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 not known.
MASTOIDECTOMY AND TYMPANOPLASTY
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 inner ear.
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 implant surgery.
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.