OPERATIVE REPORT

NAME : HODMAN FARAH GULED

DATE OF PROCEDURE:  13/8/2020
PREOPERATIVE DIAGNOSIS:
Right chronic otitis media with tympanic membrane perforation and conductive
hearing loss.
POSTOPERATIVE DIAGNOSIS:
Right chronic otitis media with tympanic membrane perforation and conductive
hearing loss.
OPERATION PERFORMED:
Right tympanoplasty, harvesting temporalis fascia graft and use of operating
microscope.
SURGEON:  SERDAR AKKAYA
Assistants: ISMAIL MAHEMED ALI
ANESTHESIA:
General.
COMPLICATIONS:
None.
INDICATION OF PROCEDURE:
This patient had a right chronic draining ear with about a 60% anterior perforation
of tympanic membrane. CT of the temporal bone was normal. She has a
conductive hearing loss in the left ear.
DESCRIPTION OF PROCEDURE:
With the patient under general anesthesia and the oral endotracheal tube in
place, the left ear was prepped and draped sterilely. The post auricular area was
injected with 1% Xylocaine with epinephrine 1:100,000 as well as the external
canal. The ear was examined under microscope and noted have a 60%
perforation in the anterior portion of the tympanic membrane. It was felt that it
was best handled through a postauricular incision. Intercanal incision was made
and then a postauricular incision was made and the two were connected through
the ear canal and the auricle retracted anteriorly.
A temporalis fascia graft was then harvested and satisfactorily used. The
perforation was then well visualized and the edges of the perforation were de-
epithelialized. Tympanomeatal flap was then elevated from 12 o’clock to 6
o’clock. The ossicles were palpated and noted to have intact motility. The middle
ear was then filled with Gelfoam, with Ciloxan drops, and the previously set aside
temporalis fascia graft was then placed underneath the tympanomeatal flap.
Then, the tympanomeatal flap was returned to its original position. The graft was
then meticulously tucked under all edges with perforation under the operating
microscope. Once this was in proper location, the external canal was filled with
Gelfoam.
The subcutaneous tissue was closed with 3-0 chromic and skin was closed with
a running 4-0 nylon. A mastoid dressing was applied. The patient tolerated the
procedure well. Estimated blood loss was 10 mL. The patient was brought to the
recovery room in good condition.