MICRO EAR SURGERY

With the advent of the operating microscope in 1960 there has been  a great leap in the quality and types of ear surgeries performed over the years.  The outcome of ear surgery today depends on the type of equipment used by the operating surgeon.  Sticking to our principle of offering the best to our patients we at the centre use only quality operating equipment and instruments.  Takagi OM5, a Japanese operating microscope with various types of lenses, high speed drills of French and German makes are used to drill into the bony crevices of the ear.  Tungsten Carbide burrs ensure rapid bone removal thus cutting down the operating time considerably.  Back up systems are always in place so as to ensure completion of surgery in the event of mechanical failure during the procedure.

The following micro ear surgeries are commonly performed:

a)    Myringotomy:

Middle ear effusion (MEE) or fluid in the middle ear cavities are is a common occurrence in children.  Many do respond to medical treatment. However some of them do not respond to medical line of management and the fluid in the middle ear has to be drained by placing an incision on the ear drum and aspirating the contents of the middle ear using a suction apparatus.  The opening thus created in the ear drum is known as Myringotomy.  Some of them will have to have aeration tubes inserted in order to keep the middle ear aerated for a longer period of time.  These aeration  tubes are known as tympanostomy tubes.

b)    Myringoplasty:

This is a microsurgical technique performed to repair a perforated ear drum.   The perforation of the ear drum is the result of a prior infection in the middle ear.  These patients generally experience recurrent ear discharge and hearing loss of varying degrees.  The aim of this operation is to restore the hearing deficit and stop the ear discharge permanently by reconstructing the ear drum. This surgery is usually performed under local anaesthesia in adults and the patient is usually sent home the next day after the surgery.  This surgery is successful in over 95% of the cases.

c)    Tympanoplasty:

This surgery is performed to correct the damaged middle ear bones in addition to the defective ear drum.  These patients generally experience a more severe degree of hearing impairment.  The success of this operation depends on the number of bones affected and the type of damage.  Accordingly a type I, type II, or type III tympanoplasties are performed.

d) Mastoido tympanoplasty:

This operation is performed to tackle infection that has affected the mastoid and middle ear cavities or to tackle a dangerous disease called as Cholesteatoma.  This is a more radical type of surgery to tackle more aggressive disease.  Hence the outcome of hearing impairment in these cases depend upon the damage and destruction wrought by the disease process.  Earlier the commencement of treatment better the results.  Unfortunately most of these patients would have harbored the disease for a number of years before seeking proper treatment.

d)    Stapedotomy:

This is one of the most delicate middle ear surgery performed on the tiniest bone in our human body called as the Stapes.  This surgery is performed to correct a disease called as Otosclerosis.  In this disease the sound transmission to the inner ear is impeded as a result of fixation of the stapes bone.  The surgical process invovles removal of the fixed stapes and replacing it with an artificial material like teflon.  The results of this surgery are excellent in selective cases.