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178. Lous J, Burton MJ, Felding JU, Ovesen T, Rovers MM, Williamson I (2005), Grommets (ventilation tubes) for hearing loss associated with otitis media with effusion in children. Cochrane Database Syst Rev. (1):Cd001801.
179. Cheng ATL, Young NM (1997), Middle ear effusion in children. The Indian Journal of Pediatrics. 64(6):755-761.
180. Thakur JS, Chauhan I, Mohindroo NK, Sharma DR, Azad RK, Vasanthalakshmi MS (2013), Otoacoustic Emissions in Otitis Media with Effusion: Do They Carry any Clinical Significance? Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India. 65(1):29- 33.
181. François M, Dehan E, Carlevan M, Dumont H (2016), Use of auditory steady-state responses in children and comparison with other electrophysiological and behavioral tests. European Annals of Otorhinolaryngology, Head and Neck Diseases. 133(5):331-335.
182. Jadranka Handi, Bo`o Radi, Tomica Bagatin, Aleksandar Savi (2012), Hearing in Children with Otitis Media with Effusion – Clinical Retrospective Study.
183. Ravicz ME, Rosowski JJ, Merchant SN (2004), Mechanisms of hearing loss resulting from middle-ear fluid. Hearing research. 195(1-2):103- 130.
184. Joanne Roberts, Hunter L (October 2002), Otitis Media and Children's Language and Learning. The ASHA Leader. 7:6-19.
185. Mutlu C, Odabasi AO, Metin K, Basak S, Erpek G (1998), Sensorineural hearing loss associated with otitis media with effusion in children. International journal of pediatric otorhinolaryngology. 46(3):179-184.
186. Harada T, Yamasoba T, Yagi M (1992), Sensorineural hearing loss associated with otitis media with effusion. ORL; journal for oto-rhino- laryngology and its related specialties. 54(2):61-65.
187. Aithal V, Aithal S, Pulotu L (1995), Otitis media with effusion in children: an audiological case series study. Papua and New Guinea medical journal. 38(2):79-94.
188. Richard m. Rosenfeld, Larry culpepper, Barbara yawn, Martin c. Mahoney (2004), Otitis media with effusion. Pediatrics. 113(5):1412- 1429.
189. Rinaldo A, Ferlito A (2000), The pathology and clinical features of “glue ear”: a review. European Archives of Oto-Rhino-Laryngology. 257(6):300-303.
190. Kotaška K, Hanousková L, Průša R, Borský J, Dytrych P, Jurovčík M (2021), Hyaluronic acid concentration in the middle ear fluid as an indicator of severity of the secretory otitis in newborns with cleft palate. Acta biochimica Polonica. 68(4):795-797.
191. Choi H, Lee D, Hong Y, Kim DK (2019), Analysis of factors associated with multiple ventilation tube insertions in children with otitis media with effusion. The Journal of Laryngology & Otology. 133(4):281-284.
192. Ohnishi T, Shirahata Y, Fukami M, Hongo S (1985), The Atelectatic Ear and its Classification. Auris, nasus, larynx. 12:S211-S213.
193. Tran Anh Van (2016), Study on clinical characteristics, tympanic membrane perforation and clinical course after tympanic membrane ventilation tube placement in children [Master's thesis in Medicine], Hanoi Medical University.
194. Mandel EM, Casselbrant ML, Kurs-Lasky M (1994), Acute otorrhea: bacteriology of a common complication of tympanostomy tubes. The Annals of otology, rhinology, and laryngology. 103(9):713-718.
195. Steven Gray RPL (1993), Tympanic membrane - tympanostomy tubes.
Vol 2: Mosby.
196. Dohar J, Giles W, Roland P, et al. (2006), Topical ciprofloxacin/dexamethasone superior to oral amoxicillin/clavulanic acid in acute otitis media with otorrhea through tympanostomy tubes. Pediatrics. 118(3):e561-569.
