The article was a case report of a 15 year old female taken from a medical journal in Kuwait. The client complains of intermittent bilateral obstruction and rinorrhea associated with complete nasal obstruction for the last three weeks. History revealed that she had undergone three operations in the past. First, was the operation of her left antrochoanal polyp through simple intra nasal excision which was done twice. A year after she had endoscopic sinus surgery due to the recurrence of the polyp. However, she has not taken any medications after all the surgeries and no complications were reported.
Furthermore, inflammatory polyps has been evident in the specimens from the past three surgeries. Going back to the present condition of the client, a series of tests has been carried out in order to determine the cause of the client’s complaints. She had undergone naso-endoscopy that showed a softnontender mass on her left nasal cavity but there was no bleeding noted upon touching it. The right nasal cavity, oropharnyx, ears and neck were examined as well but revealed to be just normal. She also had Preopertive computerized tomography that still revealed the same result, a mass on her left maxillary sinus.
The latter revealed a diagnosis of Maxillary sinus mucoceles. According to Rollet and Onodi, paranasal mucoceles are less likely found in the maxillary sinuses. Its incidence is higher in the frontal and ethmoid sinus and has been reported to be common in ages 10 years older. It is said to be rare in pediatric cases. There has been no definite reason regarding the cause of these benign, cyst-like masses that are filled with mucus. Some had this ten years after a Caldwell-Luc procedure which caused a formation of the mucocele as a result of entrapped sinus mucosa.
Some had this due to trauma, prior infection and prior allergic history that probably caused the formation of fibrotic bands that interferes with normal drainage. Moreover, symptoms would depend on the expansion, pressure and obstruction brought about by the mucucele. Nasal obstruction is more likely common in maxillary sinus while headaches and visual disturbances in frontal and ethmoid sinus. In the patient’s case, the mucocele was caused by the incomplete removal of the diseased mucosa and inadequate widening of the ostium from her past three surgeries.
In order to manage this, she was subjected to the gold standard test for paranasal mucoceles which is endoscopic endonasal surgery that involves surgical decompression and marsupialization. The mass on her left nasal cavity was excised hrough a microdebrider and a clear yellowish fluid was aspirated from it as a part of the surgery. Thus, no recurrence was found upon a regular follow-up a year after and CT scan that finally revealed bilateral clear sinuses Reaction: “Constant attention by a good nurse may be just as important as a major operation by a surgeon.
” * Dag Hammarskjold Surgery is indeed one of the most interesting and best field in nursing. Its rarity makes you appreciate even the tiniest things in life. In the field of nursing, the article has taught me a lot of things. First is learning to appreciate the privilege that has been given to me now, the privilege to have my staffing rotation in the operating room department. In line with the quotation above, I strongly believe that nurses are as important to every operation a surgeon has to do because we are their partner, their angel.
We share the same responsibility with them and that obliges us to master our skills and keep on learning each day. Each day is a learning, that I believe. Whether you are still a student nurse or already a nurse because learning is lifetime. The article was just one of the many interesting cases about surgery. Even though I already had my OR rotation last semester, I truly admit that last semester’s exposure was not enough and will never be enough. You don’t just stand there and assist the surgeon during the operation, you have to know and understand first the patient’s case.
You have to be sure that’s why a series of tests is always required before coming up with the best solution to the client’s dilemma. Just like the client in the article, she already had three surgeries in the past due to the same complaints. It probably points out to one thing, that further study about the case and its management must have been done before deciding on what could have been the best solution. I certainly agree with the author stating that there could be a number of postulates behind every mucocele formation.
There is no definite reason that is why we need to study, to research in order to discover not just one, two or three but all the causes behind this incidence. And that thought makes me more thankful that I’ll be spending my three months in the operating department. That would mean learning a lot from the people here who we consider experts in surgery because they have chosen and love this field of nursing. Furthermore, this opens up my turning point in life since I am already in my fourth year college. Hopefully after graduation, will come another journey and that’s deciding on what field of nursing I shall be captivating.
I have really appreciated having this reading. Indeed, research is very important in my life as a student nurse. This article supplemented my minimal knowledge in surgery and management. I realized that aside from the fact that nursing research widens our knowledge, it also broadens our horizons in seeing nursing and the practice of it in a better way. Through research, we are able to find better ways to discharge our tasks well and to come up with ways that makes us more efficient in delivering holistic care to our clients.