Major Nasal Set

The nose is an inverted pyramidal structure that consists of an osteocartilaginous framework covered by muscles and skin. It consists of nasal bones and cartilages, including the septal cartilage that separates the nostrils, as well as the upper and lower lateral (alar) cartilages. The septum itself is formed of the columella, the membranous septum and the septum proper. It divides the interior of the nose into right and left nasal cavities. Each cavity communicates with the exterior through a nostril and with the nasopharynx through the posterior nasal aperture or the choana. Each nasal cavity consists of a skin-lined vestibule and a mucosa-lined cavity proper. The lateral wall of the nose features three turbinates (conchae), which are bony projections covered by mucous membrane. The spaces below the turbinates are called meatuses.

Diseases of the external nose include structural deformities, such as saddle or deviated noses. There may also be external congenital tumors such as dermoid cysts, benign tumors, such as rhinophyma, or malignant tumors such as basal cell carcinoma. Diseases of the vestibule include dermatitis (vestibulitis), nasal stenosis or tumors.

Some of these conditions may require a procedure known as rhinoplasty. This is a plastic surgery procedure that is performed to reconstruct the nasal shape, restore the nasal functions or correct the effects of nasal trauma and congenital defects. This can be an open or  a closed procedure. Generally, the nasal skin and the soft tissues are separated from the nasal bones and cartilage. After correction is performed, the incisions are sutured and a stent is applied externally or internally to maintain the corrected frame. Sometimes, a cartilage graft may be harvested from the nasal septum, the costal cartilage, or the ear’s external cartilage. A bone graft may also be taken from the hips or the rib cage.

The nasal septum may also be afflicted by fractures or deviation due to trauma or developmental malformations. A septal abscess may occur secondary to a hematoma. Perforation of the septum may thus be traumatic or due to infection. Septoplasty may be needed to treat these septal deformities.

Other conditions that may require surgical treatment of the nose include granulomatous conditions, foreign bodies, nasal polypi, trauma and/or epistaxis.

The paranasal sinuses are air-containing cavities in certain bones of the skull that have openings to the nasal cavity. Inflammation of these cavities can lead to acute or chronic sinusitis. Chronic rhinosinusitis hat does not improve sufficiently with medical treatment may require a procedure known as endoscopic sinus surgery. This procedure aims to open the drainage pathway of the sinuses in order to reduce sinus infections and improve the delivery of externally sprayed medications.

We at Surtex Instruments recognize the characteristic and highly cosmetic nature of nasal surgeries, especially those procedures done for reconstruction. That is why we offered this versatile surgical set with a wide range of uniquely designed instruments to provide optimal surgical technique and improved post-operative results. Our instruments minimize the risk of bleeding and adhesions with their precise and targeted function. We also included many instruments that are designed to guarantee enhanced surgical visualization in order to prevent excessive or inadequate tissue removal. Atraumatic devices are also available to prevent accidental surgical damage to the delicate nasal tissues.

The set includes the delicate dissecting Metzenbaum scissors, which are optimal for cutting delicate tissues and performing blunt dissections. They have dexterous handles and slender shapes, and come with either sharp or atraumatic blunt blades to suit different surgical needs. We also include the compact iris and strabismus scissors that can trim fine tissues, and are available with straight and curved blades. These fine scissors were designed for eye surgeries, and can be used to provide a superior solution in delicate cutting manipulations for ENT surgeries.

The Joseph Mucus Hook is another delicate tool that can be used to dissect and lift flaps of tissues in nasal procedures, such as allowing access to the nasal dorsum during intercartilagenous rhinoplasty. We also include essential tools for bony procedures, such as the Joseph Periosteal Elevator, as well as the Cottle and Sheehan Osteotomes. Another basic instrument is the Vienna Nasal Speculum, which we provide in different sizes to provide convenience and ease with different patients.

Sinus Surgery Set

 

The paranasal sinuses are air-containing cavities in certain bones of the skull that have openings to the nasal cavity. There are several paired paranasal sinuses, including the frontal, ethmoidal, maxillary and sphenoidal sinuses. The ethmoidal sinuses are further subdivided into anterior and posterior ethmoid sinuses, the division of which is defined as the basal lamella of the middle turbinate.

