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The surgical procedure for placing tubes in the ears has become one of the most commonly performed operations of any kind. A tiny tube, with a collar on both ends is slipped through a tiny incision in the eardrum. This pressure-equalization (PE) tube provides a temporary, extra eustachian tube to allow bacteria and fluid to drain from the middle ear.
The tympanic membrane, or eardrum, sometimes suffers perforations from trauma or infection. Most heal spontaneously. When a perforation is present, the ear canal must be kept dry. Repair of the tympanic membrane perforation reinstates the protective barrier to the middle ear, and in some cases can also improve hearing.
Mastoid air cells are open, air-containing spaces in the skull behind the ear. A mastoidectomy is the surgical removal of these mastoid air cells. The surgery may extend into the middle ear. The surgery used to be a common way to treat an infection in the mastoid air cells, which usually came from an ear infection that spread to the nearby bone in the skull. Mastoidectomy is now seldom needed, as the infections are commonly treated with antibiotics. However, this surgery may be used to treat other problems.
This surgery may be used to treat infections that are difficult to eradicate or alternatively, to remove cholesteatoma, a seldom occurring cyst-like growth that can erode the hearing mechanism.
Ossicular reconstruction is the reconstruction of the tiny bones of the middle ear. Reconstruction can be achieved by reshaping existing bones or using a prosthesis to reestablish the connection. These procedures are typically done to reclaim lost hearing. If the gap between the anvil bone and the stapes is small, a small piece of bone or cartilage from the patient can be inserted; if is is large, the incus bone is removed, modelled into a prosthesis, and reinserted between the stapes and the malleus. Reconstruction could also be achieved by inserting a strut made from artificial bone.
Patients with otosclerosis and significant hearing loss are candidates for a stapedectomy. During a stapedectomy, an incision is made in the skin of the ear canal, the skin and eardrum are lifted to expose the stapes bone, and the stapes bone is removed. An incision is made above the ear and the tissue is removed. The tissue is used to cover the opening created by the stapes bone removal. A prosthesis is put in place where the stapes bone had been and the eardrum and skin of the ear canal are laid back in place. The ear canal is then packed.
Septoplasty is an operation that corrects any defects or deformities of the nasal septum, which is the wall between the two nostrils. The goal of the surgery is to straighten out the nasal septum or to relieve obstructions or other problems related to deviation of the septum. An incision is made internally on one side of the nasal septum. Afterwards, the mucous membrane is elevated away from the cartilage and bone, obstructive parts are removed, and plastic surgery is performed as necessary. Then the mucous membrane is returned to its original position. The tissues covering the septum are maintained in the midline by either sutures or packing.
Turbinate Reduction Surgery
Enlarged inferior turbinates are often the cause of chronic nasal congestion. Even after the underlying problem is addressed, such as chronic infection or allergy, the enlargement may remain. There are varying ways to reduce the size of the turbinate, from radiofrequency ablation done in the office under local anesthesia (no down time for the patient), to submucous resection or even partial turbinectomy done in the operating room as an outpatient. Each has advantages and disadvantages over the other choices. The best approach for each patient would be discussed at the time of the office visit.
Endoscopic Sinus Surgery
Endoscopic sinus surgery is used to increase the amount of air flowing through the sinuses and allow mucus to drain properly out of the nose. The procedure can relieve nasal blockages, improve breathing, improve the sense of smell and taste and relieve facial pain. The endoscope, which utilizes fiberoptic technology, allows doctors to see inside the sinuses without cutting the face, and makes it possible to see parts of the sinuses that were formerly difficult to reach.