Review the report and answer the questions that follow: Preoperative Diagnosis:

Question

Review the report and answer the questions that follow:

Preoperative Diagnosis: Bilateral chronic serous otitis media; tonsillo-adenoiditis

Operation: Bilateral myringotomies and ventilation tube insertion; Tonsillectomy and adenoidectomy

Procedure: With the patient in the supine position and under general endotracheal anesthesia, inspection was made under the operating microscope. The external canal was clear, tympanic membrane was divided. A purulent discharge appeared to be present. This drainage was suctioned out and the ear thoroughly lavaged. A ventilating tube was put in place and otic drops were administered. Same procedure for other ear canal.

The patient was placed in the Rose position (supine with the head over the table edge in full extension) and the adenoids removed with adenoid curettes and adenoid biopsy forceps. A nasopharyngeal sponge was put in place. The right tonsil was then grasped with tonsil forceps, dissected free, and removed with snare. Bleeding was controlled with suction cautery, The nasopharyngeal sponge was removed and no further bleeding noted. The patient tolerated the procedure well and left the OR in good condition.

1.  How would you describe the patient’s preoperative diagnosis to the parents?
2. How would you describe the operative procedure to the parents?
3. What would account for the presence of purulent discharge?
4. What are otic drops and why would the be used?

Explanation / Answer

The pre operative dgnosis would be said to parents in simple word as it is middle ear infection cause by pathogen which characterized by secreation. Also there is inflation at back of roof of mouth which are helping in immune of body.

2. To over come the problem a small opening to be made at eardrum with a tube to be placed, and imflamted tissue at roof of mouth is to be removed.

3. Purulent discharge account for some kind of bacterial or viral infection this. Would contain immune cell's and causative agents

4. Otic drops are mainly antibiotics broad spectrum for gram negative pathogen. They are used to remove the infection causing purulent discharge.

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