SURGERY
Stacks Image 206
The Ear Treatment and Training Centre provides all forms of surgery to the ear. This will include the external ear or pinna, the ear canal, ear drum and middle ear.

Procedures aimed at improving hearing as well as stopping infection and its complications are a priority.
Certain procedures for the inner ear will also be available.
Interventions to help with vertigo, such as treatment for Meniere’s disease are offered.

Patients are made aware of the reasons and aims for the surgery and they sign or mark a printed form giving their consent to procedures.

There are 3 main goals of surgery for an infected ear.

1. Making the ear safe from further damage. Some ear infections are dangerous to life, so it is true to say that many of the operations can be life saving. Even if there is no danger to life, the infections cause many other problems: ear discharge, offensive smell, loss of hearing, dizziness, and many other risks.

2. To make an ear dry with no discharge. This is the aim but sometimes even though the ear has become safe from serious risks some wetness or discharge continues.

3. To improve hearing. This is always our aim, but when an ear has been infected for a long time this may not be possible. Sometimes a second smaller operation later, when the ear is no longer infected may be offered to repair the hearing. Even if hearing cannot be improved by surgery we aim to make the ear safe and dry, so that a hearing aid can be used.

Microsurgical operations that are routinely available are:

Minor operations:
Grommet insertion
Removal of foreign body from ear

Intermediate operations:
Myringoplasty (repair of hole in eardrum)
Stapedotomy (repair of stapes bone for otosclerosis and deafness)
Tympanoplasty (repair of damaged or infected eardrum)
Meatoplasty and Canalplasty (widening a narrow ear canal)

Major operations:
Ossiculoplasty (repair of the very small hearing bones behind ear drum, to improve hearing)
Atticotomy (clearing small area of infected bone or ‘cholesteatoma’ in the ear, near the eardrum)
Attico-Antrostomy (similar, but more bone needs clearing)
Cortical mastoidectomy (opening the bone behind the ear to clear infection)
Combined Approach Tympanoplasty (usually only for mucosal- or limited disease, or when appropriate follow up and a 2nd stage procedure is feasible)
Modified radical and radical mastoidectomy (clearing widespread infection of bone in ear)
Mastoid cavity obliteration (repairing the area in the ear where bone of mastoid has been cleaned.
Some other procedures related to the ear such as local tumours and nasal problems will be treated if they are directly related to the ear problem.

Parotidectomy and other procedures near ear.

The Ear Centre offers surgery for conditions near the ear, such as
Parotidectomy for tumours of the parotid gland. We have specialised equipment available such as Facial nerve monitoring, magnifying loupes and microscopes to help protect the facial nerve (this nerve runs through the ear and onto the face, it is responsible for movement of the facial muscles).

We offer treatment for conditions such as congenital defects around the ear. A common example is
pre-auricular sinus (a tiny hole near top and front of ear, that may often get infected).

Abscesses behind the ear, often occur due to serious infected disease inside the ear and mastoid bone. We offer full treatment for these conditions, including the underlying ear disease.

Ear and Facial plastic surgery

The ear centre and medical colleagues at GPH-RC offer plastic surgery for the pinna (external part of ear). Each case is different and needs full discussion about options and realistic possibilities. We offer treatment for keloid scarring.