Preparing the surgical area for non-shaved ear surgery: a clinical assessment

2020 ◽  
Vol 29 (1) ◽  
pp. 68-72
Author(s):  
Dong-Hee Lee ◽  
Doyeon Kim
Keyword(s):  
Middle Ear ◽  
Medical Records ◽  
Bacterial Culture ◽  
Skin Incision ◽  
Bacterial Colonisation ◽  
Ear Surgery ◽  
Suppurative Otitis Media ◽  
Skin Contamination ◽  
Surgical Field ◽  
Mastoid Surgery

Objective: To review the clinical experience for non-shaved middle ear/mastoid surgery and evaluate the proper method of preparing the postauricular surgical field. Methods: This retrospective study reviewed medical records of cases where the non-shaved surgical procedure was carried out for middle ear/mastoid diseases. In all cases, middle ear and mastoid surgery was performed by one otologic surgeon without hair shaving to treat chronic perforation of tympanic membrane, as well as chronic suppurative otitis media, with or without mastoiditis during two years. The prevalence of surgical site infection (SSI) and bacterial culture of the surgical field was assessed just before the skin incision. Results: In this review of 106 cases, the SSI rate was 1.6% for the non-shaved ear surgery. Bacterial colonisation was found on the prepared surgical field in 8.5% of cases and these bacteria was different from true pathogens. SSI of the skin incision occurred in two cases, although no bacterial colonisation of the non-shaved surgical field was found. The surgical exposure of postauricular area was enough to do tympanoplasty or tympanomastoidectomy, even though in cases where a hairline was close to postauricular sulcus. Conclusion: This study showed that when preparing the non-shaved ear surgery, the surgeons should not have to worry about skin contamination by hair. We suggest that the non-shaved ear surgery would appear to be preferable for the postauricular approach.

scholarly journals 3D visualization in otosurgery

2020 ◽  
Vol 19 (6) ◽  
pp. 38-49
Author(s):  
D. M. Kuz’min ◽  
◽  
A. A. Fedotova ◽  
Keyword(s):  
Middle Ear ◽  
3D Visualization ◽  
Research Work ◽  
Three Dimensional ◽  
Middle Ear Surgery ◽  
Ear Surgery ◽  
Task Load ◽  
Additional Information ◽  
Surgical Field ◽  
Nasa Task Load Index

The main priority of middle ear surgery is to create a safe and optimal view of the surgical field, as well as the most accurate visualization of anatomical structures, which is a driving factor in the evolution of otosurgery. The additional information provided by three-dimensional (3D) images has been proven to improve understanding of the temporal bone anatomy and improve the operator’s ability to assess associated diseases, thereby optimizing surgical management. In the presented experimental research work, a new technique for visualizing the surgical field is described, which improves the quality of the operator’s work and expands the possibilities of middle ear surgery. On the basis of the Chair of Otorhinolaryngology of the Mechnikov North-Western State Medical University a remote adapter for an endoscopic tube was created, which allows you to broadcast the video image received from its distal end to virtual reality glasses. For a detailed understanding of the principle of information transmission in a new three-dimensional reality, we used concepts such as disparity and stereopsis. All research results were evaluated according to the NASA Task Load Index scale. Analyzing the results of the experiment, in the conditions of three-dimensional visualization of the surgical field, a lower level of subjective workload was revealed, which was regarded as a positive effect of the realization of the phenomenon of stereopsis, when performing manipulations on the middle ear.

Does tranexamic acid improve intra-operative visualisation in endoscopic ear surgery? A double-blind, randomised, controlled trial

2019 ◽  
Vol 133 (12) ◽  
pp. 1033-1037 ◽  
Author(s):  
A Das ◽  
S Mitra ◽  
D Ghosh ◽  
S Kumar ◽  
A Sengupta
Keyword(s):  
Tranexamic Acid ◽  
Middle Ear ◽  
External Auditory Canal ◽  
Soft Tissues ◽  
Controlled Trial ◽  
Control Group ◽  
Endoscopic Ear Surgery ◽  
Ear Surgery ◽  
Significant Difference ◽  
Surgical Field

AbstractObjectiveTo assess the effect of tranexamic acid on intra-operative bleeding and surgical field visualisation.MethodsFifty patients undergoing various endoscopic ear surgical procedures, including endoscopic tympanoplasty, endoscopic atticotomy or mastoidectomy, endoscopic ossiculoplasty, and endoscopic stapedotomy, were randomly assigned to: a study group that received tranexamic acid or a control group which received normal saline. The intra-operative bleeding and operative field visualisation was graded using the Das and Mitra endoscopic ear surgery bleeding and field visibility score, which was separately analysed for the external auditory canal and the middle ear.ResultsThe Das and Mitra score was better (p < 0.05) in the group that received tranexamic acid as a haemostat when working in the external auditory canal; with respect to the middle ear, no statistically significant difference was found between the two agents. Mean values for mean arterial pressure, heart rate and surgical time were comparable in both groups, with no statistically significant differences.ConclusionTranexamic acid appears to be an effective haemostat in endoscopic ear surgery, thus improving surgical field visualisation, especially during manipulation of the external auditory canal soft tissues.

