Septoplasty Research Paper

Surgical Procedure Card educatee Case Study 9 Efren Gonzalez date 4/18/12 Procedure name and adjudicate/ definition Septoplasty / bilateral palatine tonsillalectomy. is a corrective surgical procedure done to uncoileden the nasal septum. surgical procedure in which the tonsils are removed from either side of the throat. What is the prognosis of the procedure? to give a good breathing passage. and to stop inflammation of the tonsils Patient level adultGender female Additional pertinent tolerant/ procedure information n/a Probable preoperative diagnosis Nasal septal excursus Tonsillitis Diagnostic intervention diviated nasal septal. Discuss the relevant anatomy and physiologyseptum made up primarily of cartilage and bone and covered by mucous membranes. The cartilage also gives shape and support to the outer grammatical constituent of the nose. The nose is the major portal of air exchange between the internal and external environment.The nose participates in the vital functions of conditioning inspired air toward a temperature of 37C and 100% relative humidity, providing local anaesthetic defense and filtering inhaled particulate matter and gases. It also functions in olfaction, which provides both a defense and pleasure for the individua keep downic Pathophysiology (disease process). disrupted sleep patterns, headaches List the equipment that will be needed for this procedure forced air heating system device , valley lab bovie, sitting stool, fiber optic headlight,List the instrument pans/sets used nasal procedures tray, microdrill, endoscopic. list the supplies that will be needed for the procedure. pack =sinus pack blades=15, drains= penrose 1/4 x 18 (but did not see it on the field used) suture= 3-0 nylon suture, 4-0 vicryl basin set= single drapes=, 1/2 sheet , adhesive strip across the forehead. U drape dressings= 44, pharmaceuticals = NS for irrigation 1000cc, lidocaine 0. 5%, epinephrine 1%, lidocaine with epinephrine 11 miscellaneous = pens Anesthesia GeneralList patients position and items used for put supine with pillow under knees. arm resting to her sides. Where razors and clippers used preoperatively no List the prep solution and perimeters of the peel prep. Duraprep the eternal nose and impertinence, extend the prep from the hairline to the shoulders and down to the table at the sides of the neck. list the order in which drapes will be placed towel, 1/2 sheet , U drape incision hemitransfixion incision, counts when performed ? onwards surgery, and after specimens tonsill , and septumPostoperative patient care considerations pain medication , no lifting , no running potential complications expel , infection , difficult breathing wound classification idle contaminated class 2 24. The patient was placed on the operating room table in the supine position. After adequate public endotracheal anesthesia was administered, the right and left nasal septal mucosa and right and left wanting(p) turbinate s were anesthetized with 1% lidocaine with 1100,000 epinephrine use approximately 10 mL. Afrin-soaked pledgets were placed in the nasal cavity bilaterally.The face was prepped with pHisoHex and draped in a sterile fashion. A hemitransfixion incision was performed on the left with a 15 blade and submucoperichondrial and mucoperiosteal flap was elevated with the Cottle elevator. Anterior to the septal deflection, the septal cartilage was incised and an opposite-sided submucoperichondrial and mucoperiosteal flap was raised with the Cottle elevator. The deviated portion of the nasal septal cartilage and bone was removed with a Takahashi forceps, and a large inferior septal spur was removed with a V-chisel.Once the septum was reduced in the midline, the hemitransfixion incision was closed with a 4-0 Vicryl in an interrupted fashion ( note, using a heaney needle holder with tissue with teeth, and suture finished sullen with a metzenbuam scissor). The right and left inferior turbinates were trimmed in a submucous fashion using straight and curved turbinate scissors under direct visualization with a 4 mm 0 degree Storz endoscope. Hemostasis was acquired by using suction electrocautery.The turbinates were whence covered with bacitracin cream after cauterizing them and bacitracin ointment soaked Doyle splints were placed in the right and left nares and secured anteriorly to the columella with a 3-0 nylon suture ( note, using a heaney needle holder with tissue with teeth, and suture finished finish up with a metzenbuam scissor). A butter natural language was inserted and turned 360 in the nose to check if the patient has enough space to allow for breathing. The table was then turned. A shoulder roll placed under the shoulders and the face was draped in a clean fashion.A McIvor mouth gag was applied. The tongue was retracted and the McIvor was gently suspended from the Mayo stand. The left tonsil was grasped with a curved Allis forceps, retracted medially, and the anterior tonsillar pillar was incised with Bovie electrocautery. The tonsil was removed from the superior celestial pole to inferior pole using a Bovie electrocautery in its entirety in a subcapsular fashion. The right tonsil was grasped with a curved allis, in a similar fashion, retracted medially, and the anterior tonsillar pillar was incised with Bovie electrocautery.The tonsil was removed from the superior pole to inferior pole using Bovie electrocautery in its entirety in a subcapsular fashion. The inferior, middle, and superior pole vessels were further cauterized with suction electrocautery. The extremely edematous portion of soft palate was resected using a right angle clamp and right angle scissor and was closed with 3-0 Vicryl in a figure-of-eight interrupted fashion , ( note, using a heaney needle holder with tissue with teeth, and suture finished off with a metzenbuam scissor).Copious saline irrigation of the oral cavity was then performed. There was no further identifi able expel at the termination of the procedure. The estimated blood loss was less than 10 mL. The patient was extubated in the operating room, brought to the recuperation room in satisfactory condition. There were no intraoperative complications. http//www. youtube. com/watch? v=kUOAhZOkgEg http//www. youtube. com/watch? v=1gnxNgP8xO4