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Case of chronic suppurative otitis media with Central perforation скачать в хорошем качестве

Case of chronic suppurative otitis media with Central perforation 6 лет назад

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Case of chronic suppurative otitis media with Central perforation
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Case of chronic suppurative otitis media with Central perforation

[20/07, 10:06 pm] +91 94463 51660: What is myringoplasy? Repair of the ear drum is called myringoplasty. It can be done by overlay or underlay technique through a post aural incision, the skin of external audiyory canal is elevated till it reaches the annulus which is also elevated. Prior to grafting the rim of the drum should be freshened because the squamous epithelial has grown inwards to fuse with the mucosal lining hence healing has not occured. All sqamous epithelium along with handle of malleus should be removed and graft placed beneath annulus and handle of malleus. In case of large perforation the graft can be tucked anteriorly below annulus and anterior canal skin. This is the underlay technique. Overlay technique involve placing the graft over the drum through a transcanal approach [20/07, 10:06 pm] +91 94463 51660: What happens to the graft following myringoplasty? The graft becomes the middle layer of the drum. The squamous epithelium grows over it literally and mucosa covers it medially [20/07, 10:06 pm] +91 94463 51660: What are the factors affecting graft uptake? 1 size of pergoration 2 expertise of surgeon 3 improvement of hearing is 8db 4 takes up even if ear is wet 5 preoperative antibiotic doesnot make a difference [20/07, 10:06 pm] +91 94463 51660: Is the polyp arising from external canal or middle ear? In external canal polyp, probe cannot be passed around. The tympanic membrane will be of normal colour and not perforated in external canal polyp. [20/07, 10:06 pm] +91 94463 51660: Which ear will you operate on? The ear with worse hearing loss or the one with larger perforation if hearing loss os same on both sides. If everything is equal the ear which the patient prefers should be operated on [20/07, 10:06 pm] +91 94463 51660: What are the complications of myringoplasty? 1 non uptake of graft 2 graft lateralization 3 graft medialization 4 reperforation of graft 5 residual perforation 6 transcient facial palsy due local anesthesia 7 graft uptake is better in older children than younger children 8 anterior blunting [20/07, 10:06 pm] +91 94463 51660: What are the indication of canal wall up mastoidectomy? 1 COM mucosal type not healed by medical treatment 2 COM of squamosal type when it can be combined with posterior tympanotomy and atticotomy 3 in acute coalescent mastoiditis/masked mastoiditis 4 in facial nerve decompression 5 endolymhatic sac 6 cholestomy during cochlear implantment 7 labyrinth, intercoastal acoustal meatus and skull base [20/07, 10:06 pm] +91 94463 51660: If ear is discharging what will be your treatment? Patient can be told to keep the ear dry using a cotton wick coated with vasoline during bathing.antibiotic ear drops like ciprofloxacin or ofloxacin can br used.systmic antibiotic does not hasten the process of infection control.URTI can be reduced medically or surgically.if ear is still discharging a canal wall up mastoid exploration can be done [20/07, 10:06 pm] +91 94463 51660: What are the signs of retraction? Loss or distortion of come of light Prominent or fore shortening of handle of malleus Prominent anterior and posterior malleolar folds Long process of incus seen through the drum on the long process of incus or incudo stapedial joint. [20/07, 10:06 pm] +91 94463 51660: What are the structures seen through a perforation? Mucosa over promontory Eustachian tube orifice Incudostapedial joint Parts of hypotympanum Attic [20/07, 10:06 pm] +91 94463 51660: What are the Tos's grading of pars flaccida retraction Stage I - pars flaccida is dimpled and more retracted than normal but is not adherent to malleus Stage II - retraction is adherent to neck of malleus but retraction pocket is well seen Stage III - retraction is out of view and partial erosion of scutum Stage IV - Definite erosion of outer attic wall and retraction pocket out of view [20/07, 10:06 pm] +91 94463 51660: What are the uses of pneumatic otoscopy? Mobility of drum Middle ear fluid Retraction pockets To distinguish between tympanosclerosis of tympanic membrane from middle ear tympanosclerosis Atelectatic process Fistula test To push eardrops into middle ear Magnification of 1.5 dioptres [20/07, 10:06 pm] +91 94463 51660: What is the differential diagnosis for a vascular mass seen behind tympanic membrane? Dehiscent jugular bulb Aberrant internal carotid artery Glomus jugular Middle ear tumors Aneurysms [20/07, 10:06 pm] +91 94463 51660: What is the differential diagnosis for a white mass seen behind tympanic membrane? Purulent debris Cholesteatoma Tympanosclerosis Middle ear avascular mass Fused ossicular chain [20/07, 10:06 pm] +91 94463 51660: Which is the more sensitive test? Weber's or Rinne's? In conductive loss, Weber is lateralised if loss is 5-8 dB and Rinne is negative if hearing loss is 15-20 dB. Hence Weber's is a more sensitive test. [20/07, 10:06 pm] +91 94463 51660: In the absence of audiometry, how can conductive hearing loss be assessed? Rinne's test wit

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