Micro Ear Surgery

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Leading Edge Technology and Micro Surgical Techniques.

Ear surgery is the one ever changing field in the way of cutting edge technologies that are developed and never ending new microsurgical techniques developed all over the world. Specialist microsurgeons are available at microcare ent hospital and research institute that adapt all the new techniques developed to the needs of those who require to get the best results out of it. We offer you the best ear surgery at very low cost by the best ear surgeons in hyderabad.

 

Highest Quality Results.

Microcare ent hospital and research institute will offer you the specialist services for the treatment of all the ear problems like hearing problems, ear pus discharge, balance disorders facial nerve paralysis, sensorineural deafness, etc. Our specialist ent microsurgeons are pride ourselves on the perfection, innovation, future thinking and also the latest updates to put together with high quality results in all the treatments.

 

All Ear Super Specialty Clinics Under One Roof.

Our approach has been completely integrated with healthcare solution to bring all the ear specialities under one roof. I.e., micro ear surgery , hearing aid, cochlear implant , neuro-otology clinic. We have specially trained staff like micro ear surgery trained ot technicians, nursing staff, audiologists and speech therapists aid . Our specialist ear surgeons will give you the best services to all the patients suffering from related ear problems from all over the world. We are one of the best ear surgery hospital by having the best ear surgery surgeons in hyderabad.

Anatomy and Functioning of the Ear.

A) The outer or external ear

It includes three parts:

Pinna (cartilage covered by skin placed on opposite sides of the head)

Ear canal

Ear drum outer layer (also called the Tympanic Membrane)

 

What is the Tympanic Membrane made up of?

The ear drum has composed with three layers. The outer layer consists of a thin layer of skin, the middle layer is made of fibrous tissue and the inner layer is mucosa (similar to the tissue in the mouth and nose). The Tympanic Membrane is secured to the sidewalls of the end of the outer ear canal by a thick band of tissue called the Tympanic ring or annulus. This ring helps the overall structural integrity and also stability of the ear drum. The integrity of the Tympanic Membrane and associated structures is important for proper sound conduction.


How big is your ear drum?

The ear drum is in oval shaped pearly white membrane, with an average size of 8 x 10 mm.


B) The middle ear includes:

Ear Drum

Middle Ear Cavity (also called the Tympanic Cavity)

Ossicles (i.e 3 tiny hearing bones are connected like a chain, Malleus (or hammer) – long handle attached to the ear drum, Incus (or anvil) – the bridge bone between the malleus and stapes, Stapes (or stirrup) – the footplate; the smallest bone in the body

 

C) Inner Ear

Inner Ear is the part in the ear that contains the organs of special sense of hearing and sense of equilibrium.The bony labyrinth in the temporal bone is divided into three parts i.e, vestibule, semicircular canals and cochlea. Within the bony labyrinth is a membranous labyrinth, which is divided into three parts

The semicircular ducts

Two saclike structures i.e the saccule and utricle are located in the vestibule

The cochlear duct, the only part of the inner ear involved in hearing. The entire inner ear is bathed in a cushioning fluid called as endolymph and the perilymph.

 

Mechanism of hearing: How sound vibrations can be transmitted in the Ear

The outer part of the ear will collect the sound and then the sound travels through the pinna and the auditory canal, a short tube that ends at the ear drum. Ear drum function is to transmit the sound from the air to the ossicles (hearing bones) inside the middle ear and then to the inner ear through a window. Sound entering the outer ear travels through the middle ear and causes the ear drum and ossicles in the middle ear to vibrate and as it travels, sound amplifies (becomes louder) and changes from vibration in air to vibration in fluid. Then the sound vibrations converted into electroneural signal and then it will reach to the hearing centre in the brain, thus we perceive the sound as hearing sensation or as an understandable sound.


Mechanism of Balance or Equilibrium:

Motions of the head cause stimulation of another auditory nerve branch, the vestibular nerve, which signals the position of the head with respect to the rest of the body.

The three semi-circular canals are arranged at right angles to each other, so that they will measure the motions in all three planes and then they transmit signals indicating the changes of position through the vestibular nerve.

Ear Conditions

What is an ear drum rupture or perforated ear drum?

