Tuesday, March 22, 2016

ENT PROCEDURES 9 Myringplasty

Myringoplasty
Objective
In cases of loss of hearing due to Chronic suppurative otitis media with safe central perforation in the tympanic membrane.
   To repair the defect
   To restore hearing.
Position
Supine with head turned to one side with the ear to be operated uppermost.
Anesthesia
Local same as described for stapes surgery.
Procedure
1.  Harvesting the graft-temporalis fascia and tragal perichond­rium. Overlay technique.
2.  Complete de-epithelialization of deep meatal skin and that of tympanic membrane remnant.
3.  Placement of graft over the defect and on to the meatal wall.
4.  Placement of gelfoam/ear dressing.
Under lay technique
1.  Elevation of tympanomeatal flap.
2.  Placement of silastic sheeting/gelfoam in the middle ear.
3.  Placement of graft and replacing the tympanomeatal flap.
4.  Gelfoam/ear dressing on the ear canal.
Instruments

Myringotomy set.

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