Tympanoplasty for COM without cholesteatoma
Tympanoplasty was also performed under general anesthesia for children
and under regional local anesthesia for adults (2% lidocaine
hydrochloride and 1:50000 epinephrine) with injection on the skin of the
tragus and ear canal. The graft material (including the perichondrium
and cartilage) was harvested from the meatal surface of the tragus, and
the wound was sutured with Vicryl 5-0 (Coated VICRYL® polyglactin 910
Suture, Ethicon, US). After denuding the perforated edge of the ear
drum, a transmeatal incision (straight upward) was made to elevate the
tympanomeatal flap. All the inflammatory tissue in the tympanic cavity
was then completely removed, and the tympanic cavity was cleaned using
saline irrigation. Furthermore, the ossicular chain was checked, and
ossiculoplasty was simultaneously performed if such was deemed
necessary. The skin of the anterior canal and the annulus were elevated,
and surgifoam (Spongostan Gelatin Hemostatic Sponge, Ethicon, US) soaked
with ofloxacin (3 mg/mL) (Tarivid; Daiichi Sankyo, Japan) was placed in
the middle ear cavity. The perichondrium graft was introduced underneath
the perforated ear drum; then, the tympanomeatal flap was repositioned.
The ear canal was then packed with surgifoam soaked with ofloxacin.