Tympanoplasty and/or mastoidectomy
| Anesthesia type | |
|---|---|
| Airway | |
| Lines and access | |
| Monitors | |
| Primary anesthetic considerations | |
| Preoperative | |
| Intraoperative | |
| Postoperative | |
| Article quality | |
| Editor rating | |
| 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 studies As indicated by H&P, consider WBC if associated with URI
Operating room setup NIMS to monitor integrity of facial nerve
Patient preparation and premedication Standard premedication
Regional and neuraxial techniques N/A
Intraoperative management
Monitoring and access Standard monitors, 18g PIV x 1
Induction and airway management Standard induction, succinycholine for intubation (avoid long acting muscle relaxants), ETT
Positioning Supine, HOB often turned 90 or 180 degrees
Maintenance and surgical considerations 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 Avoid bucking and straining on ETT, consider deep extubation
Postoperative management
Disposition Routine PACU
Pain management
Potential complications PONV, 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