Tuesday, March 15, 2016

ENT PROCEDURE 8 stapedectomy

OTOLOGY
Stapedectomy
Objective
   In cases of loss of hearing due to otosclerosis.
   To restore hearing by removing the stapes.
Position
Supine with patient’s head turned to the side with the ear to be operated uppermost.
Anesthesia
Local (Premedication given 45 min before surgery).
Procedure
   1.  Preparation of the part.
   2.  Placement of correct size ear speculum.
   3.  Use of operating microscope.
   4.  Injection of local anesthesia.
   5.  Incision in deep meatus at 6-12 o’ clock position in posterior wall 6 mm from tympanic annulus.
   6.  Elevation of tympanomeatal flap including the annulus.
   7.  Bony overhang in posterosuperior part to be curretted to expose the stapes area.
   8.  Making a hole in stapes footplate.
   9.  Division of stapedius tendon.
10.  Disarticulation of incus-stapedial joint.
11.  Enlarging the hole in the footplate.
12.  Measuring the distance between footplate and long process of incus.
13.  Placement of Teflon piston over long process of incus.
14.  Replacement of tympanomeatal flap.
15.  Placement of gel foam/and ear dressing in external canal.
Instruments
Stapes set
   Circular knife
   Microscissors
   Zollner elevators
   Bone curettes
   Right angle needles
   Straight needle stapes microdrill
   Crocodile ear specula of different sizes
   Speculum holder measuring rod and grid

   Suction tube and suction tips.

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