CHAPTER 17 OTORHINOLARYNGOLOGY
EXAM QUESTIONS AND ANSWERS
/. Which laser is useful in middle ear procedures - Answer-✅argon laser
/.What are the reasons for reversing the operating table during ear surgery? - Answer-
✅the patients head is placed at the foot, allowing space under the foot portion of the
table to accomodate the legs of any seated team members and permit proper
equipment placement
/.why is nitrous oxide restricted during reconsturctive - Answer-✅nitrous oxide cause
expansion of the middle ear and can cause dislocation of a tympanic membrane graft
/.what is the most common cause of otitis media? - Answer-✅Otitis media is a common
acute inflammation of the middle ear. it is usually initiated by blockage of the auditory
tube causing and accumulation of fluid that would otherwise be drained into the
nasopharnyx
/.what is the purpose of a myringotomy? where is the incision made ? - Answer-✅to
remove accumulated fluid and insert a PE tube to allow for additional drainage and
maintain the pressure equalization. the incision is made in the inferior posterior portion
of the tympanic membrane called pars tensa
/.why would you add an ototome to a tympanoplasty setup and complete a postauricular
or retroauricular incision - Answer-✅An ototome (ear drill) and postauricular incision are
needed for a mastoidectomy due to extended disease into the mastoid sinus
/.what source of energy will be needed to operate the rotating drill - Answer-✅the drill
may be powered electrically or pneumatically with nitrogen
/.what may be used to hold implants in place or to fill the mastoid sinus? what is used to
place it? - Answer-✅Gelfoam sponge is used, which is cut into small pieces and placed
with an alligator forceps. Gelfoam can be used dry or soaked in saline, epinephrine, or
an antibiotic solution
/.patient presents with earache, headache, purulent discharge from the ear, hearing
loss, dizziness, and weakness of the facial muscles due to damage to the 7th cranial
nerve. What is used to remove it? name the nerves located with the nerve monitor. -
Answer-✅A cholesteatoma could cause the symptoms and is removes using a rosen
, needle and picks. A nerve monitor is used to locate the facial (7th cranial) and the
acoustic (8th cranial) nerves to prevent injury
/.What is a bony overgrowth surrounding the stapes that prevents vibrations of the
ossicles? what procedure is done to remove it? - Answer-✅Otosclerosis, which is a
build up of spongy bone that fuses the ossicles, a stapedectomy can be done to remove
it
/.Once the stapes footplate is removes, what can be used between the implant and the
oval window? - Answer-✅A fat, perichondrium, vein, or fascia graft may be used
/.why might a stapedectomy be completed using a local anesthetic? - Answer-✅To test
the patient's hearing once the implant is placed by whispering
/.Hearing loss is measured in decibels. which nerve is affected in a patient with
sensorineural deafness? what can be done to help this patient? - Answer-✅The
cochlea branch of the acoustic nerve is affected in sensorineural deafness. cochlear
implants are providing some hope and progress from some patients.
/.what causes the nasal septum to deviate from the midline? - Answer-✅part of the
normal aging process or can be caused by trauma
/.Prior to the case, a separate set up may be used to prepare the site and provide
analgesia and hemostasis. What is used? - Answer-✅a clean setup containing two
medicine cups, two local syringes (luer-lock) two 25-gauge or 27- X 2-in. needles. long
cotton tip applicators. packing material. local anesthetic, with or without epi, topical
anesthetic (cocaine), nasal speculum, bayonet forceps, and small scissors for trimming
nasal hair, if necessary.
