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Surgical Nursing > Ear surgery > Flashcards

Ear surgery Flashcards

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1
Q

What conditions affect the pinna of the ear?

A

Haematoma
trauma-lacerations
Vascuilitis
neoplasia

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2
Q

What conditions affect the otitis externa?

A 
Primarily dermatological disease in dogs 
immune mediated 
parasite inciting inflammation 
poor aeration 
secondary to middle ear problems (cats)
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3
Q

What types of neoplasia can affect the ear?

A

squarmous cell carnioma
Ceriuminous gland adenoma
melanoma
Basal cell carcinoma

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4
Q

What conditions affect the middle ear?

A 
bacterial otitis media 
mechanical perforation of the tympanic membrane
tumours (rare)
cats 
inflammatory polyps
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5
Q

What is the most common mass found within the ear in cats?

A

Inflammatory polyps (pharyngeal and external ear canal)
Three main presentations
In the bulla
protruding through tympanic membrane
Nasopharyngeal growing from the eustachain tube

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6
Q

What is the typical presentation of polyps?

A

Cats
less than 3 years
URT (pharyngeal)
Neuro (if middle ear involved, horners, head tilt)
OE signs if poly protrudes through tympanic membrane

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7
Q

What are the surgical treatment options for auricular haemotoma?

A 
Prevent further fluid accumulation and allow fibrosis of the cartilage surface to the overlying skin 
closed suction drain 
penrose drain 
open drainage with mattress sutures
punch biopsy perforation
treat underlying cause of self trauma
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8
Q

How may a pinna neoplasia be surgically treated?

A

Pinnectomy
those at the base of the pinna
Ventral canal ablalation
Total Ear Canal Albation

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9
Q

What is LWR in surgical ear treatment and what does it do?

A

Lateral wall resection
vertical canal alone
removal of the secretory epithelium and lateral cartilage of the vertical canal

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10
Q

What are the complications of LWR?

A

Wound dehisence
insufficient drainage
failure to treat concurrent otits media

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11
Q

What is a VCA what does it do?

A

Ventral canal ablation
excision of the whole auricular cartilage and formation of a stoma at the level of the horizontal canal
retains hearing fuction

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12
Q

Complications of the VCA

A

Dehiscence
infection
narrow drainage
unprepared imaging, horizontal ear canal involvement

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13
Q

What is a TECA and LBO?

A

Total Ear Canal Ablation and Lateral Bulla Osteotomy
removal of all the epithelium lining and vertical and horizontal canal cartilages
permanently affects the hearing

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14
Q

What are the complications with TECA-LBO?

A 
Wound dehiscence
infection 
small drainage hole 
Horners syndrome 
cosmetic
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15
Q

When is a TECA-LBO preformed?

A

Non responsive to medical management chronic otitis externa

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16
Q

What must you consider during the post-operative care of a TECA patient?

A

Analgesia
(opiates, local wound infiltration, NSAID)
Antibiotics

17
Q

What are the intra-operative complications of a TECA?

A

Haemorrhage
Iatrogenic facial nerve injury
Trauma to local tissues
(linguinal/maxillary vessles, hypoglossal nerve)

18
Q

What are the post-operative complications of a TECA?

A 
Infection 
Fistula formation 
Facial nerve paralysis 
Horners syndrome 
Vestibular disease
19
Q

What is a VBO?

A

Ventral bulla osteotomy
usually just for cats middle ear disease
Pots-operative corticosteriods have reduced re-occurrence rates

20
Q

What is a Cholesteatoma?

A 
Epidermoid cyst 
expansile lesion of the middle ear 
locally destructive 
non-neoplastic
can be primary 
most commonly secondary to TECA-LBO
erodes bone structures
21
Q

What are the symptoms of a Cholesteatoma

A 
Similar to sings of OE/OM
head tilt 
scratching 
pain opening mouth 
discharge from aural and sinus tracts 
facial palsy 
ataxia 
Nystamgus
draining tracts
22
Q

What are the treatment options for a Cholesteatoma?

A

wide surgical resection
remove all abnormal tissue
antibiotics long term
neurological factors and bone lysis poor prognisitc factors

23
Q

What is Primary secretory otits media?

A

CKC have fluid in their middle ear

Glue ear

24
Q

How is primary secretory otits media treated?

A

Gromitt placement to allow drainage

TECA-LBO (not treating the cause)

25
Q

What is a subtotal TECA?

A

Modification of the TECA technique to preserve most of the proximal portion of external ear canal

26
Q

What are the causes of a para-aural abscess/fistula?

A

inadequate debridement of the middle ear
failure to remove all of the ear canal cartilage
osteomyelitits
parotid gland damage
cholesteatoma

27
Q

What are the symptoms of a para-aural abscess?

A 
Head tilt 
Pain on opening of the mouth 
pain around head
lethargy 
swelling/drainage over surgical site
3 to 9 months post-op
28
Q

What is the differential diagnosis of an para-aural abscess?

A

Migrating foreign body

neoplasm

29
Q

How is a para-aural abscess treated?

A

antibiotic therapy
Surgical
lateral approach
or ventral approach

30
Q

What are the complications associated with para-aural abscess surgical treatment?

A

facial nerve paralysis
otits interna
head tilt

31
Q

What are the indications for the Ventral bulla osteotomy in the dog?

A

Diseases limited to the bulla

recurrance of choleastoma

Surgical Nursing (24 decks)

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