Acute sinusitis is usually the result of an earlier upper respiratory viral infection, but can also be due to fungal invasion. These attacks can be aggravated in cases of low immunity. Sinus surgery is needed in chronic bacterial sinusitis unresponsive to adequate medical treatment, as well as cases of recurrent acute bacterial sinusitis. Chronic sinusitis means that the inflammation remains in the nose and sinuses and does not go away over time (usually for at least 3 months). They are also indicated for cases of diffuse nasal polyposis, fungal sinusitis, antrochoanal polyps, mucoceles of the frontoethmoid or sphenoid sinuses and removal of nasal foreign bodies.

Frontal sinusitis can cause pain or pressure above the eyes with a headache in the forehead. Among all of the paranasal sinuses, acute frontal sinus bacterial infections have grave intracranial complications. The external approach of frontal sinus surgery is performed to prevent potentially life-threatening complications when the infection is unresponsive to maximal medical therapy or endoscopic sinus surgery. Mucoceles, extensive tumors, and trauma have also been identified as relative risk factors for endoscopic failure with conversion to the external approach. External frontoethmoidectomy can be used for the treatment of acute sinus disease with frontal extension.

Ethmoidal sinusitis can cause pain between the eyes and on the sides of the upper part of the nose. Refractory cases of ethmoid sinusitis are treated with intranasal or external ethmooidectomy.

Sphenoidal sinusitis can cause pain or pressure behind the eyes, but often refers to the top of the head. Chronic sphenoiditis is treated with sphenoidotomy, where access to the sphenoid sinus can be obtained by removal of its anterior wall.

Maxillary sinusitis can cause pain or pressure in the cheek area, as toothache, or headache. There are several documented external approaches for the treatment of chronic maxillary sinusitis. These include the antral lavage, which involves puncturing the medial wall of the maxillary sinus in the region of the inferior meatus and irrigating the cavity. This is indicated in chronic and subacute maxillary sinusitis, but not in acute maxillary sinusitis for fear of osteomyelitis. The thin lateral wall of the inferior meatus is punctured with a trocar and cannula, which are directed towards the ipsilateral ear.

Then, the trocar is removed and the cannula is advanced until it reaches the opposite antral wall. The antrum is then irrigated with a syringe until the wash is clear. Another operation was intranasal inferior meatal antrostomy, in which an opening is made in the nasoantral wall of the inferior meatus by an intranasal route. This operation is now rarely required and has been superseded by functional endoscopic sinus surgery. The Caldwell–Luc operation is a process of opening the maxillary antrum by a sublabial approach and dealing with the pathology inside the antrum. It is also called an anterior antrostomy as access to maxillary sinus is made through the anterior wall of the sinus. An incision cuts through the mucous membrane and periosteum, and a mucoperiosteal flap is raised until the infraorbital nerve to avoid injury of the nerve.

Using cutting burr or gouge and hammer, a hole is made in the antrum. The opening is enlarged using a Kerrison’s punch. Once the maxillary antrum has been opened, the pathology is removed. Diseased antral mucosa can be removed with elevators, curettes and forceps. This includes cysts, benign tumours, foreign bodies or polyps. A curved haemostat is pushed into the antrum from the inferior meatus and then this opening is enlarged with Kerrison’s forceps and side-biting forceps to make a window. The antrum is then packed and the wound is closed.

These procedures require a range of instruments to assist in manipulating and dissecting bony surfaces. Surtex instruments provides heavy-duty instruments for this purpose, such as the Molt Periosteal Raspatory / Elevator, the Blumenthal Bone Rongeur, the Miller-Colburn Bone File, and the Gerzog Bone Mallet.

Another important instrument we provide is the straight Cottle Osteotome is used for dividing and cutting deeply into bones in a straight manner, and are used by otolaryngologists for external osteotomy in rhinoplasty and for bone cuts in maxillectomy and mandibulectomy. The Cleveland Bone Cutting Forcep have precise and sharp jaws that make them useful in a variety of orthopedic or ENT procedures for cutting bone, with enhanced access to narrow surgical fields. The Fergusson Suction Tube can be used in cleaning procedures to remove blood or irrigation fluids, and assists in keeping the surgical field clean and visible.

