Tympanoplasty
Objective
In cases of conductive hearing loss:
• Reconstructive
procedures of the tympanic membranes and middle ear structures.
Position
Supine.
Anesthesia
General or local.
Procedure
1. The tympanic membrane is
incised and reflected.
2. The
pathology within is assessed.
3. Mastoidectomy
may be required.
4. Diseased
tissues including atrophic epithelium, fibrotic tissue and damaged ossicles are
excised.
5. The
ossicular conduction system is reconstructed using artificial materials,
homograft, ossicular bone or fragments of the ossicles.
6. Myringoplasty
is performed utilizing temporalis fascia.
7. Skin
flaps, if employed, may be sutured.
8. A
protective dressing is applied.
Instruments
• Basic ear set
• Drill
(e.g. microm, stryker), burrs, and cord
• Basin
set
• Blades
(3) No. 15
• Needle
magnet or counter
• Suction
tubing
• Gelfoam
(cut 1 × 1 mm)
• Control
syringes (2) 5 ml
• Local
anesthetic with epinephrine
• Needles
27 gauge (1 1/2"), 25 gauge (1")
• Sterile,
drape
• Bulb
syringe.
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