6In Which Situations Surgery Is Necessary: Chronic otitis media sometimes remains passive without causing much discomfort to the patient. In such cases, surgery is not always preferred. However, in cases where hearing loss progresses, inflammation spreads to surrounding tissues and complications occur, the treatment option should be surgery. A condition in which the treatment is strictly surgical in middle ear infections is ‘ cholesteatoma’ Stop. Cholesteatoma is an accumulation of skin and epithelium that grows in clusters in the middle ear and dissolves the bone and spreads to the surrounding tissues. This condition, which can rarely be congenital, usually occurs due to inflammation or negative pressure due to the inoperability of the Eustachian tube, or after some eardrum surgeries. Cholesteatoma is often the cause of complications related to otitis media. Tube insertion, which is generally applied to serous middle ear infections, is explained in a separate title.
What Kind of Examinations Are Performed Before Surgery: When deciding on a middle ear infection, the issues to be considered are the patient’s hearing and how common the inflammation is. For this reason, the first examination after the examination of the patient is usually hearing tests called audiometry. In these tests, values such as hearing level and comprehension percentage are checked. The condition of the inflammation is usually examined radiologically. Normal radiographs can also be taken for this, but computed tomography or sometimes magnetic resonance gives more detailed information. Apart from these examinations, routine examinations that will show the general condition of the patient are performed. These include chest X-ray, EKG, sugar, cholesterol measurements, and urine tests.
How the Surgery is Performed: Middle ear surgeries are often performed with general anesthesia. Although the incision to reach the middle ear is sometimes made in front of the auricle, it is usually made behind the ear. In surgeries such as myringoplasty and tympanoplasty, a membrane is taken from the muscle behind the ear to close the hole in the eardrum. If mastoidectomy is to be performed, that is, if the mastoid bone behind the ear is to be opened, the bone is opened and cleaned with a tool called a drill that resembles a drill. The ossicles in the middle ear are arranged to provide sound transmission. Sometimes prostheses are used for this. In tympanoplasty, the membrane taken from the muscle is placed under or over the old perforated membrane. In radical mastoidectomy, the ossicles are completely removed and hearing is sacrificed. This is used in cases where inflammation and cholesteatoma are difficult to clear.
What are the Complications of the Surgery: There are some important formations around the middle ear. They can be damaged during surgery. These include complete and permanent hearing loss due to damage to the inner ear, facial paralysis due to damage to the facial nerve, and damage to important vessels.
What should I pay attention to after the operation: The most important issue to be considered after chronic middle ear infections is to comply with the dressings. The dressing frequency and shape will be told to you by your doctor. The dressings should not get wet and if there is any slippage, your doctor should be consulted. There is no restriction on the patient’s diet. After mastoidectomy operations, a cavity is formed in the ear and a plug (ear wax) may occur in this cavity. These need to be cleaned periodically.
Is Surgery the Final Solution? : There is no guarantee that problems will disappear and hearing will improve in chronic middle ear surgeries. Situations such as non-retention of the eardrum, dislocation of the inserted prostheses or the continuation of inflammation may occur.