An audit of ‘dead ear’ after ear surgery

2013 ◽  
Vol 127 (12) ◽  
pp. 1177-1183 ◽  
Author(s):  
P Prinsley
Keyword(s):  
Middle Ear ◽  
Adult Patients ◽  
Ear Surgery ◽  
Current Series ◽  
Mastoid Surgery ◽  
Cholesteatoma Surgery

AbstractIntroduction:‘Dead ear’ is a rare and serious complication of ear surgery. This paper presents an audit of this complication.Method:Over 6 years, data for all 617 middle-ear operations performed under the care of a single consultant were recorded for the International Otology Audit. All cases of dead ear were identified and assessed.Results:A post-operative dead ear occurred in 6 cases (approximately 1 per cent). No cases of post-operative dead ear occurred following the 83 otosclerosis operations and the 62 children's procedures. Amongst 187 adult patients undergoing mastoid surgery for cholesteatoma, there were 5 cases of post-operative dead ear (2.7 per cent of cases).Conclusion:The occurrence of dead ear after cholesteatoma surgery in adults is less rare than previously thought. This has implications for the surgical consenting process. The current series suggests that, whilst dead ear is often avoidable, it is sometimes inevitable.

The value of head dressings for middle ear surgery

1993 ◽  
Vol 107 (1) ◽  
pp. 17-19 ◽  
Author(s):  
Julian M. Rowe-Jones ◽  
Susanna E. J. Leighton
Keyword(s):  
Middle Ear ◽  
Wound Closure ◽  
Prospective Trial ◽  
Wound Complication ◽  
Operative Management ◽  
Middle Ear Surgery ◽  
Ear Surgery ◽  
Mastoid Surgery ◽  
Pressure Dressing

AbstractA prospective trial was performed to ascertain the value of head dressings in the post-operative management of patients undergoing middle ear and mastoid surgery. One hundred consecutive patients were randomly allocated to a head dressing or no head dressing group after wound closure.Nine patients in the head dressing group developed a wound complication as opposed to four patients in the no head dressing group.The application of a pressure dressing following middle ear and mastoid surgery is unnecessary and may contribute to increased wound morbidity.

scholarly journals Mastoidektomi Revisi pada Otitis Media Supuratif Kronik Tipe Bahaya

2015 ◽  
Vol 4 (3) ◽  
Author(s):  
Jacky Munilson ◽  
Tuti Nelvia
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Chronic Suppurative Otitis Media ◽  
Canal Wall ◽  
Suppurative Otitis Media ◽  
Canal Wall Down ◽  
Mastoid Surgery ◽  
Air Cells ◽  
Mastoid Operation

Abstrak Operasi mastoid berkembang sebagai penanganan terhadap Otitis Media Supuratif Kronik (OMSK). Mastoidektomi revisi dilakukan bila tujuan operasi pertama tidak tercapai. Kegagalan operasi mastoid bisa disebabkan oleh berbagai hal, diantaranya penanganan air cell yang tidak adekuat, facial ridge yang tinggi, kegagalan membuang semua kolesteatom, meatoplasti yang tidak adekuat dan ketidakpatuhan pasien untuk kontrol setelah operasi. Operasi mastoid revisi biasanya lebih sulit dan berbahaya karena anatomi telinga tengah menjadi tidak jelas, landmark dapat hilang dan struktur berbahaya sudah terpapar. Dilaporkan satu kasus operasi mastoid revisi pada seorang laki-laki berumur 25 tahun, yang ditatalaksana dengan timpanomastoidektomi dinding runtuh.Kata kunci: otitis media supuratif kronik, mastoidektomi revisi, kolesteatom, meatoplasti Abstract Surgery of the mastoid developed as a treatment for chronic suppurative otitis media. Revision mastoid surgery done if the aim of first surgery not achieved. Failure of  mastoid operation may caused by many things, including handling of air cells are not adequate, high facial ridge,  failure to remove all cholestetoma  meatoplasty in adequate and non adherence of patient to control after surgery. Revision  mastoid surgery is usually more difficult and dangerous, because anatomy of the middle ear may be altered, some of the important landmarks can be loss and dangerous  structure has been exposed. It was reported one case revision mastoid surgery in a man aged 25 years old, management with canal wall down tympanomastoidectomy.Keywords: chronic suppurative otitis media, revision mastoidectomy, cholesteatoma, meatoplasty

scholarly journals Effect of Dexmeditomidine on Isofluorane Consumption in Middle Ear Surgery