A maxillary sinus floor augmentation increases the amount of bone in the posterior maxilla by lifting the lower Schneiderian membrane and placing a bone graft. We manufacture a range of Tatum Sinus Lift Curettes for this surgery.  This is a double-ended device that consists of a central cylindrical handle which has two dissimilar curved tips on either side, in order to accommodate and conform to the different anatomical configurations that may be met in maxillary sinus procedures.

Myringotomy

A myringotomy is an operation performed by otolaryngologists to treat patients with complicated otitis media. This inflammatory disease of the middle ear cavity can lead to fluid building up in the middle ear, and is associated with hearing loss, ear pain and fever. If antibiotics fail to treat this condition, chronic or recurrent otitis media may occur, and this may result in bulging eardrums, acute excruciating pain, facial palsy and intracranial complications. This necessitates a myringotomy incision to be made in the ear drum in order to evacuate the middle ear fluid and place an ear (grommet) tube. This procedure helps relieve the pressure inside the middle ear and enables the restoration of hearing.

Surtex Instruments manufacture the instruments required for myringotomy to be carried out by ENT specialists. We manufacture each tool in this myringotomy set to fulfill an important step in the procedure.

Our myringotomy set includes 3 Hartmann Ear Specula, which are cone-shaped  devices used by ENT doctors to dilate the external ear canal and facilitate the examination of the tympanic membrane. The speculum can be attached to an otoscope to add suitable lighting and magnification of the external auditory meatus during the procedure. Otolaryngologists straighten the ear canal in adults by pulling the pinna backwards, laterally and upwards, and in children, by pulling the ear pinna backwards, laterally and downwards. This set includes 3.6 cm long specula with diameters ranging from 3.0 mm to 5.0 mm to suit different patient sizes.

Upon dilating the ear canal, thick ear wax may obscure the operator’s vision and decrease their precision. This ear wax, or cerumen, can be removed using the suitable size and shape of curette from our diverse selection of Buck Ear Curettes. Generally, ENT doctors use Buck curettes to debride and excise tissues as part of a biopsies or cleaning procedures in ear pathologies, and each curette has a long dexterous handle with a straight ring-shaped blade that is suited for this function. We manufacture blunt and sharp curettes with different sizes to clean the ear in a wide range of patient anatomies.

After clearing the wax in the ear canal, our Politzer Tympanum Needle can be used to make a radial incision in the antero-inferior quadrant of the tympanic membrane. The needle consists of a long flat handle, a tapering shaft and a diamond shaped blade. The angled corners of the handle enable the operator to possess optimal control of its manipulations, and the characteristic pointed blade delivers straight and clean-cut edges. The needle has an overall length of 17.5 cm.

Following the tympanic incision, our Baron-Schuknecht Suction Tubes can be used to extract and remove the thick and copious fluid from the middle ear cavity. The suction tube consists of an angled stainless steel catheter. Its outer end is bead-like and is connected to the suction apparatus, while the working slim end is long and cylindrical with diameters available from 1 to 2 mm. The outer portion of the catheter features an oval fenestrated pad that allows the operator to easily stop and initiate the suction process with minimal effort.

Another essential component of the myringotomy set is our fine Hartmann Aural Polypus Forceps. This model of crocodile forceps allows the easy manipulation and placement of a grommet tube in the tympanic incision. The inner jaws of the crocodile blades feature horizontal serrations to grant confident grasps of slippery materials, and the right angle between the finger ring handles and the long shaft allows the operator to easily visualize the blades and obtain maximal precision in placing the grommet tube.  The working length of the forceps is 12 cm.

Troeltsch (Wilde) Ear Forceps are instruments with flat and tapering blades that are generally used to grasp gauzes in aural packing procedures. This is assisted by their flat ridged handles that allow convenient manipulations in the ear canal. Troeltsch Forceps can be used to manipulate grommet tubes in place, and can also be used to deliver antibiotic packs into the ear canal after the myringotomy procedure is completed.

