Otalgia surgery: Difference between revisions
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<u>'''[[Otitis media]]'''</u>: Surgical options for Otitis media include : | <u>'''[[Otitis media]]'''</u>: Surgical options for Otitis media include : | ||
*[[Tympanocentesis]] - early intervention | *[[Tympanocentesis]] - early intervention | ||
*[[Myringotomy]] and [[Tympanostomy tube]] insertion | *[[Myringotomy]] and [[Tympanostomy tube]] insertion to drain the pus from the middle ear. | ||
*[[Adenoidectomy]] | *[[Adenoidectomy]] | ||
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*Canal-wall-up procedures - for those who are unwilling or unable to return for a second-look procedure. Have the advantage of maintaining normal appearance. But have the disadvantage of high probability of recurrences. | *Canal-wall-up procedures - for those who are unwilling or unable to return for a second-look procedure. Have the advantage of maintaining normal appearance. But have the disadvantage of high probability of recurrences. | ||
<u>'''[[Mastoiditis]]'''</u>: Surgical procedures may be performed (while continuing the medication) if the condition does not quickly improve with antibiotics. The most common procedure is a [[myringotomy]], a small incision in the[[tympanic membrane]] (eardrum), or the insertion of a [[tympanostomy tube]] into the eardrum. These serve to drain the pus from the middle ear, helping to treat the infection. The tube is extruded spontaneously after a few weeks to months, and the incision heals naturally. If there are complications, or the mastoiditis does not respond to the above treatments, it may be necessary to perform a [[mastoidectomy]] in which a portion of the bone is removed and the infection drained. | |||
==References== | ==References== | ||
Revision as of 15:57, 17 July 2012
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Otalgia Microchapters |
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Treatment |
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Otalgia surgery On the Web |
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American Roentgen Ray Society Images of Otalgia surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2]
Overview
Surgery forms the main stay of treatment for major ear pathologies like Otitis media (OM), Otitis externa, Cholesteatoma, Mastoiditis etc., and some non-ear pathologies like TMJ disorder, Retropharyngeal abscess etc.
Surgical treatment for Primary Otalgia
Otitis media: Surgical options for Otitis media include :
- Tympanocentesis - early intervention
- Myringotomy and Tympanostomy tube insertion to drain the pus from the middle ear.
- Adenoidectomy
Indications for Tympanocentesis include:
- Severe Otalgia, seriously ill, or appearing toxic.
- Unsatisfactory response to antimicrobial therapy.
- Onset of AOM in a patient receiving antimicrobial therapy.
- Potential suppurative complication.
- OM in a newborn, sick neonate, or patient who is immunologically deficient.
Indications for Myringotomy and Tympanostomy tube insertion:
- Chronic Otitis media with effusion
- Recurrent Acute Otitis media
- Recurrent Otitis media with effusion
- Eustachian tube dysfunction
- Barotrauma
Intratemporal and intracranial complications of Otitis media requires surgical consultation. Patients with cleft palate[1], Down syndrome, or other craniofacial abnormalities, may require early surgical intervention to prevent Otitis Media.[2]
Otitis externa: Surgery is now reserved for local debridement, removal of bony sequestrum, or abscess drainage.
Cholesteatoma: Surgery is the definitive form of treatment. Two kinds of procedures exist for treatment of Cholesteatoma. They are
- Canal-wall-down operations - for those who had several recurrences and is willing to avoid future episodes. Have the advantage of permanently ridding the patient of Cholesteatoma
- Canal-wall-up procedures - for those who are unwilling or unable to return for a second-look procedure. Have the advantage of maintaining normal appearance. But have the disadvantage of high probability of recurrences.
Mastoiditis: Surgical procedures may be performed (while continuing the medication) if the condition does not quickly improve with antibiotics. The most common procedure is a myringotomy, a small incision in thetympanic membrane (eardrum), or the insertion of a tympanostomy tube into the eardrum. These serve to drain the pus from the middle ear, helping to treat the infection. The tube is extruded spontaneously after a few weeks to months, and the incision heals naturally. If there are complications, or the mastoiditis does not respond to the above treatments, it may be necessary to perform a mastoidectomy in which a portion of the bone is removed and the infection drained.
References
- ↑ Klockars T, Rautio J (2012). "Early placement of ventilation tubes in cleft lip and palate patients: Does palatal closure affect tube occlusion and short-term outcome?". Int J Pediatr Otorhinolaryngol. doi:10.1016/j.ijporl.2012.06.028. PMID 22796197. Unknown parameter
|month=ignored (help) - ↑ Hartzell LD, Dornhoffer JL (2010). "Timing of tympanoplasty in children with chronic otitis media with effusion". Curr Opin Otolaryngol Head Neck Surg. 18 (6): 550–3. doi:10.1097/MOO.0b013e32833febc4. PMID 21045692. Unknown parameter
|month=ignored (help)