1. ENT Surgical procedures
Dr. Manal Bukhari King Saud University Otolaryngology
Assistant professor
consultant Phonosurgeon King Abdulaziz University

3. Ear Operations

4. Myrigotomy

5. Indications of myringotomy
AOM with bulging TM
Relieve pain
To produce a clean cut incision which is more likely to heal spontaneously

6. Indications of myringotomy
AOM with bulging TM
Insertion of Vetilation tube (Grommet tube)

8. Indications of Ventilation Tube Insertion
Otitis Media with Effusion
Repeated attacks of acute otitis media

9. Complications of Ventilation Tubes Insertion
Infection

10. Complications of Ventilation Tubes Insertion
Infection
Blockage

11. Complications of Ventilation Tubes Insertion
Infection
Blockage
Early extrusion

12. Complications of Ventilation Tubes Insertion
Infection
Blockage
Early extrusion
Tympanosclerosis

13. Complications of Ventilation Tubes Insertion
Infection
Blockage
Early extrusion
Tympanosclerosis
Persistent perforation

14. Myringoplasty Tympanoplasty
An operation performed to repair the tympanic membrane
An operation performed to repair the tympanic cavity (TM and/or the ossicles)

15. Indications
Chronic infections (CSOM)
Trauma
Congenital (not common)

16. Aims of Tympanoplasty and Myringoplasty
To close the perforation
To prevent re-infection
To improve hearing

19. CORTICAL MASTOIDECTOMY
An operation performed to covert the mastoid antrum and air cells into one cavity, without disturbing the existing middle ear content

20. Indications of cortical mastoidectomy
Acute mastoiditis not responding to medical treatment
Mastoid abscess

21. Technique of Cortical Mastoidectomy

23. Radical & Modified Radical Mastoidectomy
Radical An operation in which the mastoid antrum and middle ear and the external canal are converted into common cavity. The tympanic membrane, malleus and incus are removed leaving only the stapes in situ.
Modified Radical An operation in which the mastoid antrum and middle ear and the external canal are converted into common cavity. The tympanic membrane and ossicles remnants are retained

24. Indication
CSOM with Cholesteatoma (attico-antral or the unsafe type)

25. Aims of radical & modified radical mastoidectomy
Remove cholesteatoma to provide
Safety
Dry ear
Preserve hearing

26. Complications of Tympanoplasty & Mastoidectomy
Facial nerve injury
Inner ear trauma
Other complications
Chorda tympani injury
Hemorrahge, infection etc

28. The Pharynx

29. Adenoidectomy

30. Indication
Large and/or chronically infected adenoid causing symptoms or complications

32. General Contraindications
Bleeding tendency
Recent URTI

33. Local Contraindication
Palatopharyngeal incompetence
Speech path consult for speech disorder.
Submucous cp 1 in 1200

36. TONSILLECTOMY

37. INDICATIONS
Obstructing tonsillar enlargement

38. INDICATIONS
Obstructing tonsillar enlargement
Suspected malignancy

39. INDICATIONS Obstructing tonsillar enlargement Suspected malignancy
Repeated attacks of tonsillitis
Chronic tonsillitis
One attack of quinsy (peritnosillar abscess)
Others

40. CONTRAINDICATIONS
Bleeding tendency
Recent URTI

42. Post tonsillectomy

43. COMPLICATIONS Hemorrhage Respiratory obstruction
Primary
Reactionary
Secondary
Respiratory obstruction
Injury to near-by structures
Pulmonary and distant infections

44. Primary Hemorrhage Bleeding occurring during the surgery Causes
Bleeding tendency
Acute infections
Bad technique
Management
General supportive measures
Diathermy, ligature or stitches
Packing

45. Reactionary Hemorrhage
Bleeding occurring within the first 24 hours postoperative period
Causes
Bleeding tendency
Slipped ligature
Diagnosis
Rising pulse & dropping blood pressure
Rattle breathing
Blood trickling from the mouth
Frequent swallowing
Examination

46. Reactionary Hemorrhage
Treatment
General supportive measures
Take patient back to OR
Control like reactionary hemorrhage

47. Secondary hemorrhage Occur 5-10 days posoperatively Due to infection
Treated by antibiotics
May need diathermy or packing

49. Sinonasal Surgery

50. Septoplasty

51. Indications
Deviated septum causing symptoms or complications

52. Septoplasty

53. Rhinoplasty
An operation to correct external nasal deformity for functional and/or cosmotic purposes.

55. Complications of Septoplasty or Rhinoplasty
Septal hematoma & abscess
Septal perforation
Nasal deformity
Synechia (adhesion)

56. The Turbinates

58. Surgical treatment of obstructing turbinates
Partial inferior turbinectomy & turbinoplasty
Electrocautery, Cryosurgery, Laser Surgery
Submucous Diathermy

59. Complications
Bleeding
Synechia (adhesion)
Atrophic rhinitis

61. FESS Functional Endoscopic Sinus Surgery
Endoscopic surgery in the paranasal sinus aims at preserving the “function” of the sinuses

63. Indications Chronic sinusitis not responding to medical treatment
Sino-nasal polyposis
Others
Tumors
CSF rhinorrhea

64. Complications Synechia Bleeding
Orbital complications (hematoma, optic nerve injury, etc)
Cranial and intracranial complications (CSF rhinorrhea, meningitis etc)

67. Endoscopy

68. General Indications Diagnostic Therapeutics
Hoarseness, dysphagia, hemoptsis etc
Biopsy
Therapeutics
FB removal
Dilatation of stricture
Removal of benign tumors

69. Types
Flexible
Rigid

70. Flexible naso-pharyngo-laryngoscopy

73. Direct Rigid Laryngoscopy

74. Dedo
Jackson
Jako

75. Direct Laryngoscopy

76. Microlayngoscopy

77. Rigid Bronchoscopy

79. Flexible Bronchoscopy

80. Flexible Esophagoscopy

81. Rigid Esophagoscopy

82. Complications of endoscopy
Bleeding
Swelling of the mucosa of the targeted organ
Rupture of the wall
Injury to near by-structure

83. THANK YOU