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Case No: Major Scrub 1 CI: Ma’am Weng Manzarate

Name of Student: John Raphael Sanchezz Date of Submission: 09-09-2017


Year and Section: 3NUR-8
OR Preference Cards
Name of Patient: M.V.R. Age: 31 Sex: Female Civil Status: Single
Date of Admission: 09/29/17 Date of Surgery: 09/29/17 Time Started/Ended: 5:50pm-9:30pm
Bed #: 3060A Hospital No: 17-180000091552 Admission No: 17100824
Surgeon: Dr. Velasquez Assistant Surgeon: Dr. M. Alcid
Anesthesiologist: Dr. Maglay
Scrub Nurse: Marie Joy C. Ascasio, RN Circulating Nurse: Weldon M. Ola, RN
Chief Compliant: Left ear discharge

Inflammation of the Edema is formed due to


Acute infection in the ear middle ear mucosa the inflammation

T-cell acts then forms a


Epithelial lining starts to
granulation tissue causing
breakdown.
the damage to the bony
margins

complications.
Pre-Operative Diagnosis: Chronic otitis media (L) ear

Rationale/Definition: Chronic Otitis Media is a perforated tymapanic membrane with persistent drainage from the middle ear usually
lasting from 6-12 weeks. It is initiated by an episode of acute infection causing irritation and inflammation of the middle ear musoca.
The reponse creates edema then causing epithelial lining to breakdown. The host attempts to resolve the infection like a granulation
tissue which develops into a polyp in the middle ear space. T-cell mediated cellular immunity performs its role and form a granulation
tissue thus destroying the bony margins and lead to further complications.

Post-Operative Diagnosis: Chronic Otitis Media A “Inactive s/p intact canal wall Mastoidectomy with Tympanoplasty Type I
postauricular approach.
Definition: Chronic Otitis Media is a perforated tymapanic membrane with persistent drainage from the middle ear usually lasting from
6-12 weeks. It is initiated by an episode of acute infection causing irritation and inflammation of the middle ear musoca. The reponse
creates edema then causing epithelial lining to breakdown. The host attempts to resolve the infection like a granulation tissue which
develops into a polyp in the middle ear space. T-cell mediated cellular immunity performs its role and form a granulation tissue thus
destroying the bony margins and lead to further complications.

Complete Surgical Procedure: Mastoidectomy with Tympanoplasty


Rationale/Definition: It is a surgical procedure that removes diseased mastoid cells. The diseased cells are often the result of an ear
infection that has spread into your skull. The procedure can also be used to remove an abnormal growth of the ear known as
a cholesteatoma.

Type of Anesthesia: General anesthesia


Specific Technique: GA-LMA
Anesthetic Agent: Sevoflurane
Mechanism of Action: It alters the activity of fast synaptic neurotransmitter receptors like nicotinic acetylcholine, GABA, and
glutamate. It may depress myocardial contractility and decrease both BP and sympathetic nervous activity. Additionally, it has muscle
relaxant properties w/o analgesia.

Position: Supine
Tools for Positioning: Surgical table, body strap, and pillows
Incision:
Skin Preparation: Disinfectant on the left side of the face of the patient and hair removal
Drapes Used: Disposable sterile towels, small sheets, and laparotomy sheet

Sutures and Needles:

Tissue Layer Suture Used Needle Suturing Technique

Skin Silk 40 Cutting needle Simple Interrupted

Muscle Silk 40 Round needle Simple Interrupted

Instruments Used:

Cutting Grasping Retracting Clamping Others:

Knife handle Tissue forceps Self-retaining retractor Mosquito forceps 24’s OS


Blade Thumb forceps Kelly fine forceps Cherries
Metzenbaum Needle holder Towel clips 2/3’s
Mayo Straight Allis
Mayo Curve Towel clips