Question

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.  In lay terms, give a complete description of the patient’s preoperative diagnoses for the parents.

Answer 1

The patient is suffering from a disease known as bilateral chronic serous otitis media that means he is having long-term problems with the middle ear, such as a hole (perforation) in the eardrum that does not heal . Middle ear is a small bony chamber where the nerve impulses for hearing are created. The middle ear can become inflamed or infected which might result in fluid accumulation and When fluid remains in the middle ear, the condition is called chronic serous otitis media.

In addition he is suffering from tonsilo-adenoditis which is  an inflammation of the adenoids and tonsils caused by infection. Adenoids are masses of lymphatic tissue that help the body fight infection. Adenoids are found in the throat, also called the pharynx, just behind the nose. Along with the tonsils, adenoids are the first line of defense against bacteria and viruses.