/.why do you think bayonet-style forceps would be used for a deep hole such as nostril -
Answer-✅It allows the surgeon to visualize the surgical site. it offsets the band out of
the way
/.What procedures would be done during a septorhinoplasty - Answer-✅The septum
and the nasal bones would be repaired
/.what will be included in the postoperative dressings for a septoplasty? - Answer-
✅internal nasal splints, a moustache dressing, and possibly an external nasal splint
/.why would a septoplasty be Clean-contaminated (II) ? - Answer-✅Due to the mucous
membranes, which provide a moist environment for normal flora or microbes
/.Why are conchae (turbinates) removed? which set is most commonly transected -
Answer-✅A turbinectomy is completed due to the recurring inflammations that have
EXAM QUESTIONS AND ANSWERS
/. Which laser is useful in middle ear procedures - Answer-✅argon laser
/.What are the reasons for reversing the operating table during ear surgery? - Answer-
✅the patients head is placed at the foot, allowing space under the foot portion of the
table to accomodate the legs of any seated team members and permit proper
equipment placement
/.why is nitrous oxide restricted during reconsturctive - Answer-✅nitrous oxide cause
expansion of the middle ear and can cause dislocation of a tympanic membrane graft
/.what is the most common cause of otitis media? - Answer-✅Otitis media is a common
acute inflammation of the middle ear. it is usually initiated by blockage of the auditory
tube causing and accumulation of fluid that would otherwise be drained into the
nasopharnyx
/.what is the purpose of a myringotomy? where is the incision made ? - Answer-✅to
remove accumulated fluid and insert a PE tube to allow for additional drainage and
maintain the pressure equalization. the incision is made in the inferior posterior portion
of the tympanic membrane called pars tensa
/.why would you add an ototome to a tympanoplasty setup and complete a postauricular
or retroauricular incision - Answer-✅An ototome (ear drill) and postauricular incision are
needed for a mastoidectomy due to extended disease into the mastoid sinus
/.what source of energy will be needed to operate the rotating drill - Answer-✅the drill
may be powered electrically or pneumatically with nitrogen
/.what may be used to hold implants in place or to fill the mastoid sinus? what is used to
place it? - Answer-✅Gelfoam sponge is used, which is cut into small pieces and placed
with an alligator forceps. Gelfoam can be used dry or soaked in saline, epinephrine, or
an antibiotic solution
/.patient presents with earache, headache, purulent discharge from the ear, hearing
loss, dizziness, and weakness of the facial muscles due to damage to the 7th cranial
nerve. What is used to remove it? name the nerves located with the nerve monitor. -
Answer-✅A cholesteatoma could cause the symptoms and is removes using a rosen
, needle and picks. A nerve monitor is used to locate the facial (7th cranial) and the
acoustic (8th cranial) nerves to prevent injury
/.What is a bony overgrowth surrounding the stapes that prevents vibrations of the
ossicles? what procedure is done to remove it? - Answer-✅Otosclerosis, which is a
build up of spongy bone that fuses the ossicles, a stapedectomy can be done to remove
it
/.Once the stapes footplate is removes, what can be used between the implant and the
oval window? - Answer-✅A fat, perichondrium, vein, or fascia graft may be used
/.why might a stapedectomy be completed using a local anesthetic? - Answer-✅To test
the patient's hearing once the implant is placed by whispering
/.Hearing loss is measured in decibels. which nerve is affected in a patient with
sensorineural deafness? what can be done to help this patient? - Answer-✅The
cochlea branch of the acoustic nerve is affected in sensorineural deafness. cochlear
implants are providing some hope and progress from some patients.
/.what causes the nasal septum to deviate from the midline? - Answer-✅part of the
normal aging process or can be caused by trauma
/.Prior to the case, a separate set up may be used to prepare the site and provide
analgesia and hemostasis. What is used? - Answer-✅a clean setup containing two
medicine cups, two local syringes (luer-lock) two 25-gauge or 27- X 2-in. needles. long
cotton tip applicators. packing material. local anesthetic, with or without epi, topical
anesthetic (cocaine), nasal speculum, bayonet forceps, and small scissors for trimming
nasal hair, if necessary.
/.why do you think bayonet-style forceps would be used for a deep hole such as nostril -
Answer-✅It allows the surgeon to visualize the surgical site. it offsets the band out of
the way
/.What procedures would be done during a septorhinoplasty - Answer-✅The septum
and the nasal bones would be repaired
/.what will be included in the postoperative dressings for a septoplasty? - Answer-
✅internal nasal splints, a moustache dressing, and possibly an external nasal splint
/.why would a septoplasty be Clean-contaminated (II) ? - Answer-✅Due to the mucous
membranes, which provide a moist environment for normal flora or microbes
/.Why are conchae (turbinates) removed? which set is most commonly transected -
Answer-✅A turbinectomy is completed due to the recurring inflammations that have