An eardrum rupture is a small hole or tears in your eardrum. The eardrum or Tympanic Membrane is a thin membrane that divides your middle ear and outer ear canal and it vibrates when sound waves enter your ear leading to vibration of hearing bones which passes vibrations to the hearing nerve. If your eardrum is ruptured your hearing can be affected.

 

What are causes of ear drum rupture or holes?

Common causes for Tympanic Membrane perforations (eardrum holes) are:

Infection :- When you have an ear infection, fluids like pus accumulate behind the eardrum will cause pressure to build up then ruptures your eardrum.

Trauma like slapping over the ear with an open hand, ear bud can be used.

Barotrauma like sudden changes in air pressure per example scuba diving, flight journey, driving at high altitudes.

Acoustic trauma due to extremely loud noises.

 

Can a ruptured ear drum heal?

Ear drum holes usually heal spontaneously. This spontaneous healing largely depends upon two factors: the size of the hole and the presence of infection. Holes or perforations greater than 40 – 50% of the size if the ear drums rarely heal by themselves. Infected perforations rarely close spontaneously. Holes of eardrum from blunt trauma like that slapping over the ear is most likely will heal spontaneously. This is true only for eardrum holes from blunt trauma that does not become infected.

 

How long does it take for perforated eardrum to be heal?

Usually, eardrum holes which are due to injury heal in one two months period, if not healed that must be closed with operation.

Precautions to promote healing of ear drum holes

Keeps your ear dry to prevent further infection Preventing water from entering the ear canal by stuffing your ears with cotton with Vaseline helps to avoid infections in the ear and better healing Don’t blow the nose note several times absolutely. Blowing your nose will cause pressure to rise in the middle ears which can be painful and can also slow your eardrum’s healing.

 

What are treatments for ear drum holes or rupture?

Antibiotics and pain killers

The immediate problem that you may feel is the pain. To get relief from pain, you may be given anti-inflammatory medicines. And the next problem will be having a chance of infection of your middle ear in case of traumatic eardrum holes. To prevent this infection, you may be given an antibiotics which are also given in already infected cases.

 

Observation

Eardrum holes often can heal without any invasive treatment. You may be experience a temporary hearing loss, but you can expect a full recovery within eight weeks.

 

Surgery or ear drum hole operation

In these cases where your eardrum hole is not healed, surgery is required i.e patch the hole in the eardrum. A surgical repair of a perforated eardrum is called as tympanoplasty ,where your ENT micro surgeon takes grafts from another area of your body and places it onto the hole of your ear drum.

 

Ear Pus or Discharge

 

What is ear infection with discharge?

Ear discharge is the drainage of pus, blood, earwax or fluid from the ear. An infected ear can produce pus discharge continuously, sometimes intermittently it can damage your hearing. That means you are having a hole in the eardrum as the fluid builds up behind the eardrum and tear the eardrum. Doctors call this as chronic otitis media.

 

What are causes of Ear Pus or Discharge?

Frequent cold is a common cause. The cold could result in the blockage of the eustachian tube, the connection between the throat and middle ear that equalizes air pressure.

Living in overcrowded housing and eating a poor-quality diet.

A ruptured ear drum.

Skin irritations in the ear canal.

Allergies.

Enlarged adenoids.

 

What will happen to me?

It may lead to hearing loss, speech language problem in children. If it is untreated for long time, that leads to the infection for the large bone behind your ear (mastoiditis) and the extra skin growing in your ear (cholesteatoma) and also a very slight risk of infection spreading into your brain that can cause meningitis.

 

Is ear pus contagious?

No, it is not generally contagious.

 

What precautions help me from getting ear infection?

Do not use Cotton Buds to Clean Ears! These cotton buds tend to push earwax back into the canal causing wax to build up or can injure the ear drum. Ears are having self-cleaning mechanism to clean it selves. Allow the natural way to remove earwax by letting tiny hairs in the ear propel the wax outward as the canal moves with talking or chewing. Only you can use the cloth or let the nature follow its course otherwise need to contact your ENT specialist.

Take treatment at the first sign of cold and sore throat. Otherwise it may cause ear infection.

 

What treatments work for Ear Pus or Discharge?

Micro suction cleaning of your ears
Specialist ENT microsurgeon clean your ears with the help of micro suction. Cleaning your ears will clears out the pus and any debris in the canal so that the ear drops can reach the point of infection.

