Rhinologic Surgery

Station 1:

frac_nose2.jpg

1. What is the name of this surgical procedure ?

2. Name the instrument being used

3. Name one important complication of this procedure

Reduction of fractured nasal bone.

Welsham forceps

Orbital injury

Station 2:

caldwel.jpg

1. Name this surgical procedure

2. Name 4 indications of this surgical procedure

Caldwell -Luc's operation

1. Recurrent antrochoanal polyp

2. Foreign body in antrum

3. Dentigerous cyst

4. Oroantral fistula

5. Biopsy for tumors of maxilla

6. As an approach to sphenoid, pterygopalatine fossa, orbital decompression

Station 3:

agger.jpg

Name the structure pointed with an *
Enlargement of this structure causes __

Agger nasi

Frontal sinus obstruction

Station 4

View this video clipping of FESS surgery

What is the test performed called?

What is its use?

It is called Bulb press test.

It is performed by applying pressure over eyeball and seeing the bulging movements of medial orbital wall.
This test is positive in patients in whom lamina papyracea is eroded.
It tells the surgeon on the table that the medial wall of the orbit is lost and the orbital fat is just a pick away.

** Station 5 **

Watch this video:

What is this procedure called?
What endoscope is used?
What structures can be studied?

This is known as I pass diagnostic nasal endoscopy.

30 degree 4 mm nasal endoscope is used.

In this the endoscope is introduced along the floor of the nasal cavity. Middle turbinate is the first structure to come into view. Its superior attachment is studied. Inferior surface of the middle turbinate is studied. As the endoscope is slid posteriorly the adenoid tissue comes into view. On the lateral surface of the nasopharynx the pharyngeal end of eustachean tube can be identified. Its function can be assessed by asking the patient to swallow. The endoscope is now turned 90 degrees in the opposite direction, the uvula and soft palate comes into view. The endoscope is again rotated by 90 degrees in the same direction, the opposite side pharyngeal end of eustachean tube is visualised. In this field both eustachean tubes become visible.

** Station 6 **

typeI_frontal.jpg

Name the structures marked 1 and 2.

1 is type I frontal cell

2 is widened maxillary sinus ostium

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