Chapter 994 The head is still there? There is still hope!

This was something Xu Qiu couldn't predict.

The effect of the surgery and whether the patient can recover hearing after the removal all depend on the condition of the blocked area.

As he spoke, Xu Qiu had already taken the high-resolution endoscope from the instrument nurse.

He unfolded the endoscope and accurately entered the deep part of the ear canal along the route. Under the guidance of the built-in light, he passed through the closed back wall of the external auditory canal.

Squeak--

Xu Qiu's wrist shook slightly, and the endoscope kept rubbing against the back wall. The next moment, it entered the deep part at a tricky angle.

The built-in light shone through the ear, and a gray-white, translucent film appeared in everyone's sight.

Seeing the intact eardrum on the screen, everyone, including Xu Qiu, breathed a sigh of relief unconsciously.

The structure is intact, which means that the patient's hearing will not be greatly damaged after the operation!

At the same time, many people swallowed their saliva.

This shake of Xu Qiu's wrist was too outrageous...

Only when you are on the operating table can you know how big the gap is between the theoretical operation in the textbook and the practice.

Take suturing for example. For a surgical expert, a slight movement of the finger can make a perfect circle.

However, if other doctors really go to the operating table, it is already difficult to suturing step by step, not to mention using these superb skills.

If they also learn to make circles, the silk thread will immediately become a tangled mess.

The same is true for Xu Qiu's detour into the ear.

Without sufficient intervention experience and the ability to control the lesion itself, it is impossible to do it.

Everyone was amazed at the effort, and the endoscope slowly patrolled, exposing the entire granuloma on the screen.

In the picture, the granuloma cyst wall is thick, the border is clear, and brown-yellow cystic fluid and cholesterol crystals can be seen in the wide cyst cavity.

In addition, the volume of the lesion exceeded expectations.

The upper part of the granuloma directly reaches the outside of the dura mater and reaches the position of the temporal lobe.

The lower part is located at the jugular bulb.

The posterior wall of the external auditory canal, mastoid canopy, tympanic sinus cover, and epitympanic tegmentum bone surrounding this area were all damaged.

When Xu Qiu tried to fiddle with the granuloma, a scene that shocked everyone appeared.

The swollen cyst was attached to the dura mater. Although the ossicular chain was not damaged, it was surrounded by granulation tissue, and the entire Eustachian tube opening was also covered by granuloma.

"Fuck..."

"This is no longer a granuloma, but normal tissues are mixed in the granuloma!"

In the operating room, everyone's cognition was refreshed by the scene in front of them.

Judging from the breadth of the affected area, this is already a huge granuloma that can be written into an article.

"Benign or malignant?" The assistant swallowed and asked in a low voice.

Xu Qiu stared at the screen and did not give an answer immediately.

It is relatively easy to distinguish between benign and malignant cholesterol granulomas. Experienced doctors can even distinguish them with the naked eye from a macroscopic level.

For example, benign granulomas are often rich in fluid, and their morphology and spread are consistent with the patient's anatomical structure, and they will not invade adjacent bones.

However, Jia Jia obviously does not meet this requirement.

Her granulation tissue has a tendency to grow wildly, blocking the external auditory canal, blocking the tympanic sinus, tympanic cavity, Eustachian tube orifice, etc., and forming thick-walled cysts of inflammatory tissue.

This is obviously closer to malignant transformation, which is consistent with the characteristics of invasive variant granulomas.

This means that the difficulty of surgery has risen again.

For this reason, almost everyone looked at Xu Qiu at the same time, with a little more uneasiness.

The current situation is somewhat out of control. Can Dr. Xu still control it?

In response to this confusion, there is an order.

Xu Qiu retracted his gaze and said lightly while extending his hand: "High-speed drill."

The next step is to expand the radical mastoidectomy.

Of course, on this basis, the lesions in the petrous bone must be clear.

"Dr. Xu." The instrument nurse handed the drill to Xu Qiu.

Xu Qiu held it without stopping, and then went down and began to remove the air chamber at the bottom of the petrous bone.

This link has many steps.

First, the small chamber at the bottom of the petrous bone is removed, and then the internal carotid artery canal is exposed, and the air chamber and loose bone at the petrous apex are cleaned, etc. ...

After completing all this, the granuloma can be completely exposed in the surgical field.

"Drainage, decompression, prepare the suction device."

In the second hour of the operation, Xu Qiu put down the curette and diamond drill, closed his eyes slightly, and relieved his dry eyes.

At this time, the resection was almost over.

After Xu Qiu used various methods such as biting, cutting, and grinding to expand the surgical field of the petrous apex area, the entire boundary of the granuloma was exposed in the picture.

Next, it can be removed according to the clear cyst wall.

After a short rest, Xu Qiu took the knife again.

First, drainage.

Clusters of chocolate brown cystic fluid flowed out from the inside of the granuloma lesion, and the huge mass was also shrinking at a speed visible to the naked eye.

After completing the decompression, Xu Qiu began to remove the cyst wall.

At the same time, the assistant also used a suction device to continuously suck out the diseased tissue, and simultaneously used saline to wash the tissue fragments and blood stains, and the contaminated water was sucked out again...

In the fourth hour of the operation, the last attachment of the granuloma to the human body was cut open by a scalpel.

Pah--

The pink tumor was transferred to the surgical tray. There was still chocolate liquid residue on it, as well as various brown, light green, and white sticky secretions, etc. The appearance alone was disgusting.

However, the tumor was finally completely separated from the patient.

Everyone breathed a sigh of relief.

During this time, Xu Qiu was not idle. He took out a tubular silicone plate and placed it in the lesion area. This material can prevent the accumulation of local cholesterol crystals, thereby fundamentally eliminating the regeneration of granulomas.

It is the simplest and crudest means to inhibit recurrence.

At this point, the operation was completely over.

…

After leaving the operating room, everyone still felt dumbfounded.

This operation involved too many delicate operations, and the granuloma removed was unprecedentedly huge... so that until now, they have not fully recovered.

"This is not a short-term growth. I guess mastoiditis had already occurred when I wore hearing aids. It's just that the cause was not investigated at the time, which led to the development of today..." someone said.

Hearing this, many people nodded secretly.

This scale must be the result of long-term accumulation.

In other words, if the doctor at that time was more careful and the examination was more in-depth when Jia Jia's hearing decreased a year ago, today's surgery could have been avoided.

"It's not that simple." Xu Qiu, who was surrounded in the middle, shook his head.

Cholesterol granuloma is a rare disease with an incidence rate of only about 6 in 10 million.

No one would consider a patient with hearing loss and intermittent deafness in the clinic. Even if they thought of it, there were no characteristic symptoms in the early stage, and CT, otoscope, etc. might not be able to see it.

If Jia Jia had not already had abnormal symptoms such as being unable to shrug and vomiting, even Xu Qiu would not have thought in this direction.

In short, it is a great fortune to be able to discover and remove the lesion before the hearing is seriously damaged.

After walking out of the operating channel, Xu Qiu explained the postoperative matters to the grateful family members and rushed to the office.

There was too much work to do, so he couldn't relax for a moment... After all, taking some medicine after the operation and continuing medical research was the correct way to rest.

But before he reached the office, the ward in front of him started to make noise.

Before Xu Qiu approached, a loud slap was heard from the crowded crowd.

Fortunately, he was in the hospital. Unless his head was knocked off, he could be rescued at any time... Xu Qiu was not panicked at all. He put his hands in his white coat and walked towards the crowd without looking away.