Endoscopic Ear Surgery in Gurgaon | ENT Specialist | ENT Doctors in Gurgaon

THE HUMAN EAR

THE HUMAN EAR
Our ear is an organ of hearing and equilibrium that detects and analyses the surrounding sounds and maintains a sense of balance. The human ear is separated into the outer, middle and inner ear.

1. The outer ear is comprised of the visible ear projection called the auricle, or pinna, and the short external auditory canal, the inner end of which is closed by the tympanic membrane, commonly called the eardrum. The outer ear collects sound waves and guides them to the ear drum (tympanic membrane).
2. The middle ear is an air-filled cavity behind the ear drum containing a chain of three tiny bones—the malleus, incus, and stapes, collectively called the auditory ossicles responsible for conduction of the sounds to the inner ear.
3. The inner ear consists of two units: the vestibular apparatus, consisting of the vestibule and semicircular canals, which maintains postural equilibrium; and the cochlea, which contains the sensory organ of hearing.

EAR SURGERIES ROUTINELY DONE AT MAYOM HOSPITAL

TOTALLY ENDOSCOPIC EAR SURGERY
Endoscopic Ear Surgery is a new technique that is now routinely performed at our centre. Endoscopic ear surgery is a less invasive surgery that can be performed entirely through the ear canal. An endoscope can help surgeons see in the bends and crevices during surgery. It is shaped like a narrow tube and the lens is at the end. The lens can be placed extremely close to the object. This gives a very detailed view. Because the endoscope is so narrow, it can slide past the blocking structures. In some cases, this can avoid a larger incision or prevent drilling away of blocking bone. The endoscope provides a wider view.. Endoscopes are angled lenses, allowing the surgeon to literally see around corners with high-quality views and good access for ear surgery. The ultimate purpose of the endoscope is to allow surgery through the ear canal into the middle ear (this is termed transcanal endoscopic ear surgery or TEES). ENT Specialist at Mayom is actively using an endoscopic approach for several disorders include eardrum (tympanic membrane) perforations, cholesteatomas limited to the middle ear, and problems with the ossicles (bones in the middle ear) causing a conductive hearing loss.

MICROSCOPIC EAR SURGERY
In order to perform surgery on the delicate human ear anatomy, surgeons often use a microscope. Microscopes have been used in surgery for over seventy years. They make structures appear larger and clear. Surgical microscopes weigh hundreds of pounds. The microscope produces a three-dimensional image allowing the surgeon to locate and clear off the disease in the outer and middle ear cavity including the mastoid cavity. The patient often requires a small incision in the front of the ear (endaural approach) that gets hidden eventually in the pinna skin folds or a behind-the-ear incision that is often hidden away by our hair-line. Microscopic ear surgeries routinely include surgeries for external ear disease or middle ear disease such as ear drum perforation, middle ear glue, middle ear granulation tissue and infection, mastoid cavity infection, cholesteatoma, ossicular chain reconstruction (ossiculoplasty) etc.At Mayom, our ENT surgeon has expertise in performing neat and complete ear surgeries using the microscope for the patients with ear disorders.

STAPES IMPLANT SURGERY
A stapedectomy or a stapes implant surgery is needed if you are suffering from otosclerosis. In this condition, the stapes fuses with the surrounding bone tissue and ossicles and loses its flexibility to transmit sound waves to the inner ear. Therefore, the patient has hearing impairment and may also tend to speak softly. They may sometimes hear better only when there are loud surrounding noises or in a crowd. In this surgery, a Teflon implant is placed after a part of the stapes bone is removed so as to help improve the flexibility and overcome the hearing problem. This is done with the help of a microscope and the stapes implantation may often require the need of a skeeter drill or a fine laser incision to put the implant in the correct place.

COCHLEAR IMPLANT AND BAHA (Bone-anchored Hearing aids)
Hearing impairment may vary between individuals and in many cases simple hearing aids may not be the solution. In some cases, hearing implants such as Cochlear and BAHA can be helpful for patients with profound hearing loss. Cochlear implants and BAHA are implanted devices that can also be used in patients with malformations of the outer or middle ear wherein they are not able to wear the routine hearing aids. Their sophisticated technology stimulates the auditory nerve and the brain can interpret these signals into sound. The electrodes of the cochlear implant are surgically inserted into the middle and inner ear using the microscope guidance. A bone-anchored hearing solution delivers sound vibrations directly to the inner ear in direct contact with the skull bones.