197. Alaraifi AK, Alkhaldi AS, Ababtain IS, Alsaab FA (2022), Predictors of tympanostomy tube extrusion time in otitis media with effusion. 43(7):730-734.
198. Yaman H, Yilmaz S, Guclu E, Subasi B, Alkan N, Ozturk O (2010), Otitis media with effusion: Recurrence after tympanostomy tube extrusion. International journal of pediatric otorhinolaryngology. 74(3):271-274.
199. Alamgir A (2018), Comparison of Outcome of Myringotomy Alone with Myringotomy and Tympanostomy Tube (Grommet) in Otitis Media with Effusion (OME). 22:140-143.
200. Doyle WJ, Mandel EM, Seroky JT, Swarts JD, Casselbrant ML (2013), Reproducibility of the forced response test in children with chronic otitis media with effusion. Otology & neurotology : official publication
of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 34(1):16-21.
201. Swarts JD, Teixeira MS, Banks J, El-Wagaa J, Doyle WJ (2015), A method to assess the accuracy of sonotubometry for detecting Eustachian tube openings. European archives of oto-rhino-laryngology
: official journal of the European Federation of Oto-Rhino- Laryngological Societies. 272(9):2111-2119.
202. Morris MS (1999), TYMPANOSTOMY TUBES: Types, Indications, Techniques, and Complications. Otolaryngologic clinics of North America. 32(3):385-390.
203. Hawke M, Keene M (1981), Artificial eustachian tube-induced keratin foreign-body granuloma. Archives of otolaryngology. 107(9):581-583.
204. Abdel-NabyAwad OG (2016), Timing for Removal of Asymptomatic Long-Term Ventilation Tube in Children. Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India. 68(4):406-412.
205. Golz A, Goldenberg D, Netzer A, et al. (1999), Cholesteatomas associated with ventilation tube insertion. Archives of otolaryngology-- head & neck surgery. 125(7):754-757.
APPENDIX
SOME IMAGES IN THE STUDY
Cleft palate disease
Photo 1 KHVM type B 2 sides
MSBA. 1809237502
Photo 2 C-shaped KHVM 1 side MSBA. 1906297842 | |
Photo 3 C-shaped KHVM on both sides MSBA. 1809237546 |
Photo 4 D-shaped KHVM on both sides MSBA. 1806217649 |
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Car body electrical practice - 8
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If the voltage is out of specification, replace the wire or connector.
If the voltage is within specification, install the front fog light relay and follow step 5.
Step 5 Check the front fog light switch
- Remove the D4 connector of the fog light switch
- Use a multimeter to measure the resistance of the front fog light switch.
Measurement location
Condition
Standard
D4-3 (BFG) -D4-4 (LFG)
Light switchFront Fog OFF
>10kΩ
D4-3 (BFG) -D4-4 (LFG)
Front fog light switchON
<1 Ω
- Standard resistor
D4 connector is located on the combination switch assembly.
If the resistance is out of specification, replace the combination switch (the fog light switch is located in the combination switch).
If the resistance is within specification, follow step 6.
Step 6 Check wiring and connectors (front fog light relay-light selector switch)
- Disconnect connector D4 of the combination switch assembly
- Use a voltmeter to measure the voltage value of jack D4 on the wire side.
Measurement location
Control modecontrol
Standard
D4-3 (BFG) - (-) AQ
TAIL
11 to 14 V
D4 connector for the wiring of the combination switch assembly
If the voltage does not meet the standard, replace the wire or connector.
If the voltage is within standard, there may have been an error in the previous measurements.
Step 7 Check the front fog lights
- Remove the front fog light electrical connector.
- Supply battery voltage to the fog lamp terminals
Jack 8, B9 of front fog lamp on the electrical side
blind first.
Power supply location
Terms and Conditions
Battery positive terminal - Terminal 2Battery negative terminal - Terminal 1
Fog lightsbefore morning
- If the light does not come on, replace the bulb.
