Chapter 993 Fatal petrous apex granuloma! Complete ear closure!
It was Dr. Xu's phone...
Although the phone was locked, the details of the message could be seen without unlocking it.
As a quick-eyed and quick-handed circulating nurse, she could see the content clearly with a casual glance...Shi Lian won the first place!
The screen went dark, reflecting the circulating nurse's uncontrollable excitement.
She actually did it!
After Director Xu was banned from the Famous Knife Competition, not to mention other hospitals, even Linyi itself did not have much hope. As a result, Shi Lian led the team to become a dark horse again!
In the first round yesterday, Linyi was also far ahead.
Now it is the first place again...Could it be that Linyi is really going to dominate the Famous Knife Competition!
Thinking of this, the circulating nurse felt her breathing quickened a lot...After winning the last Famous Knife Competition, Linyi replaced a batch of new imaging equipment, and the direct benefits were almost nearly 100 million.
The year-end bonus of all medical staff has almost doubled.
If we can win the first place again this year, the training resources prepared by the state for Union Hospital will fall on the clinical doctors, and their year-end bonuses will break the record again...
"Doctor Xu!"
The circulating nurse hurried to the operating room.
She stepped on the airtight door, her eyes lit up, and she said excitedly: "Doctor Xu, Shi Lian won the first place again!"
Hearing this, countless eyes were cast in the operating room.
Even the anesthesiologist who was dozing off straightened up instantly.
Most doctors in other hospitals don't care too much about the famous knife competition. After all, it's just an honor and there is no benefit for non-contestants.
But clinical doctors are different.
If you win the award, the hospital will really give you money. This is the real joy of sharing with the people.
"Next year, we can enroll our children in an extra tutoring class..."
"Director Xu is really awesome. He can still win the famous knife competition even though he is in the hospital!"
"Shi Lian has the potential to be an outstanding young scholar!"
"If she also becomes an academician, then we will have two academicians in the Department of Clinical Medicine, hehe..."
Thinking of this, everyone was even more overjoyed.
Although our ability is limited, the Department of Clinical Medicine has become a strong hospital with its own efforts!
What is the difference between this and being admitted to a third-tier university, and then the school working hard to become a first-tier university...Rounding off, everyone is a graduate of a key university!
"Full score?" At this time, Xu Qiu stopped the scalpel and asked.
The atmosphere suddenly became quiet.
The circulating nurse swallowed her saliva and said unconfidently: "No, I'm not sure, it seems to be in the 9th place, not fully displayed..."
Shi Lian's message mentioned the score, but it was stuck in the first half of 93.65.
"It seems that the difficulty is not small." Xu Qiu added.
He was not surprised by this result.
I have trained Shi Lian and others for so long, and there is a teacher who is very good at cheating. Shi Lian and his group are already talented. If this is not good, then Xu Qiu will doubt his own vision.
"But it's well done." Xu Qiu said the second half of the sentence, and a peaceful smile appeared on his face.
The circulating nurses and others sighed.
That is why Dr. Xu dared to make such strict requirements. If others can win the first place in the famous knife competition, it will be no problem for the mentor to pour water for them to wash their feet...
"Continue the operation." Xu Qiu said, and his eyes fell on the surgical area again.
Jia Jia's cholesterol granuloma resection is not difficult from a technical perspective, but it is tricky and cumbersome.
Just the surgical approach and the way to enter the granuloma area are very complicated, and ordinary neurosurgeons dare not do it easily.
At present, Xu Qiu is doing an extension of the petrous apex tumor resection, and he will also use tubular silicone plates, antibiotic gelatin sponges, etc. as auxiliary.
The patient's cholesterol granuloma is located in the petrous apex, which is essentially an intraosseous inflammatory tumor. The most appropriate method is to enter the labyrinth, cochlea or foramen magnum.
At this time, the extended mastoidectomy is nearing its end.
This is the first link of the operation, that is, to make a large "C"-shaped incision behind the ear and remove the cortical bone on the outside of the mastoid, so as to fully display the mass and provide a surgical field sufficient to remove the cyst wall.
After grinding the petrous apex of the internal auditory canal, Xu Qiu turned to the external auditory canal and simultaneously removed the small granuloma secondary to the deep part of the external auditory canal.
Compared with the real protagonist, the difficulty of cleaning the outside is not much different from cleaning cerumen, and it was completed quickly.
As the last bit of the petrous apex was ground off, the buzzing sound of the high-speed drill finally stopped, and everyone breathed a sigh of relief.
Although it is only the first step, this operation is also full of risks.
Jia Jia's cholesterol granuloma is located in the petrous apex, which is surrounded by the sphenoid bone, temporal bone and occipital bone. The location is very hidden and the anatomical structure is complex. It is very easy to cause brain tissue traction during surgery, which can easily damage surrounding blood vessels and nerves.
Theoretically, the surgical approach taken by Xu Qiu is the safest and least damaging route to the petrous apex as long as the granuloma does not extend forward to the vicinity of the cerebral peduncle.
However, due to the long operating distance, the technical requirements for the surgeon are very high. In case the lesion is too large, a combined approach has to be adopted, and another incision has to be made in other parts, such as the infratemporal, posterior sigmoid sinus, and supracerebellar pathways.
Swish!
Under the shadowless lamp, Xu Qiu's scalpel cuts smoothly and freely.
Cut off the superior petrous vein.
Separate the trigeminal nerve.
After the dura mater, sigmoid sinus, etc. are completely exposed in the surgical field, Xu Qiu takes out the antibiotic gelatin sponge, covers it strictly on the top, and then fills the surgical cavity in a conventional way.
At this time, everyone has the mind to observe the inside.
Under the bright light, a huge cystic mass was hidden behind the semicircular canal. The area that originally belonged to the endolymphatic sac and the entire petrous apex was completely replaced by granuloma.
The posterior wall of the left external auditory canal was also pushed out by the lesion, and the entire ear canal was blocked.
"No wonder I can't hear..."
"The ear is completely sealed!"
Seeing this scene, everyone in the operating room suddenly realized the cause of deafness.
At the same time, many people frowned with worry.
The ear canal is blocked, what about the auditory structure behind it?
If the auditory system is not damaged, then removing the granuloma and opening the ear canal can restore hearing.
On the other hand, if there is other damage to the auditory system, then removing the tumor at this time is a bit of a remedy after the sheep have been lost... The patient's hearing loss may become irreversible for life.
"The eardrum problem should not be big, it's just the volume of the granuloma..." On the operating table, Xu Qiu's expression was a little serious.
Although the ear canal is closed, in a sense, it is also a protective barrier for the auditory organs in the ear, and generally there will be no problems.
After all, the granuloma itself will not affect other tissues, and all lesions are based on the "space-occupying effect".
But the bad thing is that from the glimpse just now, it can be seen that the patient's cholesterol granuloma may be larger than he imagined!
This not only means that the difficulty of resection increases.
At the same time, it also indicates that the risk of surgery has increased exponentially!
If it is adjacent to the brainstem, occipital foramen, vertebral artery and other parts, it is easy to have dyspnea and cerebral hypertension during the operation; and if it is close to the pontocerebellar angle, jugular foramen, etc., the subsequent exposure difficulty will be far beyond expectations...
"Use the endoscope." Taking a deep breath, Xu Qiu adjusted his mood and prepared to enter the closed ear canal to find out.
Whether the hearing system is damaged and how far the granuloma has spread are all deep in the thick posterior ear wall.
