MYRINGOTOMY
By SAFNA C.H -62
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Myringotomy and Myringoplasty: Surgical Procedures for Middle Ear Conditions, Schemes and Mind Maps of Earth Sciences
A comprehensive overview of myringotomy and myringoplasty, two surgical procedures used to treat middle ear conditions. it details the indications, anesthesia techniques, operative steps, postoperative care, and potential complications for both procedures, offering valuable insights into otolaryngological surgical practices. Suitable for medical students and professionals seeking to enhance their understanding of these procedures.
Typology: Schemes and Mind Maps
2024/2025
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MYRINGOTOMY
By SAFNA C.H -
- (^) It is a incision of the tympanic membrane
- (^) With the purpose to drain suppurative or nonsuppurative effusion of middle ear or
- (^) To provide aeration in case of malfunctioning eustachian tube.
Anaesthesia
- (^) Infants and children- GENERAL ANAESTHESIA
- (^) Adults -GENERAL ANAESTHESIA (only when tympanic membrane-inflamed)
- (^) If no inflammation- LOCAL ANAESTHESIA
steps of operation
- (^) Ear canal → cleaned of wax and debris
- (^) Under operating microscope → use sharp myringotome and good suction apparatus
- (^) In ASOM → circumferential incision is made in the posteroinferior quadrant of tympanic membrane.
- (^) In otitis media with effusion → small radial incision is made in anterioinferior quadrant
- (^) When ventilation tube is to be inserted
- (^) Incision should be just enough to admit the tube
- (^) Placed in the anterosuperior quadrant for longer retention
Complication
- (^) Injury to incudostapedial joint or stapes
- (^) Injury to jugular bulb with profuse bleeding
- (^) Middle ear infection
Myringoplasty
Contraindications
- (^) Active discharge from middle ear
- (^) Nasal allergy
- (^) Otitis externa
- (^) In growth of squamous epithelium in middle ear
- (^) When other ear is dead or not suitable for hearing aid rehabilitation
- (^) Children below 3 years
Anaesthesia
- (^) Local, →mostly prefer
- (^) General
- (^) Incision for exposure of tympanic membrane depends
- (^) Size of ear canal
- (^) Endomeatal
- (^) Endaural
- (^) Post aural
Technique
- (^) Harvesting the graft
- (^) Preparing the tympanic membrane for grafting
- (^) Inspecting the middle ear
- (^) Placing the Graft → middle eat is packed with gel foam soaked with antibiotic proper sized graft is placed, Underlay technique
- (^) Harvesting the graft → temporal facial or perichondrial graft
- (^) Incision is made in the meatus and mental skin with tympanic membrane Overlay technique
- (^) Graft placed on the outer surface of tympanic membrane
- (^) Mental skin is replaced
- (^) Covering the periphery of the graft
- (^) Ear canal packed with gel foam
- (^) Small antibiotic pack
- (^) Closure of endaural or post aural incision and mastoid dressing