Myringotomy
Myringotomy is the process where a hole is created in the eardrum, and the fluid trapped in the middle of the ear is drained out. The fluid may contain blood, pus, or water. To maintain the drainage, a small tube is inserted in the eardrum through the hole. It is a surgical process in which a small incision is created to drain out the pus and relieve the pressure caused by excessive fluid buildup. It is a process where the eardrum or tympanic membrane goes through a surgical procedure. It is carried out by making a tiny incision with a myringotomy knife. It is done through the layers of the tympanic membrane. The surgical course of action allows access to the middle ear space. It lets the release of middle ear fluid, which ultimately is the result of otitis media with effusion(OME), whether chronic or acute. OME can be further classified into severe, mucoid, or purulent.
Tympanoplasty
Tympanoplasty is the surgical operation performed to reconstruct the tympanic membrane, commonly known as the eardrum and the small bones of the middle ear (ossicles). This surgical technique is used to repair a defect in the tympanic membrane by placing a graft, either medial or lateral, into the tympanic membrane annulus. Its goal is to improve hearing and close the perforation as well as remove the necrotic tissue and granulations that can spread the infection. The success of the procedure depends on the ability to completely eradicate the disease from the middle ear, for example, cholesteatoma and inflamed granulation. A number of techniques and methods have been refined, and various grafting materials are available nowadays.
Tympanoplasty is an effective and relatively safe procedure that eradicates the disease from the middle ear as well as restores hearing and intermediate ear functions. For the surgeon, several surgical approaches and techniques of grafting are available.
To repair a perforated eardrum in a child’s ear, the tympanic membrane, Pediatric tympanoplasty is the procedure performed.
Forming a hole in the eardrum has many possible reasons, a surgical procedure like the placement of an ear tube, lousy ear infection, or trauma from Q-Tip jabbed inside your ear canal( use of cotton swab for cleaning the ear must be avoided because of this reason). Commonly, Tympanoplasty surgery is performed to repair the perforation caused due to many reasons.
Ossiculoplasty
The hearing system found between the tympanic membrane, and the oval window can be restored by a surgical process called Ossiculoplasty. The main objective of the Ossiculoplasty surgery is to mend and reform the faulty ossicular chain, the chain of three bones: Malleus, Incus, and Stapes, which is present in the middle ear cavity. Ossiculoplasty surgery restores hearing and repairs, reconstructs, and refines the movement of the three bones mentioned above. The middle ear bones are sometimes damaged and injured and have restricted movement due to a disease or an infection such as Otitis Media( a long-standing middle ear infection)or a trauma such as an injury on the head.
The surgery involves either replacing the existing bones with a prosthesis or shaping the existing bones so that the function can be improved. A tiny incision is made either in the front or on the back of the ear to reach the affected area.
Based on the history of the patient and physical examination, the diagnosis of the ossicular damage is established by an Otolaryngologist. To find out the type of hearing loss, Audiometric tests may help. To confirm the presence of ossicular damage, radiological investigations like CT scan or MRI scan can also be done.
Stapes surgery
In Stapedectomy, the original stapes bone is replaced with an artificial device by a surgeon. This allows the sound waves to enter the inner ear once again for hearing. This procedure is performed through the ear canal, and an operating microscope is used.
Early attempts at the surgery were not so good and came with many complications like fatal labyrinthitis, and sometimes provided hearing gain only for a few days. But the recent techniques which have been developed are time tested and have very promising results.
BAHA
BAHA is a technology that amalgamates a sound processor with a small titanium fixture which is then implanted behind the ear. This system lets the bone transfer sound to a functioning cochlea rather than via the middle ear; this process is known as direct bone conduction. For patients with aural atresia or chronic ear drainage problems who cannot wear air conditioning hearing aids, BAHA or Bone Anchored Hearing Aid is quite advantageous and shows better performance. It is becoming increasingly popular because it has both cosmetic and acoustic advantages over conventional hearing aids. It significantly reduces ear discharge and improves the quality of hearing. It is a bone conduction implant which is a device designed to enhance the quality of hearing for people with particular forms of hearing loss and who cannot be helped via the most common and conventional aids. Majorly, the traditional hearing aids transmit sound through the medium of air conduction, whereas in BAHA, the cochlea is stimulated by sharing the sound waves through the skull and its bones, thus bypassing the outer and middle ear. Once the cochlea receives the sound signals, the sent information is converted into neural signals and is then transferred to the brain, where it is perceived as sound. There are quite several implants available, and one can choose accordingly.
Cochlear Implant
Cochlear implants can benefit people who have suffered severe hearing loss caused due to inner ear damage with no practical help from hearing aids. It is an electronic device that can restore hearing partly. A person with moderate to profound sensorineural hearing loss or a modified sense of sound can profit from the cochlear implant; which is a surgically implanted neuroprosthetic device. CI bypasses the normal acoustic hearing process to replace it with electric signals, directly stimulating the auditory nerve. It consists of an external portion that is fitted to sit behind the ear while the second portion is surgically placed under the skin. An implant has the following parts:
- A microphone. It helps pick up sound from the environment.
- A speech processor. It selects and arranges sounds picked up by the microphone.
- A transmitter and receiver/stimulator. It receives signals from the speech processor and then converts them into electric impulses.
- An electrode array is a group of electrodes that collect the impulses from the stimulator and send them to different regions of the auditory nerve.
It may not completely restore normal hearing, but it can give deaf people a fair amount of representation of sounds around them and help them understand speech.
It is especially suited for newborns or children with severe hearing problems. If the procedure is done timely, it can help in the normal hearing and speech development of the child.
Lateral Skull Base Surgery
Lateral skull base surgery can be performed by two processes; the surgery can be completed endoscopically or using a microsurgical approach. It can be used to treat conditions like meningiomas, acoustic neuromas, glioma tumors, encephaloceles, cholesteatomas, schwannomas, glomus tumors, etc, Stapes surgery in ahmedabad.