2020 ◽  
Vol 5 (2) ◽  
pp. 14-19
Author(s):  
Smriti Bandhu ◽  
Arunabh Mukharjee
Keyword(s):  
Heart Rate ◽  
Middle Ear ◽  
Normal Saline ◽  
Middle Ear Surgery ◽  
Ear Surgery ◽  
Mean Values ◽  
Isoflurane Concentration ◽  
Significant Difference ◽  
Surgical Field ◽  
End Tidal

Background: With the introduction of intentional hypotensive anesthesia in the surgical field to achieve a relatively bloodless surgical field along with the use of the operative microscope, it has revolutionized the middle ear surgery practice. Dexmedetomidine is a relatively new and potent α2 agonist prototype found efficient in rendering bloodless intra-surgical field and inducing controlled hypotension during the surgeries of the middle ear. The objective is to present prospective study was aimed at evaluating with and without dexmedetomidine infusion effect on end-tidal isoflurane concentration for lowering blood pressure by 30%, awakening time and quality of bloodless surgical field during middle ear surgical procedure. Subjects and Methods:54 patients who were to undergo middle ear surgery and had ASA I and II were randomly divided into the two groups. In Group I Dexmedetomidine was used and in Group II Normal saline. Effect of Dexmedetomidine infusion on end-tidal isoflurane concentration for lowering blood pressure by 30%, awakening time, quality of bloodless surgical field during middle ear surgical procedure, heart rate was evaluated. The data collected were statistically analyzed. Results: The mean values of the heart rate were statistically non-significant between the groups when recorded at the baseline, whereas, a statistically significant difference was seen in the values for heart rate intra-operatively. The mean values for heart rates were significantly higher for the placebo group. A significant difference in Isoflurane concentration was found with dexmedetomidine requiring a percentage of 0.6 0.4 and normal saline 1.8 0.5. Less bleeding was seen with dexmedetomidine. Conclusion:  Dexmedetomidine is a potent hypotensive agent which also reduces the requirement of Isoflurane compared  to the normal saline placebo. The use of dexmedetomidine is relatively safe and provide a relatively bloodless surgical field, hence, increasing efficacy, and improving visibility at the surgical site.

Evaluation of Taste Disturbance in Pre and Post Mastoid Surgery Patients

2019 ◽  
Vol 2 (2) ◽  
pp. 4-11
Author(s):  
Sriti Manandhar ◽  
ST Chettri ◽  
DR Kandel
Keyword(s):  
Tympanic Membrane ◽  
Middle Ear ◽  
Analytical Study ◽  
Middle Ear Surgery ◽  
Chorda Tympani ◽  
Chorda Tympani Nerve ◽  
Ear Surgery ◽  
Taste Disturbance ◽  
Duration Of Operation ◽  
Mastoid Surgery

Background: Mastoid surgery is one of the commonest surgeries in Otolaryngology & Head & Neck department. Surgeons are less aware of preserving chorda tympani nerve (CT). Injury to the chord tympani nerve is common in middle ear surgery as the course of CT runs between ossicles and close to tympanic membrane. It makes the surgeon difficult to preserve it during the surgery. The study was done to observe frequency of taste disturbances (TD) in all patients undergoing mastoid surgery and to correlate between intra operative status of CT and type of intra operative status of CT injury with postoperative taste disturbances. Methods: A prospective analytical study was conducted in patients who underwent mastoid surgery. The intra operative status of CT was studied, different forms of injury to the nerve were noticed and its impact on taste disturbances was assessed subjectively with questionnaire. The patients with taste disturbances were followed till twelve weeks. Result: None of the patients had taste disturbances prior to surgery. Out of 65 patients, only 15 patients became symptomatic in second postoperative day and the taste disturbances were in the form of altered taste (26.66%), dry mouth (26.66%) and numbness (46.66%). Symptoms like altered taste and numbness were present till the eighth week of surgery and disappeared by the twelfth week except one patient in whom numbness persisted till twelfth week. The symptoms did not correlate with the intra operative status of CT. The symptoms disappeared with duration of operation and it was significant. Conclusion: None of the patients voluntarily complained regarding taste disturbances until they were specifically asked. Only 15 patients had taste disturbances; 7 had numbness, 4 dryness of mouth and 4altered taste. The taste disturbances did not correlate with the type of intra operative status of CT. CT was not identified in 9 patients and only 3 (33.3%) became symptomatic and CT was cut with micro scissors in 26 patients but only 4 (15.38%) patients were symptomatic.

Sign in / Sign up

Export Citation Format

Share Document