Group⟨D⟩~[4th Year]^(39)

Tilley Lichtwitz Trocar & Cannula Composed of: Handle Trocar with sharply pointed end Cannula Used for antral washout Indication: Recurrent acute maxillary sinusitis Chronic m. Sinusitis Dental maxillary sinusitis Infection not responding to Rx Irrigation & washout of purulent material Complication of the procedure: Osteomyelitis Air embolism Trauma according to the site Contraindication: children under 15yrs

Plastic type Tracheostomy tube metallic & plastic (portex) Composed of: Outer tube with wings for fixation + knobe to fixate the inner tube Inner tube Trocar (introducer) External and internal Cuff for plastic type Disadvantages + complication; Metallic --> traumatic + can't be used in artificial ventilation Plastic --> has no inner tube, pressure necrosis and subglottic stenosis because of the cuff Advantages: Metallic --> has inner tube can be removed easily for cleaning Plastic --> less traumatic, used in artificial ventilation, protect airway form secretion, can be used in radiotherapy. Post operative care: Semi sitting position Suction cleaning Humidify the air Care of wound multiple dressing + disinfection

Metallic type

Name: Laryngeal mirror composition: made of stainless steel composed of a handle without a curve band and its end is a mirror directed downward with 45 degree Uses: for indirect laryngeoscope abnormal findings: 1-sore throat 2-polyp 3-FB 4-Hoarseness of voice 5-Vocal cord palsy

same as above 👆🏻 except it has a very small opening to avoid any trauma of EAC during FB removal

Name: Tilley nasal dressing forceps Composition: its made of stainless steel composed of two rings extend into 2 handles that are bent in the midline and connected by a box joint and extend into two plates of 8 cm length (to prevent entery to postnasal space) with two serrated ends. Uses: 1-Removal of foreign body 2-Anterior nasal packing in epistaxis

Name: post nasal mirror composition: Uses: to examine 1-Nasopharynx 2-the post nasal space 3-the posterior nasal opening

Name : killian nasal speculum Composition: made of stainless steel composed of two strong handles with a spring action connected to each other by a screw joint and 2 plates directed anteriorly to fit into the nasal cavity Uses: 1-Anterior rhinoscopy 2-nasal foreign body removal 3-nasal polypectomy

Name: Thudichcum nasal speculum Composition: made os stainless steel composed of two plates with a spring action bulging anteriorly to enter the nasal cavity Uses: Anterior rhinoscopy Abnormal things we can detect: 1-Epistaxis 2-Infection 3-Masses 4-FB

Name: jobson’s horne probe Composition: its made of stainless steel composed of cylindrical plate with two ends serrated end and a ring curate end Uses: Serrated end: 1-used with cotton for mopping 2-chemical cautary to stop epistaxis with trichloric acid or silver nitrate Ring end: 1-chemical cautary if area small or mild bleeding 2-removal of foreign body (beads) 3-removal of wax 4-palpation of any mass or soft tissue

Name: Otoscope Composition: metalic part made of stainless steel for handling and has batteries container rotating switch ear piece composed of 2 ends : lens (2-3 magnifying power) and aural speculum Uses: 1- examination of the external auditory canal 2-examination of the TM 3-examination of the middle ear when the TM is perforated TM perforation types: 1-Central(safe and its anterior/poeterior/subtotal) 2-Marginal(unsafe can cause ostitis) 3-Attic(unsafe)

🔹 Nasal endoscopy 🔺 Indication: A_Diagnostic: 1_Rhinosinusitis 2_Chronic nasal obstruction 3_CSF rhinorrhea 4_Epistaxis 5_Foreign body 6_ biopsy from nasal and nasopharyngeal tumour 7_ unilateral secretory otitis media in old age B_Therapeutic: 1_Allergic polyp and fungal sinusitis 2_Antro_choanal polyp 3_Angifibroma 4_Benign tumour of nose and sinuses 5_Choanal atresia 6_CSF rhinorrhoea 7_Epistaxis 8_Fronto_ethmoidal mucocele 9_Glima,meningocele encephalocele 🔺 Contraindications: 1_Malignant tumour 🔹 Complications: A_Major 1_Anesthetic complications 2_Btain injury 3_Carotid injury 4_Diplopia and optic injury B_Minor 1_Anosmia 2_Adhesions intranasal 3_sinusitis 4_epistaxis 5_Ecchymosis

🔺 it's radical antrum (Caldwell_Luc) operation 🔹 Indication: 1_Chonic sinusitis 2_recurrent antro_choanal polyp 3_oro_antral fistula 4_benign tumour 5_Ligation of maxillary artery 6_removal of foreign body 🔺 Complications 1_injury to the types infra_orbital nerve 2_post_operative oedema of the cheek 3_recurrence of the diseases

🔶 Uses of DL A- diagnostic ➡️ 1- to see hiden areas of larynx : Laryngral surface of epiglottis, ant comissure, ventricle, subglottic area, Post cricoid area 2- to assess laryngeal masses (site,shape, size, extension, degree of stenosis,) and to take biopsy B- Therapeutic 1- ttt of laryngeal lesion ( as Reinke's edema, polype, cyst, cordectomy, granuloma) 2- excisional biopsy 3_To remove foreign body 🔶 CI of DL 1-Fracture mandible or trismus of TMJ 2- fracture cervical vertbrae 3- bloody pharyngeal or laryngeal tumor 4- kyphosis 🔶 Complications of DL 1- cardiac arrest Due to either Vagovagal attacks or GA 2- injury as bleeding, cartilage dislocation, VC injury...

Asch septal forceps Used to reduce fractured nasal septum. Walsham forcep Used to refracture and realign the nasal bones Smaller in size

Myringotomy nife used to make an incision on the tympanic membrane for serous otitis media or unresolved acute otitis media

Ear washing syring Uses: a. To remove softened wax b. To remove foreign body ( not impacted) . Contraindications: a. Perforated tympanic membrane b. Otitis externa c. CSF otorrhea d. foreign body impacted e. Atrophic or thinned out tympanic membrane. Complications: a. Tympanic membrane rupture b. Vasovagal attack c. Injury to the external auditory canal d. Vertigo due to stimulation of labyrinth.

Aural speculum Type 1. Plastic aural speculum 2. Metalic aural speculum Uses: a. Examination of the external ear canal and tympanic membrane b. Removal of wax, foreign body, otomycosis or ear discharge c. In operative procedures like myringotomy, myringoplasty, stapedotomy, stapedectomy

Siegle pneumatic otoscope Use a•Siegelization b. Fistula test c. Examination of external ear canal and tympanic membrane.

Tunning fork test Use for Rinne test and Weber's test To detect the type of hearing loss To make an approximate estimate of the degree of hearing loss. Types according to their frequency: 512 Hz preferable (give sound within the speech frequency --> heard easily) Disadvantage of: - high freq. Fork --> fast tone decay - low freq. Fork --> cause strong vibration Advantages of: - high freq. Fork --> give strong sound heard easily - low freq. Fork --> slow tone decay Rinne test --> compare air vs bone conductance of a single ear Weber test --> to compare bone conductance of both ear at same time Lateralization of sound mean either ipsilateral conductive deafness Or contralateral sensorineural hearing loss.