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    Add as FriendSurgery of the ear ppt by Dr Manas

    by: Dr Manas Ranjan Rout

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    1 : Surgery of the Ear Dr Manas
    2 : Myringotomy Incision of the tympanic membrane with the purpose to drain the suppurative and non suppurative effusion of the middle ear Grommet can be inserted at the latter date.
    3 : Indications – Some cases of ASOM Serous otitis media Atelectatic ear Contraindications – Suspected intra tympanic glomus tumor
    4 : Anaesthesia – General or Local
    5 : Steps of Surgery Clean the external ear Ideally under operating microscope Sharp myringotome used In ASOM Incision given in the posterior inferior quadrant( Circumferential) In serous otitis media radial incision in the anterior inferior quadrant and ventilation tube inserted.
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    8 : Atelectasis of the middle ear
    9 : Secretory otitis media
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    12 : Post operative care – Dry mopping of the ear In ASOM a cotton plug is to be given for 24 – 48 hrs. Avoid entry of water
    13 : Complications – Injury to I.S joint or stapes Injury high jugular bulb Middle ear infection
    14 : Operation for Chronic ear infection Myringoplasty – Repair of tympanic membrane Tympanoplasty – To eradicate the disease from middle ear and to reconstruct the hearing mechanism. Mastoidectomy ( Cortical, Modified radical, radical) Meatoplasty Mastoid obliteration
    15 : Surgical approaches and Incision Endo meatal or Trans canal approach (Rosen’s incision) Endaural approach (Lempert I & II incision) Postaural approach ( Wild’s incision)
    16 : Endomeatal approach used for Stapedectomy Exploratory tympanotomy Myringoplasty Ossicular reconstruction
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    18 : Endaural approach used for Excision of osteoma or exostosis of ext.canal Large T.M. perforation Attic perforation with limited cholesteatoma MRM with disease in attic, antrum & mastoid
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    21 : Postaural approach used for Cortical mastoidectomy MRM or Radical mastoidectomy Tympanoplasty(Ant. Perforation) Facial nerve decompression in vertical segment Endolymphatic sac decompression
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    23 : Mastoidectomy
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