If the light is on, re-plug the jack and continue to step 8.
Step 8 Check wiring and connectors (relay and front fog lights)
- Disconnect the B8 and B9 connectors of the front fog lights.
- Use a voltmeter to measure voltage at the following locations:
Measurement location
Switch location
Terms and Conditions
B8-2 - (-) AQ
Electric lock ON TAIL size switchFog switch ON
11 to 14 V
B9-2 - (-) AQ
Electric lock ONTAIL size switch Fog switch ON
11 to 14 V
B8 and B9 connectors on the front fog lamp wiring side
Voltage is not up to standard, repair or replace the jack. If up to standard, there may have been an error in the measurement process.
2.2.4. Procedure for removing, installing and adjusting fog lights 1. Procedure for removing
- Remove the front inner ear pads
Use a screwdriver to remove the 3 screws and remove the front part of the front inner ear liner
-Remove the fog light assembly
+ Disconnect the connector.
+ Use a screwdriver to remove 3 screws to remove the fog light cover
2. Installation sequence
-Rotate the fog lamp bulb in the direction indicated by the arrow as shown in the figure and remove the fog lamp from the fog lamp assembly.
-Rotate the fog light bulb in the direction indicated by the arrow as shown in the figure and install the light into the fog light assembly.
- Use a screwdriver to install the fog light cover
-Install the electrical connector
Attention: Be careful not to damage the plastic thread on the lamp assembly.
- Install the front inner ear pads
Use a screwdriver to install the front inner bumper with 3 screws.
3. Prepare the vehicle to adjust the fog light convergence. Prepare the vehicle:
- Make sure there is no damage or deformation to the vehicle body around the fog lights.
- Add fuel to the fuel tank
- Add oil to standard level.
- Add engine coolant to standard level.
- Inflate the tire to standard pressure.
- Place spare tire, tools and jack in original design position
- Do not leave any load in the luggage compartment.
- Let a person weighing about 75 kg sit in the driver's seat.
4. Prepare to check the fog light convergence
a/ Prepare the vehicle status as follows:
- Place the car in a dark enough place to see the lines. The lines are the dividing line, below which the light from the fog lights can be seen but above which it cannot.
- Place the car perpendicular to the wall.
- Keep a distance of 7.62 m between the center of the fog lamp and the wall.
- Park the car on level ground.
- Press the car down a few times to stabilize the suspension.
Note: A distance of approximately 7.62 m is required between the vehicle (fog lamp center) and the wall to adjust the convergence correctly. If the distance of 7.62 m cannot be achieved, set the correct distance of 3 m to check and adjust the fog lamp convergence. (Since the target area varies with the distance, please follow the instructions as shown in the figure.)
b/ Prepare a piece of thick white paper about 2 m high and 4 m wide to use as a screen.
c/ Draw a vertical line through the center of the screen (line V).
d/ Set the screen as shown in the picture. Note:
- Keep the screen perpendicular to the ground.
- Align the V line on the screen with the center of the vehicle.
e/Draw the reference lines (H, V LH and V RH lines) on the screen as shown in the figure.HINT:
Mark the center of the fog lamp on the screen. If the center mark cannot be seen on the fog lamp, use the center of the fog lamp or the manufacturer's name mark on the fog lamp as the center mark.
H line (fog light height):
Draw a line across the screen so that it passes through the center mark. Line H should be at the same height as the center mark of the fog light bulb.
Line V LH, V RH (center mark position of left fog lamp LH and right fog lamp RH):
Draw two lines so that they intersect line H at the center marks.
5. Check the fog light convergence
a/ Cover the fog lamp or remove the connector of the other side fog lamp to prevent light from the unchecked fog lamp from affecting the fog lamp convergence test.
b/ Start the engine.
c/ Turn on the fog lights and make sure that the dividing line is outside the standard area as shown in the drawing.
6. Adjust the fog light convergence
Use a screwdriver to adjust the fog light to the standard area by turning the toe adjustment screw.