 

Ear drops

Antibiotic ear drops help to dry up your ear as antibiotics kill the bacteria that cause infection. Some of the antibiotics might damage your hearing if you have a hole in your eardrum only specialist doctors prescribe these types of antibiotics.

 

Surgery

This operation is called as myringoplasty or tympanoplasty that done to repair hole in your eardrum. The specialist ENT microsurgeon can put a small patch of graft onto your eardrum hole. The Surgery is more likely to work if your surgeon is experienced in this kind of micro surgeries.

 

Common myths

Going in cold weather causes ear infections: No, ear infections are not caused by going in cold weather without your ears covered. The middle ear most often becomes infected from bacteria that travel up the eustachian tube which is opened behind the nose from the throat.

Ear infections run in families: No, there is no evidence that ear infections are inherited and runs in families. Ear infections are common in infants and young children because they have immature immune system and a shorter, less angled eustachian tube. Those who had frequent ear infections as a child may or may not continue to get ear infections them as adults.

 

Earwax

Earwax is made up of a slightly different mixture of substances in each individuals depending upon their environment, age, race, and diet.

Diagnosis of Ear Conditions

Hearing Clinic: Computerized Cochleo Vestibular Lab

 

One Stop Clinic

MicroCare ENT Hospital and Research Institute, is an international super speciality ENT hospital at Hyderabad, India which provides you the best hearing services for your hearing problems, and all the services under one roof.

 

State of Art Hearing Diagnostic Equipment

MicroCare hearing clinic is equipped with the state of art, modern equipment to help you to get the correct diagnosis and treatment for your hearing problems.

Treatment options

We MicroCare ENT Hospital and Research Institute will provide you all the treatment options for all ear conditions. We assess many factors, including your age, the severity of symptoms and other health conditions and provide you best treatment possible.

 

Wait-and-see approach

Some ear infections can resolve even without the treatment with antibiotics. Symptoms of ear infections usually improve within few days and most infections clear up on their own within one to two weeks without any treatment.

 

Antibiotic therapy.

Treatment with antibiotics might be beneficial for ear infections. You should weigh the benefits of antibiotics against the potential side effects and concern about overuse of antibiotics creating strains of resistant disease.

 

Managing pain

Warm compress: Placing a moist and warm cloth over the affected ear may lessen the pain.
Pain medication: use of over-the-counter acetaminophen or ibuprofen to relieve pain.

 

Ear ventilation tubes.

If your child has the recurrent infection of ear or Glue ear, you may be recommended for procedure to drain fluid from the middle ear called as Grommet insertion. Some ventilation tubes are intended to stay in place for three to six months and then fall out on their own. Other tubes are designed to stay in longer even up to two years and may need to be surgically removed. The eardrum usually get closes up again after the tube falls out.

 

Treatment for chronic ear infection

Chronic ear infection that results in perforation of the ear drum is often treated with antibiotics administered as drops. You will be recommended regular hearing tests and in case of children speech and language tests.

For persistent ear infections not responding to the medication, you will be advised surgical intervention in the form of Tympanoplasty with or without mastoidectomy.

For hearing loss, depending upon the cause, you will be advised the latest treatment. Treatment for severe hearing loss usually means using different hearing technology to improve your hearing. There is no single therapy best for every person with the condition. You will be recommended based on how much hearing you lost, how healthy you are, your lifestyle and how your ears were damaged.

Latest advancements

Latest advancements in MicroCare ENT Hospital and Research Institute, ENT Super Speciality International Hospital in Hyderabad strives to provide the best research outputs in the field of ENT and micro ear surgery to patients who require those advancements. Recent Advances and Future Directions in Hearing Research.

 

Stem Cell Therapy for the inner ear.

Hearing in humans is mediated through the mechanosensory hair cells located within the inner ear. Hair cells are generated only during a short period of embryonic development. As a result, loss of hair cells are in a consequence of disease, injury or genetic mutation, will leads to the permanent hearing loss. At present, cochlear implantation which bypasses hair cells is the only option for profound hearing loss. However, the outcome with the cochlear implantation are still variable and even the best implant will not provide the acuity of a biological ear.

Recent emergence of the stem cell technology has more potential for new therapy for profound hearing loss through the hair cell regeneration.

