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RT LT CSOM UNSAFE Rt TYMPANO-MASTOIDECTOMY 1. Keep ear dry 2. Do not lie on the operated side. 3.

Do not shake your head vigorously. 4. Do not blow your nose. If you have to sneeze,keep your mouth open while sneezing. 5. Do not use a tongue cleaner. 6. Do not wash your hair vigorously. 7. Prevent constipation. Do not strain.A mild laxative may be taken 8. Do not travel by motor cycle, bicycle or scooter. 9. Avoid hard work # lifting heavy articles, bending,vigorous exercise, outdoor games etc. 10. Do not expose yourself to loud noise. strict bed rest for 2 days if getting giddiness then can move with support if giddiness improves

Inj cefuroxime 750 mg tds (intra & periop period) + supportive strict voice rest ,do not whisper/ shout do not cough hard do not lie down immediatly after meals gap should be 2 hrs atleast avoid polluted places , smoke ,dust Do not blow nose hard Avoid dust, polluted places Quit smoking Avoid trauma to nose Do not shake your head vigorously. If you have to sneeze, keep your mouth open while sneezing. Do not use a tongue cleaner. Do not wash your hair vigorously. Prevent constipation. Do not strain. Do not travel by motor cycle, bicycle or scooter. Avoid hard work # lifting heavy articles, bending, vigorous exercise, outdoor games etc.

tab ceftum 500 mg bd x 3days tab sporlac 1 bd x5 days tab rantac 1 bd x 5 days tab voveran sos x 5 days n/d nasivion 2 drops tds wokadine gargles tds syp cremaffin 3 tsf hs tab stemetil sos tab emcet sos tab stugeron 1 bd x 5 days CHR TONSILLITIS TONSILLECTOMY -soft bland diet x 7 days -avoid hot food stuffs -follow up immediatly if throat pain increases and not able to take oral feeds and fever spikes > 100F -do gargling after each meal

STAPEDECTOMY vein graft from rt dorsum hand. endomeatal incision l ear. tm flap elevated. post overhang drilled out. chorda cut. ossicular chain viewed along with pyramidal process. stapes fixation confirmed. foot plate exposed after removing supra str stapes. hole drilled with perforator.FP thined with hand burr. 0.6mm x 4 mm piston put with vein graft on FP hearing impr checked on table. gel foam in ME and over TM. TM flap repositioned.sialastic placed dressing.

Pt intubated and draped. Head extended, Davis Boyle mouth gag inserted with Draffins bipods. Incision taken along ant pillar of lt tonsillar fossa. Tonsils dissected out upto lower pole,cut with tonsillar snare. Strip gauze inserted in tonsillar fossa.Procedure repeated for rt tonsil. Haemostasis achieved with bipolar cautery. B/L tonsillar fossae clear. Throat pack removed. Pt extubated without complications.

TYMPANOPLASTY Pt. under i.v sedation. Local infiltration done with 2% xylocaine with Adrenaline. Postaural incision taken. TFG harvested. Periosteal flap elevated. Posterior meatotomy done. CP visualised-edges freshened, undersurface made raw. TM flap elevated. IS joint visualisedintact and mobile. Middle ear mucosa healthy. Graft placed underlay HOM. TM flap reposited back. Betnesol-N soaked gelfoam kept. Wound closed in layers. Sterile mastoid dressing given. Post-op facial nerve function Normal.