Farrell Cotton Applicators with spiral or triangular shaped ends are also available as part of this set, to enable the operator to add antibiotic-laden cotton pieces into the ear canal.  The applicators are 16 cm long and have a working diameter of 1.1 mm.

Ear Microsurgery Set

The ear consists of three consecutive cavities from outside to inside, that are responsible for the sense of hearing. The outermost cavity is the external auditory canal, which is an air-filled tube that conducts the sound vibrations from the outer ear pinna to the ear drum. The middle ear cavity contains three intricate and articulating bones known as the auditory ossicles, which are the malleus, incus, and stapes (hammer, anvil, and stirrup). It also features a canal known as the Eustachian tube, which connects the middle ear with the nasal cavity and helps to equalize the pressure around the ear drum.

The stapes or the stirrup is the smallest bone in the body, and has a foot that is attached to a membrane known as the oval window. This oval membrane conducts the vibrations of the middle ear ossicles to the inner ear vestibule. The ossicles help amplify the sound vibrations to the inner ear’s cochlea, which transmits the auditory information via the eighth cranial nerve to the brain’s auditory cortex.

Damage to any component in this continuum of structures, from the tympanic membrane to the foot of the stapes, can lead to hearing defects and may require surgical intervention.

The tympanic membrane consists of three layers of thin tissues. Perforation of the ear drum due to trauma or infection damages the integrity of the tissues, and affects the ear drum’s function in transmitting sound. This may also occur in condition known as tympanosclerosis, which leads to fibrosis and thickening of the ear drum. Otosclerosis is the development of pathological firm tissue in the middle ear that prevents the ossicles from conducting sound properly. Inflammations of the middle ear cavity can also lead to fluid building up in the middle ear, and this condition, known as otitis media, is associated with hearing loss, ear pain and fever.

Tympanoplasty may be needed to reconstruct the eardrum or the small bones of the middle ear in such cases of conductive hearing loss. Grafting of the ear drum may be needed, and this requires taking thin layers of tissue from the tragus or temporalis fascia.This procedure may also be accompanied with the exploration of the mastoid bone, especially in cases of mastoiditis that can result from untreated otitis media. Any of several types of tympanoplasty can be performed depending on the extent of the ear drum and ossicular damage. In these procedures, the surgeon may require a microscope to properly view the small ear structures and grafts. This operation also requires microsurgical instruments with small blades that can reliably grasp and mobilize delicate tissues and ultra-fine materials. Micro-Hooks with relatively small and angled blades are also needed to extract and remove scarred or pathological tissues.

Surtex Instruments manufacture the ear microsurgery set to deliver the best results in these delicate manipulations. This includes a wide variety of self-retaining retractors, such as the Plester Self Retaining Retractor, and ear specula, such as the Hartmann Ear Specula, to open and maintain the surgical field. Hemostatic forceps, such as the straight Rochester-Pean Haemostatic Forcep, are also available to decrease bleeding and maintain clarity. Several figures of micro ear needles are included. These tools are used to perform different and gentle manipulations like freshening the margins of ear drum perforations. Barbara needles with tips that are angled at 25°, 45°, 90° or are curved down, are also available to accommodate different anatomical and surgical indications.

Bellucci Micro Scissors are fine-cutting scissors that can deliver optimal cuts of vital and fragile structures such as the tympanic membrane, minute muscles like the tensor tympani and the stapedius, or nerves such as the chorda tympani. The scissors have dexterous finger ring handles and a prolonged shaft to reach anatomically narrow sites. The Plester Flap Knive is another important instrument in procedures in myringoplasty, tympanoplasty and ossiculoplasty to mobilize tympanomeatal flaps. The McGee Micro Ear Needle is specialized for stapedectomy procedures, to excise pieces of broken footplate and reshape tympanic perforations before placing grafts.

The Rosen Circular Cut Knife is another superior instrument that is designed to raise ear canal skin flaps during tympanoplasty procedures. The advantage of using this knife is that it causes minimal bleeding because it has a duller blade and crushes the blood vessels more firmly. Wullstein Sickle Knives are used to cut through mucosa, freshen eardrum perforations, remove adhesions and excise tendons like that of the stapedius muscle.

