It is used as a diagnostic tool to examine various diseases of nose, ear & larynx.
Rigid instruments w·e preferred ( 4 mm or 2.7 mm, 0, 30, 45, 70 degrees ) because of superior image quality and angular viewing ability.
It is used as a therapeutic modality is sinus sw·gery, polypectomy, choanal atresia, dacrocystorhinstomy, septal & turbinate sw·gery, managemeut of cpistaxis, circumscrihed benign tumors & foreign bodies. .
It has grown to include new territories of anterior skull base, pituitary surgeries & optic nerve.
Endonasal surgery provides a better tool to control rhinogenic causes for middle ear sepsis and combination of this with micro ear techniques offern a definite advantage is middle ear reconstrnction.
The excellent illumination and selective magnification produce by zeiss operating microscope has replaced other instruments is micro ear surgeries like Tympm1oplasty, Stapedectomy, Facial nerve surgery etc.,
It has grown to new horizons and is employed is middle cranial fossa & skull base operations.
Apart from the ear it forms a useful tool is pituitary glruid surgery, microlruyngeal surgery for removal of vocal nodule, polyps, cysts etc.,
Recently ther·e is a. trend toward wuse of microscope is thyroid & parntid glw1d sureris to prevent damage to recur,rent lruyngeal nerve & facial nerve.
Technological advance in producing increasingly smaller diameter fibreoptic endoscopes for examination of the ai1way.
The main indications for bronchoscopy are diagnostic is case of hnemoptysis, suspected bronchial obstruction, obscure chest symptoms and therapectic in case of bronchiaJ toilet and removal of foreign bodies.
The main strength of flexible method is the abilily to visualize and biopsy relative peripheral lesions compared to the rigid method but is also practfr.able is case of cervical spinal obnormalities or thoracic anemysms.
Light Amplification by Stimulated Emission of RadiatiotL 111e main properties of Laser are Monochromaticity — single wave length
Coherence — wave fronts oflaser bean are precisely is step across time and spaces. Direction or Collimation that allows the bean to be easily controlled or focussed accurately on tissue.
Co2 laser is the only laser which is entirely absorbed by water. As our body tissue comprises of 800/o of water, when co2 laser bean is focussed on body tissues it will vaporize the same tissue and at the same time due to release of thenna.l energy seal the small blood vessel with and lymphatics._
Microdebriders were pioneered in endonasal & sinus surgery in 1992 by Reuben setliff when heused on otthopaedic microdebrider in nasal polyp surgery. Manufacturers are now producing instruments which are solely dedicated to rhinological surgery and the various alterations is design and capability have led to significant improvements in the suitability and versati lity of microdebrider for endonasal surgery. It produces less collateral tissue damage then traditional grab & tear sinus surgery instruments and blood loss less.
They are used is case of nasal polyps, fess, endoscopic DCR, Endoscopic SMR, Lysis of nasal adhesions, tumor debulking, endoscopic repair of choanal atresia and removal of lingual tonsils.
An electric drill with a minimum speed of 15,000 rpm and a maximum speed of 40,000 rpm with hm1d piece is used. Tungsten Cm·bide tipped bun-s provide faster bone removal and longer halflife for the burr & hand piece.
It is used is micro ear surgery like mastoidectomy, nasal surgeries like choanal atresia
and in pituitary surgery.