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The middle ear is an air filled cavity lying behind the eardrum, which is also called the tympanic membrane. There are three bones or ossicles in the middle ear known as the malleus (hammer), the incus (anvil) and the stapes (stirrup). If there is any infection, trauma or if the bones are worn out or the eardrum is damaged greatly, then there will be loss of hearing. If it is diagnosed as the inner ear problem, then surgery is advised. This is done under local or general anesthesia on an outpatient basis and takes about an hour to three hours.
The middle ear bones may be replaced by manmade prostheses which are used for the middle ear reconstruction and they are quite effective. If the stapes bone is defective it can be removed and an artificial one inserted. If the perforation of the tympanic membrane is small it can be sutured. If any of the inner ear bones are worn out, artificial manmade ones can replace them. The body accepts these prostheses and generally there is no problem.
Cholesteatoma is a growth of skin in the middle ear. Skin lines the entire ear and the ear canal with the outer layer of skin getting constantly expelled. Keratin is a major constituent of this skin cells. A perforation of the eardrum because of injury or infection can result in a cholesteatoma. The problem occurs when this dead skin cannot be expelled from the ear and these dead cells produce an enzyme which causes destruction of the bones causing dizziness and hearing loss.
The problem is diagnosed through a CT scan. The main goal for cholesteatoma is treating the infection and the secondary one is to restore the hearing. If the cholesteatoma is small it can be removed entirely in one piece and the eardrum and the ossicles reconstructed in one single operation. If it is bigger it can be removed in pieces. Sometimes a piece may remain behind and regrow when another operation may be necessary.
Surgery is performed either through the ear canal or in combination with a cut behind the ear. The procedure lasting up to three hours is performed using a high-powered microscope. Patients can go home the same day. Restrictions are that the patient is not supposed to blow his nose or sneeze with the mouth open. Healing period is generally three weeks though hearing is restored almost immediately. Most of these procedures are highly successful. |