Identification of molecular component stereocilin prestin has advanced by understanding hair cell transduction at which the hair cells convert the sound vibrations into an electrical signal. Dozens of new gene defects in the hereditary hearing loss that have been identified in the recent years to predict the better course of hearing loss and develop stem cell therapeutic interventions like as possible use of endogenous inner ear stem cells to induce repair as well as the transplanting stem cells into the ear.

 

Recent advances and future directions in balance disorders research.

Advancement in understanding of comorbid relationships among the balance disorders, migraine and anxiety will lead to the better treatments.

The effectiveness of canal repositioning manoeuvres for the treatment of positional vertigo (BPPV) offering clinicians’ wide range of possibilities in the development of new technologies.

The development of vestibular prosthesis from re-engineered commercial cochlear implant which provide a means of stimulating the semicircular canals, part of balancing system of the ear. This vestibular prosthesis can be a treatment for Meniere’s disease and other balance disorders.

 

Hearing aid’s and implantable hearing devices

Advancement in the digital technology of hearing aids will provide noise reduction, directional hearing and feedback cancellation. Binaural hearing aids further improve sound direction localization.

Combined use of a hearing aid and a cochlear implant in opposite ears or the same ear helps hearing communication more than either device alone. The use of binaural cochlear implants has improved further directionality and performance in noise.

Experimental cochlear implant is designed with Infrared cochlear nerve stimulation and intra-nerve electrodes offer more precise stimulation of specific nerve sites.

The auditory brainstem implant (ABI) is the more advanced version of cochlear implant as of now, typically used in cases where the auditory nerve has been surgically removed due to tumor growth, such as in people with neurofibromatosis 2 (NF2). It stimulates the part of the brain that processes sound.

 

Tinnitus

Tinnitus is the abnormal brain activity of auditory and non-auditory areas involved in the perception of sound. Newer therapies will use brain stimulation to treat Tinnitus. The use of vagus nerve stimulation is paired with a variety of tones over an extended period has been effective in the treatment of noise-induced Tinnitus in experimental models.

 

Auditory processing

Advances in brain imaging along with the behavioural studies of auditory perception about the integration of auditory activity with other sensory systems (balance, movement and body position, vision) and cognitive function (learning, memory, attention) have increased in understanding real-world auditory processing and of various auditory neuropathies.

Lasers in ENT

LASERS IN ENT at MicroCare ENT Hospital and Research Institute in Hyderabad strives to provide the best research outputs in the field of ENT to the patients who require those treatment.


Laser Treatment

Lasers in ENT surgery is a common practice today. Lasers areused for ENT surgeries to perform minimally invasive, highly precise surgery. Lasers are suitable for a wide range of treatments for the disease of Ear, Nose, Throat, Head and Neck.

CO₂ laser are mostly used in ENT, particularly for the high degree of precision in cutting combined with an excellent coagulation effect.


The main advantages of CO₂ laser surgery are

Simplicity.

Speed

Minimally invasive surgery

Low morbidity

possibility of operating on elderly or debilitated patients or with pacemaker

Shorter hospitalization (cut in healthcare costs)


Main Treatments:-

Transoral Laryngeal Microsurgery.

Middle Ear Surgery.

Oral Surgery.

Nasal, Endonasal & Endoscopic Sinus Surgery.

Tracheobronchial Tree

Head & Neck.


Uses CO2 laser in ENT:-

Nose :- Papillomas, Rhinophyma, Relangiectasias, Nasal polypi, Choanal Atresia, Turbinectomy.

Benificial in bleeding dyscrasias and couagulopathies.


Oral cavity :-

Leukoplakia, erythroplakia, superficial cancers, debulking of large inoperable tumors.


Advantages

Transpolar approach, precision surgery, haemostasis, less post-operative edema and pain.


Oropharynx :-

Tumours, laser tonsillectomy in coagulopathies.


Larynx :-

papillomas, laryngeal web, subglottic stenosis, capillary haemangioma, vocal nodule,arytenoidectomy, malignant T1 lesions of VC.


Trachea & bronchi :-

Papillomatosis, tracheal stenosis, granulation tissue, bronchial adenoma, debulking of obstructive malignant lesions.


Plastic surgery :-

Benign & malignant tumo of skin, vaporization of naevi and tattoos.


Neuro-otology :- 

Acoustic neuroma.