tympanic tube placement through the external auditory canal

Chronic non-suppurative otitis media is a frequently-occurring disease, common disease, more common in children. The impact on hearing is so severe that it affects children's intellectual development and learning. It is characterized by obstruction of the eustachian tube, causing tympanic effusion. The tympanic effusion is caused by diseases such as catarrhal otitis media, secretory otitis media, bariatric otitis media, and aviation otitis media. Drainage of tympanic effusion is one of the important measures for the treatment of non-suppurative otitis media. The common method is tympanotomy. The cannula can be inserted into the inner tympanum through the external auditory canal and tympanic membrane. Curing disease: Indication The external ear canal tympanic catheter is the same as the indication of the placement of the snorkel through the tympanic membrane, but it is most suitable for the person who is repeatedly discharged through the tympanic membrane. Contraindications 1. Initially suffering from secretory otitis media, tympanostomy can be performed first. 2. Jugular spheroid tumor (tympanic type). 3. People with severe heart disease or blood diseases. Preoperative preparation Anesthesia: infants do not need anesthesia, general anesthesia for children over one and a half years old, local anesthesia for adults, tympanic membrane anesthesia with cotton or cotton pads, tympanic anesthetic from equal amounts of pure phenol (carbonic acid), menthol crystals and cocaine The crystals are mixed and directly anesthetized for 10 to 15 minutes. When the tympanic membrane is whitish, surgery can be performed. Adults with tension can also use general anesthesia. Position: Adults with local anesthesia can take a seat, children with general anesthesia are the same as ear surgery. When the child is not anesthetized, the child's upper limbs are straightened and close to the sides of the torso, the lower limbs are stretched, and the child is wrapped with a sheet. An assistant fixed the head of the child. Another assistant fixes the child's body and can perform the operation. Surgical procedure 1. Place the otoscope and expose the lower part of the ear canal. 2. On the inferior wall of the ear canal, use a curved scalpel to make a parallel arc-shaped incision at a distance of 10 mm from the sulcus, which is about 8 mm long. 3. Separate the periosteal flap from the incision direction to the sulcus with a periosteal stripper, and separate the tympanic membrane cartilage ring from the posterior to the tympanic cavity. 4. Use a drill to drill a small groove perpendicular to the sulcus on the lower wall of the external auditory canal, straight through the lower tympanic cavity or to the tympanic crypt. 5. Place the vent tube to insert the vent tube into the small groove, the front end of the edge protrusion is placed in the tympanic chamber, and the other end is exposed outside the incision. 6. Reset the ear canal flap to cover the ear canal bone and snorkel. The tympanic membrane and the ear canal skin are fixed with a gelatin sponge and a gauze or iodoform gauze impregnated with cortisone and antibiotics. complication 1. Infection: otitis media: can occur several days after the operation, mostly due to improper selection of indications or due to lack of disinfection. 2. Jugular bulb injury: Many patients have jugular bulb malformation. Inadvertent incision often causes bleeding to hinder the operation. The operation should be stopped and the ear canal should be stopped. It should be checked carefully before surgery. 3. When the ear canal skin edema blocks the snorkel, it is treated with anti-inflammatory and swelling drugs. After a few days, the outer end of the snorkel can be exposed. 4. Ventilation tube obstruction: The ventilator placed through the ear canal is too long to be blocked. It should be checked regularly. If there is obstruction, it can be perfused with 3% hydrogen peroxide external ear canal, 6 drops each time, 2 times a day. If there is clogging, it should be probed with a fine needle or a thin steel wire under local anesthesia with a microscope, taking care not to damage the tympanic mucosa. 5. Ventilation tube discharge is less common, often caused by chronic inflammation around the snorkel. The infection should be quickly controlled and the snorkel cannot be repositioned. Occasionally, people who were mistaken for foreign objects were forcibly removed. 6. Sensorine : very rare, the pathogenesis is unclear.