Middle Ear Set

The middle ear is a six-sided box with that is bounded laterally by the tympanic membrane and medially by the labyrinth of the inner ear. It is connected to the nasal cavity by the Eustachian tube, and contains the auditory ossicles. The roof separates it from the cranial cavity, the floor separates it from the jugular bulb, the anterior wall separates it from the internal carotid artery, and the posterior wall lies close to the mastoid air cells. The upper and outer part of the middle ear is known as the attic, and it communicates with a large, air-containing space in the upper part of mastoid, known as the mastoid antrum.

The function of the middle ear is conducting the sound vibrations from the tympanic membrane, through the auditory ossicles (malleus, incus and stapes), to the oval window and the inner ear’s cochlea. The Eustachian tube connects the middle ear with the nasal cavity and helps to equalize the pressure around the ear drum.

Damage to the structures conducting sound, from the tympanic membrane to the foot of the stapes, can lead to hearing defects and may require surgical intervention. This includes conditions such as acute suppurative otitis media, which is an acute inflammation of the middle ear by pyogenic organisms. If this condition is not treated properly by antibacterials, a surgical procedure known as myringotomy may be needed. It involves incising the drum to remove the fluid surgically and evacuate the pus.

Severe acute necrotizing otitis media may damage the whole tympanic membrane and require a procedure known as tympanoplasty. Affection of the mastoid air cells in long standing otitis media may require cortical mastoidectomy. Cases of otitis media with non-purulent effusion may also require myringotomy, especially when the fluid is thick and medical treatment does not help. If the condition recurs after myringotomy, a grommet tube maybe inserted to provide sustained aeration of the middle ear. The tube can be left in place for weeks or months or until it is spontaneously extruded.

Myringotomy may also be performed for cases of otitic barotrauma, which occurs when the eustachian tube fails to maintain middle ear pressure at during rapid descent of air flights or in underwater diving. Alternatively, catheterization or politzerization can be used to restore middle ear aeration.

Surtex Instruments manufacture the Middle Ear Set with a wide range of instruments to perform these procedures with superior results. Farrior Ear Specula are cone-shaped tools that are attached to otoscopes to allow the focused inspection of the external auditory meatus and the ear drum. The speculum has a blunt atraumatic tip, and is covered with a black coating to avoid the glare caused by the reflection of light from the otoscope.

Upon dilating the ear canal, thick ear wax may obscure the operator’s vision and decrease their precision. This ear wax, or cerumen, can be removed using the suitable size and shape of curette from our diverse selection of Buck Ear Curettes. Two sizes of Frazier Suction Tubes and three sizes of Baron-Schuknecht Suction Tube are available to be used in cleaning procedures. The suction allows for quick and easy removal of excess amounts of cerumen and thick fluid in otitis media.

This set offer instruments that can serve to deliver precise cutting action includes fine scissors such as the curved Mayo Dissecting Scissor, the straight and curved Strabismus Scissor, as well as the reinforced UltraCut™ TC Metzenbaum-Fine Dissecting Scissor. The Rosen Circular Cut Knife is another superior instrument that is designed to raise ear canal skin flaps during tympanoplasty procedures. It decreases bleeding because it crushes the blood vessels firmly with its blunt blades. Wullstein Sickle Knives are used to cut through mucosa, freshen eardrum perforations, remove adhesions and excise tendons like that of the stapedius muscle. Bellucci Micro Scissors can deliver optimal cuts of vital and fragile structures such as the tympanic membrane, minute muscles like the tensor tympani and the stapedius, or nerves such as the chorda tympani. House-Dieter Malleus Nippers are used to trim the head of the malleus and parts of the incus. The House Micro Ear Curette is a double-ended surgical instrument used to excise bone fragments in mastoid surgery, stapedotomy, facial nerve decompression and tympanoplasty. Langenbeck retractors are used to retract soft tissues and wound edges in order to enhance the visualization of deep structures in mastoid procedures.

