_PC- Myringotomy

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School

Houston Community College *

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SRGT 1405

Subject

Medicine

Date

Apr 3, 2024

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docx

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Uploaded by Saffie96

Houston Community College Surgical Technology Program Preference Card Sheet Name: Sapphire Fuller Clinical Site: TCH Wallace Tower Procedure Name: Myringotomy Insertion Pressure Equalizing Tubes- Incision of tympanic membrane. Have to eliminate the buildup of fluid and introduce the PE tube in order to preserve pressure equalization and enable for further drainage. Patient Symptoms: Patient has OME (otitis media with effusion), and bilateral conductive hearing loss. There may have been an infectio in the middle ear that has caused OME, resulting in fluid being collected and causing infection. The fluid could be under pressure due to blocked eustachain tube, causing patient pain. The potential danger presented by otitis media ia hearing loss. Relevant anatonoy is the tympanic membrane, which is the separation between the outer and middle ear. It consist of three layers: outer epithelial, fibrous connective tissue middle, and mucous membrane inner layer. The fibroug ring surrounding the tymbranic membrane is the annulus. Patient Information: (No identifying info) 2 year old female Supplies: suctioning tube 6’, towel OR 15 x 26” blue non-absorbant w adhesive strip, gloves, ear tube Paparella type 1 silicone, gauze 4x4 raytech, Eyepad Instrument Pans: Myringotomy Set, Handgrips for the microscope Specialty Supplies/Equipment: Blade Beaver Myringotomy Spear Tip Narrow Shaft, Ear Tube Paparella, Eye Pad, ENT CHair, Microscope: Leica F12 M325 ENT, Microscope: Leica F20 ENT Drapes (In order of use):drape OR 15 x 26” blue non-absorbant w adhesive strip Suture, needle, absorbable, non-absorbable and tissue used on: none Medication dosage and amount used: Ofloxacin Otic Solution 0.3% - 5 drops

Houston Community College Surgical Technology Program Preference Card Sheet Mayo (what you have on your mayo, if permitted may attach a picture): Surgeons Gloves (6 ½), suction tube, Ofloxacin, Instrument Set, Cotton Balls Formed from Eye Pad, Farrior Ear Specula (sized 3.5 and 4mm), Buck Ear Curette, Disposable Myringotomy Knife, (size 5) Baron Suction Tip, HOuse Alligator Ear Forceps, and (size 3) Baron Suction Tip Steps of procedure (what was done during your case): Patient is placed on OR bed from circulator. The anesthetic medication is given, and the patient is placed in a supine position. Blue non-absorbant with adhesive strip drape is placed along with suction tubing attaching the size 5 Baron suction tip. The microscope is employed to visualize middle and inner-ear structures. The Surgeon assesses the diameter of the patient’s ear canal to determine whether to use the 3.5mm speculum. A Farrior ear speculum is inserted in the ear canal, and cerumen is removed with buck ear curette. An incision is made in the inferior posterior portion of the tympanic membrane with a disposable myringotomy knife. Suction is used with the size 5 stylet to remove fluid. The PE tubes are placed into the tympanic incision, grasping and passing the tube on the alligator forceps. Once the tube is placed in the final position, suctioning is taking place using the size 3 stylet. Adding 5 droplets of Ofloxacin into the ear canal. The speculum is removed, canal is packed with cotton balls. The procedure is bilateral, the patient's head is repositioned, and the surgical team switches sides with the surgeon. The sequence is repeated. Specimen (what it was and what solution it is sent): none Prognosis: No complications: patient is expected to return to normal activities within a few hours; hearing is expected to return to normal in a short period

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