At Sinus and Nose Hospital we also do Microear
Surgery. When Microscope was introduced for ear
surgery it transformed the face of the ear surgery.
Today many of the surgical procedures for ear
diseases are pretty standardized.
We do small fenestra, Stapedectomy surgery for
OTOSCLEROSIS. Otosclerosis is hereditary disease,
which runs in some families, when one of the tiny
bones in the middle ear gets fixed by new bone
formation. The new bone formation prevents the
stapes from vibrating effectively and sound is not
transmitted to the inner ear from the ossicular
chain. In STAPEDECTOMY surgery the fixed stapes is
disconnected from the incus and its suprastructure
is removed. A small fenestra is drilled in the foat
plate by fine skeeter drill. Then a teflon piston is
placed between the incus and the fenestra (hole)
made. This effectively conducts sound into the inner
ear and the hearing ability is restored.
Otosclerosis affects females commonly, and with each
pregnancy the hearing becomes worse. If one parent
has Otosclerosis, 25% of the children are likely to
inherit the disease. The etiology of the disease is
Mastoidectomy is an operation done to clear the
mastoid air cell system situated behind the ear.
Tympanoplasty is an operation done to close any
perforation present in the tympanic membrane and
reconstruction of the ossicular chain - the three
bone chain made of maleus, incus, and stapes which
conducts sound from the tympanic membrane to the
Mastoidectomy and Tympanoplasty are usually done
together most of the times and separately if the
situations warrants that Mastoidectomy and
Tympanoplasty are usually done for CHRONIC
SUPPURATIVE OTITIS MEDIA - which means chronic
infection of the middle ear cleft. Middle ear cleft
comprises of the EUSTACHIAN TUBE, MIDDLE EAR AND
MASTOID AIRCELL SYSTEM.
Two types of Chronic Suppurative Otitis Media one
recognized – The Safe Type and Unsafe Type. The Safe
Type of CSOM usually has a central perforation with
ear discharge. The chances of complication in this
type of CSOM is very rare and that is the reason it
is called safe type.
The Unsafe Type of CSOM is usually associated with
Cholesteatoma – a tumour like, expanding mass
situated in the middle ear, attic and mastoid, which
is made-up of desquamated squamous epithelium. This
entity has a property of eroding the bone and
destroying the normal Mastoid boundaries.
Intracranial complications and Facial nerve palsy
are associated with Cholesteatoma. Hence it is
called the unsafe type. Surgical clearance of the
disease is a must in unsafe type of CSOM.
IMPLANTABLE HEARING AIDS
Cochlear implants are electronic ears which are
introduced into the inner ear, which do the function
of the inner ear namely cochlear transducer
function. The mechano-transducer function is the
conversion of mechanical energy into electrical
energy by the fine hair cells present in the organ
of corti of the inner ear. Cochlear implant is
useful is patients with damaged hair cells. In
children born with congenital deafness and hair cell
damage the cochlear implant surgery will help them
hear sounds and to develop speech. Best results are
obtained when performed before the age of 3 years.
In patients who develop sensori-neural hearing loss
at a later age will also be benefitted by cochlear
Cochlear implant has a receiver and an electrode
which goes into the receiptients body. An external
device is worn outside behind the ear which picks up
the sound, processes it and transmits it to the
receiver. The electrode away attached to the
receiver inturn stimulates the nerve endings in the
chochlea and electrical energy is transmitted via
the cochlear nerve to the auditory cortex where it
is decoded into sound.
We have started a ‘Hearing Restoration Foundation’
which is a charitable organisation involved in
collection of funds and facilitating cochlear
implant surgery for patients who cannot afford it.