Tuesday, March 29, 2016

ENT PROCEDURES 10 Tympanomastoidectomy

Tympanomastoidectomy
Objective
In cases of loss of hearing due to chronic suppurative ottitis media with unsafe atticoantral type disease.
Position
Supine with head turned diseased side up.
Anesthesia
Local.
Procedure
   1.  Post aural/and aural incision.
   2.  Harvesting the temporalis fascia graft.
   3.  Elevation of posterior meatal wall skin flap.
   4.  “Outside in”/or “Inside out” approach to be used for bone work.
   5.  Exploration of mastoid antrum.
   6.  Exposure of tegmen tympani, sinus plate, tip cells and lateral semicircular canal.
   7.  Removing the posterior meatal wall and defining the fascial ridge.
   8.  Clearance of disease from peripheral labyrinthine cells and removal of outer attic and wall bridge.
   9.  Clearance of disease from middle ear.
10.  Wide meatoplasty.
11.  Reconstruction of ossicular chain, and placement of graft.
12.  Gelfoam/ear packing.
13.  Closure of skin wound.
Instruments
   Stapes set 1
   Skin knife
   Iris scissors
   Fine forceps
   Cautery mastoid drill
   Mastoid retractor
   Gauges
   Chisel
   Bone curettes

   Suction.


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