1. Grommet insertion
2. Removal of lesion from pinna – wedge excision
3. Excision of preauricular sinus
4.Myringoplasty
5.Ossiculoplasty
6. Stapedotomy
7. Mastoidectomy and canalplasty
1. Grommet insertion /
1 position pt , table head-up , pt’s head away from operative side
position aperture drape
2 examination under microscope , clean extn auditory canal
– inspect tympanic memb
– avoid injury to extn auditory canal skin
3 myringotomy – ใช้ myringotomy knife , radial incision , antero-infr
length incision – match dia of inner flange-หน้าแปลน of grommet
– middle ear effusion – remove ด้วย 22 gauge suction
4 Grommet incision , insert ผ่านทาง myringotomy , ใช้ crocodile forceps
-complete incision grommet โดยใช้ slightly curve needle
– suction bloody /fluid from – grommet lumen
-instill drop to prevent blockage grommet lumen
ถ้าผปเป็น Down’s ต้องระวัง neck position – โอกาสเกิด atlanto-axial instability
ถ้าดูด suction ที่ edge of myringotomy เพราะจะทำให้ periop bleeding , tympanosclerosis
2. Removal of lesion from pinna – wedge excision
3. Excision of preauricular sinus
4.Myringoplasty
5.Ossiculoplasty
6. Stapedotomy
7. Mastoidectomy and canalplasty