Ear surgery• May involve the tympanic membrane, the middle ear cavity, the mastoid, or the inner ear• It may be done for perforation of the eardrum, to facilitate drainage and remove diseased tissue in cases of infection, to relieve vertigo, or to treat hearing loss.
Tympanoplasty• Reconstruction of diseased or deformed middle ear components
Myringotomy• creating a surgical opening into tympanic membrane (with knife or laser) for possible drainage tube insertion
• Type I (myringoplasty)• Purpose: – To close perforation by placing a graft over it to create a closed middle ear to improve hearing and decrease risk of infection and cholesteatoma
• Perforation is closed using one of the following: – Fascia from temporalis muscle – Vein grafts from hand or forearm – Epithelium from auditory canal (eustachian tube)
• Type II to V• Suitable replacement is used to maintain continuity of conduction sound pathway – Polyethylene – stainless steel wire – Bone – cartilage
• The necessity of a two-stage procedure is determined – First stage—eradication of all diseased tissues; area is cleaned out to achieve a dry, healed middle ear – Second stage—performed 2 to 3 months after first stage; reconstruction, using grafts.
Mastoidectomy• Removal of mastoid process of temporal bone – Simple—performed through the ear with a tympanoplasty (closed approach) – Modified or radical—wide excision of the mastoid and diseased middle ear contents through an occipital incision (open)
Stapedectomy• Removal of footplate of stapes and insertion of a graft or prosthesis
Labyrinthectomy• Destruction of the labyrinth (inner ear) through the middle ear and aspiration of the endolabyrinth
Endolymphaticdecompression and shunt• Release of pressure on the endolymphatic system in the labyrinth and creation of a shunt for fluid to the subarachnoid space or the mastoid
Cochlear implant• Implantation of electronic device that bypasses cochlea and stimulates auditory nerve