Tympanoplasty And Stapedectomy Set

The tympanic membrane is a three layered membrane that is the window of the middle ear cavity. It is important for the conduction of sound from the external auditory canal to the auditory ossicles (malleus, incus and stapes), which then conduct the sound to the inner ear’s cochlea. The normal ear drum is shiny and pearly grey in colour, with a bright cone of light can be in the anteroinferior quadrant. A normal tympanic membrane is mobile when tested with pneumatic otoscope or Siegle’s speculum.

Diseases of tympanic membrane may be primary or secondary to conditions affecting the external ear, middle ear or eustachian tube. Some condition may be self-resolving, such as tympanic retraction caused by eustachian tube blockage. Injury and perforation can occur to the tympanic membrane from a variety of reasons. This includes acute suppurative otitis media, which is an acute inflammation of the middle ear by pyogenic organisms. Severe acute necrotizing otitis media may damage the whole tympanic membrane. A choleasteatoma developing in the middle ear may also affect the membrane integrity.  Another reason for damage of the membrane is otitic barotrauma, which occurs when the eustachian tube fails to maintain middle ear pressure in descending flights or underwater diving. Affection of the eardrum leads to conductive hearing loss.

Tympanoplasty is a procedure performed by otolaryngologists to eradicate disease in the middle ear and to reconstruct the hearing mechanism. It may be combined with mastoidectomy. The procedure may involve repair of the tympanic membrane only (myringoplasty), reconstruction of the ossicular chain (ossiculoplasty), or both (tympanoplasty). This can be done with the placement of a tympanic membrane graft. Surtex Instruments manufacture this tympanoplasty set with specifically designed  microsurgical instruments to facilitate this surgery with all its types and deliver optimal results.

Myringoplasty is the repair of the tympanic membrane alone. Graft materials can be harvested from the temporalis fascia. Repair can be with the underlay technique, where margins of perforation are freshened and the graft placed medial to the perforation or the tympanic annulus. This graft can be supported by gelfoam in the middle ear. The overlay technique can also be used, where the graft is placed lateral tympanic membrane. In ossicular reconstruction, several types of prosthesis can be used to replace the ossicles, such as with autografts that have been shaped to fill the gap. The types of prosthesis include incus prosthesis, incus–stapes prosthesis, partial ossicular replacement prosthesis (PORP) or total ossicular replacement prosthesis (TORP).

Stapedectomy is a procedure performed in cases of otosclerotic fixation of the stapes footplate. Here the fixed stapes is removed and a prosthesis, such as a teflon prosthesis, is inserted between the incus and the oval window. This leads to great improvement in hearing in a majority of patients.

Lempert Periosteal Elevators are used to elevate the periosteum in several surgeries such as mastoidectomy and the Caldwell-Luc operation. The Plester Self Retaining Retractor is used in different surgical procedures, such as mastoidectomy and tympanoplasty, to maintain the surgical field open in order to allow the surgeons to be free for important surgical manipulations. The set also includes Plester Flap Knives, which are used in middle ear procedures such as myringoplasty, tympanoplasty and ossiculoplasty to mobilize tympanomeatal flaps. Sexton Myringotomy Knives can serve to perform superior and clean incisions in the tympanic membrane to relieve serous or severe acute otitis media. The Fisch Micro Dissector is a double angled instrument that can be used in different ear procedures to perform clean-cut separations of soft tissues.

The Politzer Furuncle Knife is used to make clean-cut incisions in ear procedures using a characteristic and sharp diamond shaped blade. A Barbara Micro Ear Needle is an angled tool used to move and position delicate tissues in ear microsurgeries, such as tympanoplasty procedures. The House Micro Ear Curette is a double-ended surgical instrument used to excise bone fragments in mastoid surgery, stapedotomy, facial nerve decompression and tympanoplasty. Micro Alligator Forceps are fine finger-ring forceps used in micro-otology procedures to move and excise delicate tissues in the narrow spaces of the ear. House-Dieter Malleus Nippers are used in middle ear procedures to trim the head of the malleus and parts of the incus. The nipper has finger ring handles that allow efficient and controlled manipulations.

Basic Throat Surgery

The throat consists of the pharynx, the larynx and the trachea. It acts as the vital channel for the passage of air into the lungs (through the larynx and trachea) and the food into the stomach (through the pharynx and esophagus). It also has several anatomical structures that may require surgical manipulations during times of disease. These structures include the tonsils, adenoids, vocal cords, trachea and thyroid gland.

