scholarly journals Stapes surgery under local anaesthesia

2013 ◽  
Vol 95 (1) ◽  
pp. 37-39 ◽  
Author(s):  
JA Lavy ◽  
HRF Powell
Keyword(s):  
General Anaesthesia ◽  
Middle Ear ◽  
Local Anaesthetic ◽  
Local Anaesthesia ◽  
Stapes Surgery ◽  
Middle Ear Surgery ◽  
Ear Surgery ◽  
Hearing Results ◽  
Accepted Practice ◽  
The Uk

In the UK, stapes surgery is performed almost universally under general anaesthesia. In 1984 there was consensus that local anaesthesia should be the technique of choice in stapes surgery. Despite reports of successful use of local anaesthesia for middle ear surgery, this is still not widely accepted practice in the UK. We describe the senior author’s technique for local anaesthetic stapes surgery and present the hearing results for a series of 100 consecutive cases.

scholarly journals Anaesthesia for ear surgery in remote or resource-constrained environments

2018 ◽  
Vol 133 (1) ◽  
pp. 34-38 ◽  
Author(s):  
B Kaur ◽  
M P A Clark ◽  
J Lea
Keyword(s):  
General Anaesthesia ◽  
Middle Ear ◽  
Local Anaesthesia ◽  
Effective Means ◽  
Middle Ear Surgery ◽  
Ear Surgery ◽  
Advantages And Disadvantages ◽  
Resource Setting ◽  
Low Resource Setting ◽  
Constrained Environments

AbstractBackgroundThe successful provision of middle-ear surgery requires appropriate anaesthesia. This may take the form of local or general anaesthesia; both methods have their advantages and disadvantages. Local anaesthesia is simple to administer and does not require the additional personnel required for general anaesthesia. In the low-resource setting, it can provide a very safe and effective means of allowing middle-ear surgery to be successfully completed. However, some middle-ear surgery is too complex to consider performing under local anaesthesia and here general anaesthesia will be required.ConclusionThis article highlights considerations for performing middle-ear surgery in a safe manner when the available resources may be more limited than those expected in high-income settings. There are situations where local anaesthesia with sedation may prove a useful compromise of the two techniques.

Glyceryl Trinitrate as a Hypotensive Agent in Middle-Ear Surgery

1987 ◽  
Vol 15 (4) ◽  
pp. 251-253
Author(s):  
R. J. Eltringham ◽  
P. A. Littlejohns ◽  
P. N. Young ◽  
J. M. Robinson
Keyword(s):  
Glyceryl Trinitrate ◽  
General Anaesthesia ◽  
Middle Ear ◽  
Scoring System ◽  
Middle Ear Surgery ◽  
Controlled Hypotension ◽  
Ear Surgery ◽  
Hypotensive Agent ◽  
Operating Field

A total of 47 patients having microsurgery of the middle-ear under general anaesthesia received an infusion of glyceryl trinitrate to produce controlled hypotension. The operating field was evaluated by the surgeon by means of a simple scoring system. Using this technique satisfactory conditions were achieved in all patients without complications.

Middle-ear surgery under sedation: comparison of midazolam alone or midazolam with remifentanil

2011 ◽  
Vol 125 (6) ◽  
pp. 561-566 ◽  
Author(s):  
J J Lee ◽  
J H Lee
Keyword(s):  
Adverse Events ◽  
Middle Ear ◽  
Local Anaesthesia ◽  
Injection Pain ◽  
Control Group ◽  
Middle Ear Surgery ◽  
Ear Surgery ◽  
Pain Anxiety

AbstractObjective:Performance of middle-ear surgery under local anaesthesia has several advantages, but many patients complain of pain, anxiety and adverse events (e.g. dizziness and nausea). To minimise such problems, we compared sedation with midazolam alone versus midazolam with remifentanil.Patients and methods:We initially observed 19 patients undergoing middle-ear surgery under local anaesthesia, as controls. We then sedated a further 40 patients undergoing such surgery, with either midazolam or midazolam plus remifentanil.Results:The sedated patients had significantly lower incidences of local anaesthesia injection pain (p < 0.001), intra-operative pain (p < 0.001), intra-operative anxiety (p < 0.001) and adverse events, compared with the control group. Patients sedated with midazolam plus remifentanil reported less intra-operative anxiety (p = 0.010) and greater post-operative satisfaction with sedation (p = 0.007), compared with those sedated with midazolam only.Conclusion:Patients undergoing middle-ear surgery under local anaesthesia alone frequently report pain, anxiety and adverse events. However, the majority of our patients who were sedated with midazolam satisfactorily overcame pain, anxiety and adverse events. Results were better still when midazolam was accompanied by remifentanil.

Self-retaining aural speculum: a valuable aid to middle-ear surgery

2001 ◽  
Vol 115 (1) ◽  
pp. 44-45
Author(s):  
P. N. Gana ◽  
T. N. Reddy
Keyword(s):  
Middle Ear ◽  
Stapes Surgery ◽  
Middle Ear Surgery ◽  
Ear Surgery

We report the use of a self-retaining aural speculum that provides an excellent view of the middle ear through a small endural incision. We have found this instrument of value in tympanoplasty and stapes surgery in particular.

Local anaesthesia for middle ear surgery

1988 ◽  
Vol 13 (5) ◽  
pp. 367-374 ◽  
Author(s):  
J. M. LANCER ◽  
U. FISCH
Keyword(s):  
Middle Ear ◽  
Local Anaesthesia ◽  
Middle Ear Surgery ◽  
Ear Surgery

Is Hospitalization Necessary after Ear Surgery? A National Survey and Retrospective Review of Postoperative Events

2017 ◽  
Vol 157 (4) ◽  
pp. 707-715 ◽  
Author(s):  
Tanja Jelicic ◽  
Julian Richard Savage ◽  
Margaret Aron
Keyword(s):  
Health Care ◽  
Middle Ear ◽  
National Survey ◽  
Day Care ◽  
Readmission Rate ◽  
Day Surgery ◽  
Stapes Surgery ◽  
Middle Ear Surgery ◽  
Ear Surgery ◽  
Otologic Surgery

Objective First, to survey our national otolaryngology colleagues on their postoperative care habits (hospitalization vs day surgery) after elective middle ear surgery. Second, to evaluate the necessity of hospitalization and safety of day surgery after these procedures. Methods A national survey regarding postoperative habits after elective middle ear surgery was launched. Then, the cases of all patients having undergone these surgical procedures at our center between 2010 and 2016 were reviewed. They were divided into 2 groups: hospitalization and day surgery. Postoperative events during hospitalization and rate of consultation/readmission for day surgery were recorded. Results Heterogeneity in postoperative habits for most elective otologic surgery exists among otolaryngologists. For tympanoplasty, however, day surgery was uniformly favored. At our institution, 88.6% of hospitalization patients had no complications during their stay. Complications noted for others were nausea (7.2%), bleeding (3.1%), hematoma (0.5%), and sensorineural hearing loss (0.5%). In the day surgery group, 3.0% consulted within 48 hours following their procedure, and the readmission rate was 1.3%. Nausea was the only cause for readmission, and stapes surgery accounted for 100% of readmissions. Discussion Most elective middle ear surgery can be safely performed as day care. Hospitalization does not provide care that could not have been provided at home in the majority of cases. Overnight hospital stay may be considered for stapes surgery. Implications for Practice Day surgery for elective middle ear surgery is sufficient for most cases. Transferring these cases to day care should lower costs to our health care system and increase bed availability.

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