Endoscopic Myringoplasty

Synonyms: Myringoplasty, Tympanoplasty.

Definition: Myringoplasty is a procedure used to prevent perforated tympanic membranes using corruption.

Temporalis fascia is a commonly used material because:

1. It is an autograft with excellent opportunities to take

2. It can be found near the operation site which makes harvesting easier

3. It has a low base metabolic rate, brightening its success rate

4. Its thickness is like a membranous membrane

There are two methods available for performing myringoplasty:

Compression technique

Under the technique of lying down

Compression technique: This is a difficult technique to master. Here bribe material is inserted under the squash (skin layer) of the ear drum. It is a difficult task to remove only the skin layer from the tympanic membrane, to place graft on perforation and to redrap the skin.

Technique below: This is an easier technique to use. Here, the bribe is usually placed under the female flutes raised by tympano, whose name is below. The main advantage of this procedure is that it is easy to do with good success rates.

Myringoplasty instructions:

1. Perforation of the center has dried for at least 6 weeks.

2. As a follow up to the mastoidectomy procedure to reconstruct the hearing mechanism

Prerequisites for myringoplasty:

1. Penetration of centers that have been dry for at least 6 weeks

2. Normal middle ear tumor

3. The ocular chain is intact

4. Good cochlear reserve

Procedures: First, the fascia temporalis is sufficiently harvested and allowed to dry.

The surgery was performed under local anesthesia. Temporalis fascia graft was harvested under conventional local anesthesia and allowed to dry. The external auditory canal was then treated with 2% xylocaine mixed with 1 in 10 adrenaline injections. About 1/2 cc infiltrates at 3 - o, 6 - o, 9 - o, and 12 - o position about 3mm from the annulus. The patient was initially injected with 1 amp amp of fortwin and 1 ampere phenergan intramuscular injection.

Step I: Improve the penetration margin - Refine the perforation margin by using a sickle knife by selecting an angle. This step is very important as it breaks down the adhesion formed between the outer ear squamous margin (outer layer) and the middle ear mucosa. This approach if left untreated will prevent neo tympanic graft recruitment. This procedure will actually expand the existing penetration. No need to worry.

Step II: This step is better known as the height of the tympano flap. Make a curvilinear incision approximately 3 mm lateral to the annulus. These cuts are usually extended between 12 o'clock, 3 o'clock, and 6 o'clock position in the left ear, and 12 o'clock, 9 o'clock and 6 o'clock hours in the right ear. The skin is slowly lifted from the bone of the outer canal. Always apply pressure to the bone during height. It serves two purposes:

1. It prevents excessive bleeding

2. It prevents vapor deposition

Step III: Increase in annulus and cause middle ear mucosa. In this step, the annulus is gradually pulled from its rim. Once the annulus is raised, use a sickle knife to attach the middle ear mucous attachment with the potting flap. This is a very important step as the inner layer of the left ear drum continues with the middle ear mucosa. Once the middle ear mucosa is raised, the flap is pushed anteriorly until the handles are exposed.

Step IV: Release the bladder flaps from the malleus grip. In this step, the tymano sheet flaps are released from the malleus controller with a sharp operation of the middle ear mucosa. Sometimes malleus guards can be turned into them causing promontory. In this scenario, an attempt is made to overcome the malleus guard. If it is not possible to handle the malleus handle, a small portion of the handle may be cut. The mulch holder was refreshed and stripped of the mucosal lid.

Step V: Corruption placement (underlay technique). Now the right dry fascia temporalis with the right size is introduced through the ear. The roll is slowly pushed under the raised tympano pot flakes. The corruption case was inspired by malleus control. The feather fish flap flap is repositioned in such a way that it covers the advantages of the free bribe introduced. The gelfoam bit is placed around the edge of the raised flap. A bit of gel foam is placed over the closed perforation. This gelfoam has a special role to play. As a result of the suction effect, it removes corruption to the edge of penetration thereby preventing the materialization of the corruption.

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