The tonsils are lymphoid tissues at the back of the throat. They are an important part of the body’s immune system. It is part of the Waldeyer’s tonsillar ring of tissues, which also includes the adenoid tonsil, two tubal tonsils and the lingual tonsil. These lymphoid tissues may be inflamed repeatedly and need removal in a procedure called tonsillectomy. Sometimes, the removal of the adenoid tissues is also required, and this is known as adenoidectomy. Tonsillectomy and adenoidectomy often are performed at the same time in a procedure called adenotonsillectomy. Tonsillectomy with or without adenoidectomy is one of the most common surgical procedures performed in children.

An adeno-tonsillectomy procedure is usually performed under general anesthesia. Otolaryngologists and anesthesologists are cautious during this procedure as it involves a shared airway between the two specialties. During the procedure, the patient is placed on a monitor to observe their oxygen saturation, so that no obstruction of their breathing occurs.   At the end of the procedure, an otolaryngologist is cautious to remove the inflamed tissues adequately, and that the bleeders are properly stopped. This set includes a wide variety of tonsillectomy instruments, such as the Henke Tonsil Elevator, the Schnidt Tonsil Haemostatic Forcep and the teethed Blohmke Tonsil Grasping Forcep.

The larynx is the anatomical box that is responsible for our voice. It performs that function because it contains the vocal cords and resides as a continuation above the trachea. As the air passes outwards from the lungs during expiration, a set of muscles move the vocal cords to make the sounds of speech. The structures of the larynx may be affected by benign or malignant tumors. The most common benign tumours in the larynx are papillomas. Such tumors may affect the person’s voice or breathing and require dissection and removal.

The trachea is also known as the wind-pipe, and it carries the air we breathe down to the lungs. Obstruction of this flow of air by a foreign body or a mass may lead to emergency and life-threatening situations. Foreign bodies can be removed by procedures known as laryngoscopy, where the inner lumen of the airways is directly or indirectly visualized, and forceps are used to remove the intruding material.

Patients with chronic upper airway obstruction by a tumor, and patients who have respiratory difficulty who require long-term invasive ventilation, may require a procedure known as a tracheostomy. In this procedure, an incision is made in the anterior aspect of the neck and trachea to bypass a higher obstruction or avoid the need for a long-term ventilation. In this procedure, the skin, the subcutaneous tissues and the muscles at the front of the trachea are properly incised and retracted to visualize the anterior surface of the trachea. After an incision in the trachea is made and dilated properly, a tracheostomy tube is inserted to maintain the opening after the procedure.

The thyroid gland is a bi-lobar endocrine gland that secretes thyroid hormones into the blood to regulate metabolism and various bodily functions. The gland lies in front of the trachea, and sometimes, when the gland enlarges and forms a goitre, this leads to the affection of breathing. An increased release of thyroid hormones may also affect the heart and cause a condition known as thyrotoxicosis. In other cases, the gland may enlarge due to a tumor. The surgery in which the thyroid gland is removed is known as a thyroidectomy.

We at Surtex Instruments manufacture this basic throat surgery set to cover a wide variety of manipulations and procedures. This includes instruments to increase the visualization of the surgical site, such as the Volkmann retractors and instruments to move the soft tissues, such as the  Bruenings Tongue Depressor.

We also provide instruments for cutting, dissection and trimming tissues, using a wide assortment of handles and blades to suit different surgical preferences. This includes the Reynolds Dissecting Scissor, the Metzenbaum Dissecting Scissor and the UltraCut™ TC Metzenbaum-Lahey Dissecting Scissor.

We also manufacture a range of hemostatic forceps for critical procedures, such as tonsillectomy, which require impeccable postoperative results, as bleeding in this area can lead to life-threatening respiratory obstruction.  These include Birkett Haemostatic Forceps, and Negus Haemostatic Forceps. Versatile surgical tools are also included, such as the Allis Intestinal and Tissue grasping forceps which can be used to hold and place gauze materials in packing procedures and stopping bleeders. The     Fergusson Suction Tube is also included to aid in removing blood and fluids in order to optimize the surgical field.

