1 C J Mieny, U Mennen: Principles of Surgical Patient Care - Volume ...

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Table 5.1.3. Complications of Foreign Bodies in the ENT1. Ear- Otitis externa- Excoriation of external canal skin- Dermal necrosis- Stenosis of the external canal- Chondritis- Persistent tympanic membraneperforation- Ossicular disruption- Facial paralysis- Otitis media- Deafness- Dysequilibrium2. Nose- Septal perforation- Vestibular stenosis- Nasal synechia- Rhinitis- Rhinolith- Loss of smell- Pungent smell- Cerebro-spinal fluid rhinorrhoea3. Pharynx- Laceration- Perforation- Surgical emphysema- Cellulitis- Retropharyngeal orparapharyngeal abscess- Mediastinitis- Stenosis- Pharyngo-cutaneous fistula4. Larynx- Perichondritis- Stenosis- Vocal cord paralysis- Abscess formation- Mediastinitis5. Trachea- Perichondritis- Stenosis- Abscess formation- Injury to recurrent laryngeal nerve- Mediastinitis- Aortic penetration- Tracheo-oesophageal fistula6. Bronchi- Atelectasis- Emphysema- Lung abscess.CommentForeign Body in the Ear, Nose and ThroatS L SellarsWith five major body orifices in the head and neck, foreign body problems arecommon in this region, especially in children. When impaction in the aerodigestive trafct hasoccurred in these sites, they may result in lethal consequences. Foreign body in theoesophagus and bronchial tree may be difficult to diagnose.The use of special radiological studies, such as contrast and radioisotope, assistdetection of bronchial foreign bodies. However, a good history is paramount and this oftenprovides the most relevant information upon which clinical suspicion of the correct diagnosiscan be founded.6
Chapter 5.2: Acute Infections of the Ear and Upper Aerodigestive TractJ G SwartIntroductionMore than half of all diagnoses made in children under the age of 10 are infectionsof the upper respiratory tract and ear. Otitis media is the most important of these.Viral causes predominate in the early phase of the disease, only to be replaced bybacterial infections later. There is a clear correlation between low IgA in nasal secretion andupper respiratory tract infection.Acute Infection of the External EarThese infections involve either the skin, outer layer of the tympanic membrane orcartilage of the external ear and may be localized or diffuse.The external ear consists of an outer cartilaginous portion including the pinna and aninner bony portion lined by skin. The skin of the medial part of the external meatus isparticularly thin and contains no appendages.EtiologyThe causative factors often occur in combination, i.e. an infective agent such asStaphylococcus aureus and trauma due to a cotton bud or hairpin.Generalized skin conditions such as psoriasis or impetigo can also result in an acuteotitis externa. The organisms most commonly found are Pseudomonas, Proteus,Staphylococcus and even anaerobes.Fungi are common but tend to cause a more chronic type of infection.Classification of Otitis Externa1. Localized otitis externa- Furuncle- Myringitis- Herpetic eruptions- Perichondritis.2. Diffuse otitis externa- Diffuse infective otitis externa- Eczematous otitis externa- Seborrhoeic otitis externa- "Malignant" otitis externa.PathologyThe most common form of localized otitis externa is the furuncle due to astaphylococcal infection of a hair follicle. It is usually single but may be multiple in immunecompromised persons. Diffuse infective dermatitis usually starts near the external meatus fromwhere it spreads in the epithelial or subepithelial layers of the canal.7
Page 1 and 2: C J Mieny, U Mennen: Principles of
Page 3 and 4: informative and is easy to perform.
Page 5: 4. Larynx- Heimlich manoeuvre- Dire
Page 9 and 10: Table 5.2.2. Treatment of Acute Oti
Page 11 and 12: DiagnosisOtoscopy will reveal tympa
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Page 15 and 16: TreatmentAdequate bedrest and fluid
Page 17 and 18: Acute StomatitisAcute inflammatory
Page 19 and 20: although not dangerous in itself, c
Page 21 and 22: - motor-vehicle accidents- assaults
Page 23 and 24: The fracture line runs through the
Page 25 and 26: than that of the Le Fort II fractur
Page 27 and 28: Lateral or Supero-Lateral Orbital M
Page 29 and 30: Coronal tomography of the ethmoidal
Page 31 and 32: Haemorrhage and ShockSevere bleedin
Page 33 and 34: - laceration of the facial region-
Page 35 and 36: Le Fort III and Combined Le Fort Fr
Page 37 and 38: Surgical AnatomyThe mandible has a
Page 39 and 40: The "area of fracture" describes th
Page 41 and 42: Radiographs may reveal the extent,
Page 44 and 45: In a case where sufficient soft-tis
Page 46 and 47: classical "moon face" swelling with
Page 48 and 49: After carefully doing this clinical
Page 50 and 51: 2. Thermal3. Caustic- Inhalation of
Page 52 and 53: Table 5.4.3. The Diagnostic Work-Up
Page 54 and 55: CommentLaryngotracheal TraumaS L Se
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Tracheotomies are classified as:- e
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Table 5.5.4. Etiology of Laryngeal
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Table 5.5.7. Conditions Leading to
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- The median raphe of the sternohyo
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CommentTracheotomyS L SellarsCondit
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- Examination of the anterior chamb
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maintained only if such injuries ar
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