LATERAL SKULL BASE SURGERY
‘Skull base’ refers to a narrow gap between the lower part of the brain and the part of skull below it which contains blood vessels and the critical nerves that allow vision, smell, heaing, facial movement and breathing. Lateral skull base is located at the side of the skull. This is an advanced surgical technique used by skilled trained surgeons as a microsurgical or endoscopic approach to treat diseases and tumors like meningiomas, acoustic neuromas, gliomas, encephalocoele, cholesteatoma, schwannomas, glomus tumors, etc. At Mayom hospital, our multi-disciplinary team has extensive experience in lateral skull base surgery and contain surgical expertise in this complex procedure.

OFFICE PROCEDURES/ DAY-CARE PROCEDURES ROUTINELY PERFORMED AT MAYOM HOSPITAL

PAINLESS EAR PIERCINGS
Ear piercing has transitioned from a trend to a tradition. With so many parts of the ear to wear your piercings on, it speaks of that accented style you always wanted. It is always better when its quick, simple, easy and painless. Sterile piercing guns and studs are used at Mayom hospital to pierce through the non-cartilage area of the earlobe. You are asked to apply some numbing cream beforehand and the process is seamless and quick; perfect for young children who walk out of the OPD with bedazzled smiles and cute ear studs.

INTRATYMPANIC INJECTIONS
This is a simple, relatively painless minor OT procedure wherein the patient is given an injection inside the middle ear via the ear canal in order to treat disorders like sudden onset hearing loss, tinnitus, vertigo, Meniere’s disease etc. The injection often contains low-dose steroid or gentamicin and is given under local anesthesia. A series of such injections (3 injections at an interval of 1 week each) are often required for the patients before any significant improvement can be noted. These patients are kept under close follow-up. At Mayom hospital, we have delivered excellent results with this simple day-care procedure.

MYRINGOTOMY AND GROMMET INSERTION
In this procedure , a small opening is made in the ear drum to allow drainage of fluid in the middle ear and to relieve the pressure from the middle ear. Sometimes, we may have to insert a small tube called the grommet or a ventilation tube. This procedure is done commonly in children with adenoid hypertrophy or adult patients with eustachian tube dysfunction. The increased middle ear pressure, if not treated, may result in perforation of the ear drum and decrease in hearing along with nagging pain in the ears and a feeling of ear blockage.
The grommet is a self-retaining tube and it comes out naturally from the ears once the outer and middle ear pressure has equalized.
This day-care procedure is of major significance to prevent any chronic ear disease and is done routinely at Mayom hospital.

FOREIGN BODY REMOVAL
This is usually an emergency office procedure but sometimes one may also need to be taken into the minor operation theatre to remove the foreign body from the ear under anesthesia. Although it is frequently seen in young children while playing, adults may also present with ear foreign bodies. Some of the common foreign bodies encountered routinely amidst children and adults include flying insects, parts of toys, pencil lead, hearing aid pieces, ear bud cotton plugs etc. It is recommended that one avoids inserting any kind of blunt or sharp objects in the ears in order to prevent any damage to the ear drum.Foreign body removal is routinely done by our team of expert ENT surgeons at Mayom Hospital.

EAR CLEANING
The human ear is self-cleansing. However, if too much ear wax builds-up and causes symptoms such as ear blockage, decreased hearing or ear pain, it is recommended to seek your ENT doctor for ear cleaning. A combination of sterile, special tools such as wax curette, suction technique or warm water syringing is used to remove the impacted cerumen from the ears. One may even be prescribed ear drops to soften the hard ear wax so as to allow smooth cleaning of the ears.
If you are prone to excessive ear wax production, it is ideal to regularly get the ears cleaned atleast twice a year.
Ear cleaning may also be required for fungal infections of the ear or in case of pus discharge from the ears.

TIPS AND TRICKS TO TAKE CARE OF OUR EARS AT HOME
1. Avoid ear pricking with keys, ear buds, pencil ends or any other objects.
2. Avoid excessive noise exposure.
3. Choose head-sets over in-the-ear plugged headphones.
4. Keep the ears dry; avoid using oil/ water in the ears.
5. Use water-resistant ear plugs when swimming.
6. Get an audiometry (hearing test) done periodically if you have occupational noise exposure.
7. Visit your ENT doctor in case of upper respiratory tract infections for early treatment.
8. Visit your ENT for routine ear checks and wax cleaning.

Ent Surgries