Morbidity & mortality

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Morbidity &mortality in E.N.T. surgeriescauses, diagnosis & prevention : 

Morbidity &mortality in E.N.T. surgeriescauses, diagnosis & prevention

Common E.N.T. surgeries;1- adenotonsillectomy2- UPPP 3- septal & terbinate4- FESSS5- nasal tumors6- ear surg. Grommet insertion , tympanoplasty, mastiod surg.7- laryngeal ; D L for VC nodules, polyp , mass : 

Common E.N.T. surgeries;1- adenotonsillectomy2- UPPP 3- septal & terbinate4- FESSS5- nasal tumors6- ear surg. Grommet insertion , tympanoplasty, mastiod surg.7- laryngeal ; D L for VC nodules, polyp , mass

8- Neck surg. Thyroid , thyrogossal cyst &fistula, branchial cyst &fistula, other neck masses : 

8- Neck surg. Thyroid , thyrogossal cyst &fistula, branchial cyst &fistula, other neck masses

Mortality in E.N.T. due to ;A- anesthetic causes B – surg. Causes A- anesthetic causes;1- poor preoperative evaluation;chest; wheezy, asthma, heart; CHD,valvular lesion. HFabdomen; liver, spleen, LN.Neck; vs,LN,thyroid,short obese neckreceding mandible, large tongue, trismus, stridor : 

Mortality in E.N.T. due to ;A- anesthetic causes B – surg. Causes A- anesthetic causes;1- poor preoperative evaluation;chest; wheezy, asthma, heart; CHD,valvular lesion. HFabdomen; liver, spleen, LN.Neck; vs,LN,thyroid,short obese neckreceding mandible, large tongue, trismus, stridor

All cause difficult intubation so stylet , lary. Mask, tracheostomy &its alternatives jaundice …..> isofluranecyanosis………O2 * invest. ; CBC,BT&CT,ESR, liver& kid. Function , PT,RBS : 

All cause difficult intubation so stylet , lary. Mask, tracheostomy &its alternatives jaundice …..> isofluranecyanosis………O2 * invest. ; CBC,BT&CT,ESR, liver& kid. Function , PT,RBS

Intraoperative causes;1- idiosyncrasy of drugs2- anaphylaxis3- cardiac arrest *prevention;1- venous line2- monitoring of vital signs3- drugs& equipments; adren.,atropine ,ephedrine, xylocaine, steroids &DC shock : 

Intraoperative causes;1- idiosyncrasy of drugs2- anaphylaxis3- cardiac arrest *prevention;1- venous line2- monitoring of vital signs3- drugs& equipments; adren.,atropine ,ephedrine, xylocaine, steroids &DC shock

*Postoperative causes;usually due to respiratory obst. By secretion , bld. Clot ,pack ,vomiting , incomplete recovery &poor positioning of PT.*Diag. difficult resp. stridor , chocking &cough, irritability : 

*Postoperative causes;usually due to respiratory obst. By secretion , bld. Clot ,pack ,vomiting , incomplete recovery &poor positioning of PT.*Diag. difficult resp. stridor , chocking &cough, irritability

*prevention &TTT;1- full recovery2- proper positioning3- clearance of secretions4- adjust of pack5- if resp. obstruction ….airway, intubation, consultation, tracheostomy or its alternatives : 

*prevention &TTT;1- full recovery2- proper positioning3- clearance of secretions4- adjust of pack5- if resp. obstruction ….airway, intubation, consultation, tracheostomy or its alternatives

B- surgical comp;I- adenotonsillectomy ;1- Hge; due to;slipped ligature, rise of BP, incomplete removal of adenoid ,excessive curettage of adenoid , trauma by endotracheal. tube : 

B- surgical comp;I- adenotonsillectomy ;1- Hge; due to;slipped ligature, rise of BP, incomplete removal of adenoid ,excessive curettage of adenoid , trauma by endotracheal. tube

*C/P ; bleeding/mouth or nose, false hematemesis*TTT; 1- guard against airway obst. 2- coagulants 3- pack 4- antishock measures 5- consultation : 

*C/P ; bleeding/mouth or nose, false hematemesis*TTT; 1- guard against airway obst. 2- coagulants 3- pack 4- antishock measures 5- consultation

II- UPPP ;the same + respiratory obst. Due to palatal edema TTT; steroids , airway. : 

II- UPPP ;the same + respiratory obst. Due to palatal edema TTT; steroids , airway.

III- septal &terbinate serg. respiratory obst. By secretion , bld. Clot ,pack , incomplete recovery &poor positioning of PT. *diag. difficult resp. stridor , chocking &cough, irritability : 

III- septal &terbinate serg. respiratory obst. By secretion , bld. Clot ,pack , incomplete recovery &poor positioning of PT. *diag. difficult resp. stridor , chocking &cough, irritability

*prevention &TTT;1- full recovery2- proper positioning3- clearance of secreations4- adjust of pack5- if resp. obstruction ….airway, intubation, consultation, : 

*prevention &TTT;1- full recovery2- proper positioning3- clearance of secreations4- adjust of pack5- if resp. obstruction ….airway, intubation, consultation,

IV- FESS :the same + periorbital ecchomosis, edema & surg. Emphysema .orbt. Hge. Diag.; periorbital reddish or bluish swelling& crepitus, progressive proptosis&loss of vision TTT ; avoid nasal blowing , ice packs, haemostatic, : 

IV- FESS :the same + periorbital ecchomosis, edema & surg. Emphysema .orbt. Hge. Diag.; periorbital reddish or bluish swelling& crepitus, progressive proptosis&loss of vision TTT ; avoid nasal blowing , ice packs, haemostatic,

Consultation lat. Or med. Canthotomy V- nasal tumors ; -Hge, edema . *prevention ; - close observation of vital signs- anti shock measures . : 

Consultation lat. Or med. Canthotomy V- nasal tumors ; -Hge, edema . *prevention ; - close observation of vital signs- anti shock measures .

VI- Ear surgery vestibular manifestations due to trauma to inner ear TTT ; primpiranVII- laryngeal surgerystridor , resp. obst. Due to edema, VC. Palsy,cricoarytenoid dislocationTTT; O2,steroids, intubation, tracheostomy : 

VI- Ear surgery vestibular manifestations due to trauma to inner ear TTT ; primpiranVII- laryngeal surgerystridor , resp. obst. Due to edema, VC. Palsy,cricoarytenoid dislocationTTT; O2,steroids, intubation, tracheostomy

VIII- Neck surgery - thyroidectomy , sistrunk op.- excision of neck swellings *complications ; 1- Hge, shock, respiratory obst. Due to Hge. in closed space, TTT; removal of stitches & evacuation of hematoma , anti shock measures : 

VIII- Neck surgery - thyroidectomy , sistrunk op.- excision of neck swellings *complications ; 1- Hge, shock, respiratory obst. Due to Hge. in closed space, TTT; removal of stitches & evacuation of hematoma , anti shock measures

2- VC palsy ; due to injury of rec. laryngeal n. …….stridor &respiratory distress TTT ; - O2 , steroids - if bil…….. Intubation , tracheostomy or its alternatives : 

2- VC palsy ; due to injury of rec. laryngeal n. …….stridor &respiratory distress TTT ; - O2 , steroids - if bil…….. Intubation , tracheostomy or its alternatives

Thank you : 

Thank you

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