FIG. 7.6 Caldwell-Luc operation. (From Ignatavicius DD, Workman ML: Medical surgical nursing: critical thinking for collaborative care, ed 5, St Louis, 2006, Mosby.)
Go ahead and use the template available on the Evolve Resources site to map the remaining procedures:
• Tympanoplasty
• Mastoidectomy
• Stapedectomy
• Cochlear implant
Nasal Procedures
Procedures
• Septoplasty
• Turbinectomy
• Nasal polypectomy
• Choanal atresia repair
• FESS (functional endoscopic sinus surgery)
• Caldwell-Luc antrostomy (a.k.a. nasal antrostomy; Fig. 7.6)
• Rhinoplasty
Additional Facts to Remember
• Cocaine 4% is used as a topical anesthetic; it also acts as a vasoconstrictor.
• Any surgery performed through the nose is considered nonsterile, with a wound classification of class III (contaminated).
• Repair of choanal atresia (congenital absence of an opening into the nasopharynx) is performed in pediatric patients. The condition is usually suspected if an 8F catheter cannot be inserted where the opening should be. A powered burr or microdebrider is used to make the repair.
• In Caldwell-Luc antrostomy, the incision is made above the canine and second molar.
• It is important to identify and avoid damaging the infraorbital nerve, which could result in blindness or infraorbital neuralgia, a painful disorder that may be misdiagnosed as migraine.
• Absorbable sutures are used in these procedures.
Mapping
Surgical Mapping
Rhinoplasty
| Instruments | Important Anatomy Involved | Pathophysiology |
| Basic nasal instrumentation |
Nasal septum
Ethmoid and vomer bones
|
Deformity of external nose (traumatic, congenital, or disease-related) |
| Microbiology/Wound Classification | Skin Prep/Incision/Patient position | Pharmacology |
| Class III (dirty) |
Prep: none
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