Note: If the screw is adjusted too far, loosen it and then tighten it again, so that the last rotation of the light adjustment screw is clockwise.
3. Self-study questions
1. Describe the operating principle of the lighting system with automatic headlight function
2. Describe the operating principle of the lighting system with the function of rotating headlights when turning
3. Draw diagram and connect lighting system on Hyundai Porter car
4. Draw diagram and connect lighting system on Honda Accord 1992
5. Draw the lighting circuit on a 1993 Toyota Lexus
LESSON 3 MAINTENANCE AND REPAIR OF SIGNAL SYSTEM
I. IMPLEMENTATION GOAL
After completing this lesson, students will be able to:
- Distinguish between types of signals on cars
- Correctly describe common symptoms and suspected areas causing damage.
- Connecting signal circuits ensures technical requirements
- Disassemble, install, check, maintain and repair the signal system to ensure technical requirements.
- Ensure safety in work and industrial hygiene
II. LESSON CONTENT
1. General description
The signal system equipped on cars aims to create signals to notify other vehicles participating in traffic about the vehicle's operating status such as: stopping, parking, braking, reversing, turning...
Signals are used either by light such as headlamps, brake lights, turn signals….. or by sound such as horns, reverse music….
Just like the lighting system. A signal system circuit usually consists of: battery, fuse, wire, relay, electrical load and control switch. Only some switches of the signal system are on the combination switch. The switches of other signals are usually located in different locations such as in the gearbox or brake pedal……
2. Maintenance and repair
2.1. Turn signals and hazard lights
The installation location of the turn signal is shown in Figure 3.1. The turn signal control switch is located in the combination switch under the steering wheel. Turning this switch to the right or left will make the turn signal turn right or left.
The hazard light switch is used when the vehicle has a problem while participating in traffic. When the hazard light switch is turned on, all the turn signals on the vehicle will light up at a certain frequency. The hazard light switch is usually placed separately from the turn signal switch (some old cars integrate the hazard and turn signal switches on the same combination switch cluster).
Figure 3.1 Turn signal switch Figure 3.2 Hazard switch
The part that generates the flashing frequency for the lights is called a turn signal relay. The turn signal relay usually has 3 terminals: B (positive power supply); E (negative power supply); L (providing the turn signal switch to distribute to the
lamp)
2.1.1. Circuit diagram
To generate the frequency for the turn signal, a turn signal relay is used in the turn signal circuit. The current from the turn signal relay will be sent to the turn signal switch assembly to distribute the current to the turn signal lights for the driver's purpose.
Figure 3.3. Schematic diagram of a turn signal circuit without a hazard switch
1. Battery; 2. Electric lock; 3. Turn signal relay; 4. Turn signal switch; 5. Turn signal lamp; 6. Turn signal lamp; 7. Hazard switch
Figure 3.4 Schematic diagram of turn signal circuit with hazard switch
1. Battery; 2. Combination switch cluster; 3. Turn signal;
4. Turn signal light; 5. Turn signal relay
Today's cars no longer use three-pin turn signal relays (B, L, E) but use eight-pin turn signal relays (figure 3.5) (pin number 8 is used for hazard lights).
For this type, the current supplying the turn signal lights is supplied directly from the turn signal relay to the lights.
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Ear endoscopy image
Photo 5 MN swollen, opaque white
MSBA. 1904282223
Photo 6 MN has translation level MSBA. 1811255336 |
Photo 7 MN concave, opaque white
MSBA. 1904282049
Photo 8 MN concave, yellow MSBA. 1912331936 | |
Photo 9 MN concave, blue MSBA. 1806217636 |
Photo 10 MN collapsed and not touching MSBA bulge . 1806217633 |
Photo 11 MN collapsed and touched the anvil joint MSBA. 1806217173 |
Photo 12 MN attached to the protrusion, MSBA pedal-anvil joint. 1901263977 |
