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

Pre-operative diagnosis :

swelling of tonsils and adenoids. Fluid also seen in middle part of both ears with swelling.

Operation:

The pus discharge inside the ear was removed and cleaned and needed. Antibiotic drops are added.

For the adenoids, they are removed along with the right tonsil.

Purulent discharge would be due to bacterial infection.

Otic drops are a combination of anti-infective drugs and corticosteroids. They are added to reduce the infection inside the ear.

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