Difference between revisions of "Tympanoplasty and/or mastoidectomy"

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{{Infobox surgical procedure
| anesthesia_type =
| airway =
| lines_access =
| monitors =
| considerations_preoperative =
| considerations_intraoperative =
| considerations_postoperative =
}}
 
Provide a brief summary of this surgical procedure and its indications here.
 
== Overview ==
 
=== Indications: Repair perforated or damaged eardrum, remove mastoid air cells damaged by infection or cholesteatoma ===
 
=== Surgical procedure: Incision can be postauricular, endaural or transcanal ===
 
== Preoperative management ==
 
=== Patient evaluation<!-- Describe the unique and important aspects of preoperative evaluation. Add or remove rows from the systems table as needed. --> ===
{| class="wikitable"
|+
!System
!Considerations
|-
|Airway
|Possibly more prone to laryngospasm of associated with URI
|-
|Neurologic
|
|-
|Cardiovascular
|
|-
|Pulmonary
|Patients may have associated otitis or URI
|-
|Gastrointestinal
|
|-
|Hematologic
|
|-
|Renal
|
|-
|Endocrine
|
|-
|Other
|
|}
 
=== Labs and studies<!-- Describe any important labs or studies. Include reasoning to justify the study and/or interpretation of results in the context of this procedure. If none, this section may be removed. -->As indicated by H&P, consider WBC if associated with URI ===
 
=== Operating room setup<!-- Describe any unique aspects of operating room preparation. Avoid excessively granular information. Use drug classes instead of specific drugs when appropriate. If none, this section may be removed. -->NIMS to monitor integrity of facial nerve ===
 
=== Patient preparation and premedication<!-- Describe any unique considerations for patient preparation and premedication. If none, this section may be removed. -->Standard premedication ===
 
=== Regional and neuraxial techniques<!-- Describe any potential regional and/or neuraxial techniques which may be used for this case. If none, this section may be removed. -->N/A ===
 
== Intraoperative management ==
 
=== Monitoring and access<!-- List and/or describe monitors and access typically needed for this case. Please describe rationale for any special monitors or access. -->Standard monitors, 18g PIV x 1 ===
 
=== Induction and airway management<!-- Describe the important considerations and general approach to the induction of anesthesia and how the airway is typically managed for this case. -->Standard induction, succinycholine for intubation (avoid long acting muscle relaxants),  ETT ===
 
=== Positioning<!-- Describe any unique positioning considerations, including potential intraoperative position changes. If none, this section may be removed. -->Supine, HOB often turned 90 or 180 degrees ===
 
=== Maintenance and surgical considerations<!-- Describe the important considerations and general approach to the maintenance of anesthesia, including potential complications. Be sure to include any steps to the surgical procedure that have anesthetic implications. -->Avoid long acting muscle relaxants, volatile anesthetic/TIVA, '''avoid''' N2O, remifentanil to maintain a still patient, dexamethasone and ondansetron as patients are prone to PONV ===
 
=== Emergence<!-- List and/or describe any important considerations related to the emergence from anesthesia for this case. -->Avoid bucking and straining on ETT, consider deep extubation ===
 
== Postoperative management ==
 
=== Disposition<!-- List and/or describe the postoperative disposition and any special considerations for transport of patients for this case. -->Routine PACU ===
 
=== Pain management<!-- Describe the expected level of postoperative pain and approaches to pain management for this case. --> ===
 
=== Potential complications<!-- List and/or describe any potential postoperative complications for this case. -->PONV, facial nerve injury ===
 
== Procedure variants<!-- This section should only be used for cases with multiple approaches (e.g. Laparoscopic vs. open appendectomy). Otherwise, remove this section. Use this table to very briefly compare and contrast various aspects between approaches. Add or remove rows as needed to maximize relevance. Consider using symbols rather than words when possible (e.g. +, –, additional symbols such as ↑ and ↓ are available using the "Ω" tool in the editor). --> ==
 
{| class="wikitable wikitable-horizontal-scroll"
|+
!
!Variant 1
!Variant 2
|-
|Unique considerations
|
|
|-
|Position
|
|
|-
|Surgical time
|
|
|-
|EBL
|
|
|-
|Postoperative disposition
|
|
|-
|Pain management
|
|
|-
|Potential complications
|
|
|}
 
== References ==
 
[[Category:Surgical procedures]]

Revision as of 16:49, 4 April 2022

Tympanoplasty and/or mastoidectomy
Anesthesia type
Airway
Lines and access
Monitors
Primary anesthetic considerations
Preoperative
Intraoperative
Postoperative
Article quality
Editor rating
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User likes
0

Provide a brief summary of this surgical procedure and its indications here.

Overview

Indications: Repair perforated or damaged eardrum, remove mastoid air cells damaged by infection or cholesteatoma

Surgical procedure: Incision can be postauricular, endaural or transcanal

Preoperative management

Patient evaluation

System Considerations
Airway Possibly more prone to laryngospasm of associated with URI
Neurologic
Cardiovascular
Pulmonary Patients may have associated otitis or URI
Gastrointestinal
Hematologic
Renal
Endocrine
Other

Labs and studiesAs indicated by H&P, consider WBC if associated with URI

Operating room setupNIMS to monitor integrity of facial nerve

Patient preparation and premedicationStandard premedication

Regional and neuraxial techniquesN/A

Intraoperative management

Monitoring and accessStandard monitors, 18g PIV x 1

Induction and airway managementStandard induction, succinycholine for intubation (avoid long acting muscle relaxants), ETT

PositioningSupine, HOB often turned 90 or 180 degrees

Maintenance and surgical considerationsAvoid long acting muscle relaxants, volatile anesthetic/TIVA, avoid N2O, remifentanil to maintain a still patient, dexamethasone and ondansetron as patients are prone to PONV

EmergenceAvoid bucking and straining on ETT, consider deep extubation

Postoperative management

DispositionRoutine PACU

Pain management

Potential complicationsPONV, facial nerve injury

Procedure variants

Variant 1 Variant 2
Unique considerations
Position
Surgical time
EBL
Postoperative disposition
Pain management
Potential complications

References

Top contributors: Ed Nguyen and Tony Wang

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