Basic Ear Set

Otology is the medical specialty that deals with the disease conditions of the ear. The ear consists of three consecutive cavities from outside to inside, that are responsible for the sense of hearing. The outer ear consists of the ear pinna and the external auditory canal. The canal is an air-filled tube that conducts the sound vibrations to the ear drum. The middle ear cavity is a six-sided box with that is bounded laterally by the tympanic membrane and medially by the labyrinth of the inner ear. It is connected to the nasal cavity by the Eustachian tube. It contains three intricate and articulating bones known as the auditory ossicles, which are the malleus, incus, and stapes (hammer, anvil, and stirrup). The inner ear contains the cochlea which is responsible for hearing and the labyrinth that is responsible for the sense of balance.

Diseases of the ear include hearing loss due to conductive defects, foreign body impactions in the external ear, infections such as otitis media, ear pain and tinnitus. Surtex Instruments manufacture the diverse instruments of the Basic Ear Set to enable and assist otologists in delivering superior diagnostic and therapeutic procedures to properly manage this wide range of diseases.

The set includes 3 models of the Hartmann Ear Specula. They are streamlined cone-shaped devices that facilitate the examination of the external ear canal. Each speculum can be attached to an otoscope to obtain proper lighting and magnification, and has a converging cylindrical tip that can be gently inserted into the external ear canal. In adults, the otolaryngologist straightens the canal by pulling the pinna backwards, laterally and upwards, and in children, the ear pinna should be pulled backwards, laterally and downwards.

Upon dilating the ear canal, thick ear wax may obscure the operator’s vision and decrease their precision. The otolaryngologist can remove this ear wax, or cerumen, using one of two profiles of Buck Ear Curettes. These devices are also used to debride and excise tissues as part of a biopsies or cleaning procedures in ear pathologies. Frazier Suction Tubes are also added to facilitate irrigation during cleaning procedures of the external auditory meatus. These tubes feature a dexterous thumb-interruption feature that enables proper control of the start and end of suctioning.

Jansen Ear Forceps are bayonet-shaped flat-handle devices used by otolaryngologists for aural procedures, such as packing and removal of foreign bodies. The serrations on the handles offer a more competent grip for the operator, and the bayonet-shaped shafts are designed to give a more direct line of vision to the blades. The serrated jaws of the forceps are ideal for securely handling a wide range of materials

We also manufacture a range of surgical instruments for the open surgical procedures in the ear, Weitlaner Retractors and the blunt Jansen Retractors are optimal tools to maintain self-retained retractions of wound edges, thus freeing the operator’s hands to more important manipulations. Our Langenbeck retractors can also be used to retract soft tissues and wound edges in order to visualize deeper structures, in addition to the Allport Wound Spreader which has 4 x 4 Sharp Prongs. The Freer Septum Elevator is a long slender instrument that can be used for periosteal elevation in bony procedures. It is used in myringoplasty operations to separate the temporalis fascia. The elevator consists of a central holding shaft and two curved flat blades, where one end is sharp and the other end is blunt to fit a wide range of surgical manipulations.

Good hemostasis is essential for clarity of the surgical field to deliver a proper surgical technique. Therefore, we included several hemostatic forceps such as the straight Halsted-Mosquito Haemostatic Forceps and the Kely Haemostatic Forceps.

If dissections are needed of small ear structures, curved Strabismus scissors can be used to trim fine tissues and provide a superior solution in delicate cutting manipulations for ENT surgeries.  Several finely designed dissecting scissors are also included for firmer cutting and trimming. These include the curved UltraCut™ TC Mayo Dissecting Scissor and the UltraCut™ TC Metzenbaum-Fine Dissecting Scissors, which feature resilient performance with reinforced tungsten carbide materials.

Versatile surgical tools are also included, such as the Allis Intestinal and Tissue grasping forceps which can be used to hold and place gauze materials in packing procedures and stopping bleeders, and the Backhaus Towel Clamps which are used for grasping tissues, towels or drapes and mobilizing bone fractures.