Microscopic examination at ENT Centre

The use of high-powered Carl Zeiss operative video-microscope gives the best visualization of the ear canal and the ear drum.

Ear Toilet under microscope

Apart from examining the ear canal and the ear drum, the microscope can also help removing any ear wax, foreign body or infective material like pus.

Wax Impaction

Otitis media with effusion is a common ENT disease.
If medical treatment is tried and failed, surgical drainage is indicated. A small incision (hole) can be made with a micro-instrument and fluid can be drained by suction.

In case of certain middle ear illness, injection through the ear drum has to be performed. In such situation, the microscope is used to aid the whole process.

Normal Ear Drum

Fluid Behind Ear Drum

Myringotomy

Grommet

Grommet is a small ventilation tube which is inserted through the small artificial opening on the ear drum. The tube will fall off in 6 to 18 months.

Who needs the operation?
Those who have middle ear infection with effusion

Why having the operation?
The aim is to equalize the pressure on both sides of the ear drum so as to improve hearing. In case of acute middle ear infection, insertion of the small tube can help to drain the pus out.

Surgical risk and possible complications:

• Common risk: recurrence, infection, bleeding, residual perforation of ear drum (around 1 %)
• Less common risk: hearing loss, vertigo, facial nerve paralysis, dislodgement of ventilation tube into middle ear, implantation cholesteatoma

What would happen if NO operation?
Complication of acute middle ear infection will result, such as acute mastoiditis, intracranial spread.

Perforated Eardrum

To repair an ear drum through surgical means, a graft from the muscle near the ear is taken which is then used to repair the hole on ear drum.

Surgical Risk and Complications:

• More common risk (around 1 %): allergic reaction to ear packing, infection, bleeding, loss of taste sensation
• Less common risk (<1%): hearing impairment, dizziness

Tympanoplasty

What would happen if NO operation?
Recurrent infections with ear discharge, sometimes it may come with further hearing impairment due to damage to the inner ear structures.

Cholesteatoma

Mastoidectomy is an operation to remove disease in the middle ear cavity, mastoid antrum and mastoid air cells. (The bony structure behind the ear)

Who needs the operation?
People who have Cholesteatoma, acute mastoiditis, some cases of chronic suppurative otitis media need the surgery.

Surgical risk and possible complications:

• Commoner risk: recurrence and residual disease, infection, bleeding, worsening of conductive hearing loss, taste loss or disturbance, allergic reaction to packing, dizziness
• Less common risk (<1%): facial nerve injury, partial to total sensorineural hearing loss, ear canal stenosis, pinna deformity due to infection of pinna, intracranial injury