway assessment and management. It discusses assessing the airway based on history, physical exam including tests like Mallampati score, and tertiary exams. The goals of airway management are maintaining a patent airway to allow for gas exchange. Difficult airways can occur due to anatomical abnormalities. Proper preparation includes thorough assessment, having a back-up plan, and calling for help if needed. Skills like manual techniques and use of airway devices are important for supporting the airway.

CLINICAL AND RADIOLOGICAL EVALUATION OF DEVIATED NASAL SEPTUM IN CLASSIFYING ...

Dr.Juveria Majeed

1. The document presents a study evaluating 30 patients with deviated nasal septums through clinical examination and CT scans to classify the deviations according to the Mladina classification system. 2. Vertical deviations (types 2, 3, and 4) accounted for the majority of cases. Type 3 deviations, described as posterior vertical C-shaped, constituted 26% of cases. 3. The study aims to accurately classify septal deviations to help determine the relationship between type of deviation and severity of symptoms to predict surgical outcomes and complications.

OTITIS MEDIA

Otitis media, or middle ear infection, is a common childhood illness that occurs when the middle ear becomes inflamed and infected. It can cause symptoms like ear pain, fever, hearing loss, and discharge from the ear. The document discusses the anatomy of the ear, signs and stages of otitis media, risk factors, potential complications, diagnosis, and treatment options which include antibiotics, surgery like myringotomy or tympanoplasty, and nursing care such as cleaning the infected ear and providing pain relief. Otitis media is usually treated with antibiotics but surgery may be needed in some cases to repair damage to the eardrum.

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This document discusses chronic suppurative otitis media, both with and without cholesteatoma. It defines these conditions, describes their pathogenesis and risk factors. Diagnosis involves history, exam, and CT scan. Treatment for chronic suppurative otitis media without cholesteatoma involves topical antibiotics and tympanoplasty, while treatment for chronic suppurative otitis media with cholesteatoma often requires additional mastoidectomy. Complications can arise from bone destruction or infection spreading to nearby structures like the brain.

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This document discusses the identification and management of difficult airways. It notes that maintenance of the airway is the anesthetist's primary responsibility, and 30% of anesthesia-related deaths are due to inability to manage the difficult airway. Key points include: - Properly identifying patients at risk of a difficult airway through history, physical exam, and airway assessments is critical for optimal patient preparation and equipment selection. - Various physical exam tests and indices like Mallampati score, thyromental distance, and neck mobility can help predict difficult intubation. - Multiple techniques and personnel experienced in difficult airway management may be needed to secure the airway when difficulties are encountered. Proper planning can help reduce

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The Oral Cavity, with it's seven subsites,is a host of multiple epithelial, mesenchymal & glandular structures. Thus, if exposed to multiple risk factors, either in isolation or in combination, could undergo drastic histological changes leading to malgnancies. A thorough clinical examination, diagnosis and timely intervention followed by rehabilitation of the patient, via a multi disciplinary approach is the mainstay of treatment.

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The document discusses diseases of the external ear, including: 1. Congenital disorders like atresia of the ear canal and microtia. 2. Acquired disorders of the pinna like hematoma, perichondritis, and keloid formation. 3. Infections of the external ear including perichondritis, herpes zoster oticus, and different types of otitis externa like diffuse and fungal (otomycosis). 4. Surgical treatments for some conditions are discussed, like reconstruction for atresia and excision of keloids or perichondrial infections.

Ent gp emergencies (edited)

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The document discusses several ENT emergencies including facial palsy, sudden hearing loss, epistaxis, fractured nose, sinusitis complications, periorbital cellulitis, tonsillitis complications, croup, epiglottitis, and airway foreign bodies. It provides details on clinical assessment, differential diagnosis, management strategies, and when to refer for various conditions. Key points include distinguishing features and treatment approaches for conditions like Bell's palsy, mastoiditis, lateral sinus thrombosis, and peritonsillar abscess.

Cholesteatoma & management

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Cholesteatoma is a benign skin tumor in the middle ear that grows by pushing away surrounding tissues. It is caused by an inflammatory process in the upper airways and middle ear mucosa. The growth pattern depends on the origin site, most commonly the pars flaccida or posterosuperior pars tensa areas of weak lamina propria. Cholesteatoma is diagnosed clinically and surgically removed to provide a disease-free dry ear. However, the goal is also a functionally improved ear given changing patient profiles. Surgical techniques include anterior-posterior approaches, posterior tympanotomy, or reconstruction to address complications like hearing loss and bone erosion while preventing recurrence.

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