Our Summary

This research paper is about a new method of ear surgery called totally endoscopic ear surgery. The researchers watched 25 endoscopic tragal cartilage tympanoplasties, a specific type of ear surgery, to understand all the tasks and subtasks required to successfully complete the procedure. They used a method called the Systematic Human Error Reduction and Prediction Approach (SHERPA) to identify possible mistakes that could be made during the surgery and ways to prevent or fix these mistakes. They identified 8 main tasks and 50 smaller tasks necessary for the surgery and assessed the risk level for each. This information can be used as a reference for the correct way to perform this type of ear surgery and to improve patient safety by minimizing potential errors.

FAQs

  1. What is totally endoscopic ear surgery and how does it differ from traditional ear surgery methods?
  2. What is the Systematic Human Error Reduction and Prediction Approach (SHERPA) and how was it used in this research?
  3. How can the findings from this research be used to improve patient safety during ear surgeries?

Doctor’s Tip

One helpful tip a doctor might tell a patient about tympanoplasty is to follow all pre-operative instructions provided by the medical team, such as avoiding certain medications or fasting before the surgery. It is also important to discuss any concerns or questions with the surgical team before the procedure to ensure a successful outcome. Additionally, following post-operative care instructions, such as keeping the ear dry and avoiding activities that could put pressure on the ear, can help promote proper healing and reduce the risk of complications.

Suitable For

Patients who may be recommended for tympanoplasty include those with chronic ear infections, perforated eardrums, hearing loss, or other issues affecting the middle ear. Tympanoplasty is typically recommended for patients who have not responded to other treatments such as antibiotics or ear drops, and who continue to experience symptoms such as ear pain, drainage from the ear, or hearing loss. Additionally, patients who have experienced trauma to the ear or who have a history of repeated ear infections may also be candidates for tympanoplasty. It is important for patients to undergo a thorough evaluation by an ear, nose, and throat (ENT) specialist to determine if tympanoplasty is the most appropriate treatment option for their specific condition.

Timeline

Before tympanoplasty:

  1. Patient consults with an ear, nose, and throat (ENT) specialist to discuss symptoms and determine the need for surgery.
  2. Patient undergoes pre-operative testing, such as hearing tests and imaging scans, to assess the extent of damage to the eardrum.
  3. Patient receives pre-operative instructions, such as fasting before surgery and medication adjustments.
  4. Patient undergoes anesthesia before the surgery begins.

During tympanoplasty:

  1. Surgeon makes an incision behind the ear to access the eardrum.
  2. Surgeon removes any scar tissue or damaged portions of the eardrum.
  3. Surgeon takes a graft of cartilage or tissue from the patient’s body to repair the eardrum.
  4. Surgeon places the graft over the eardrum and secures it in place with sutures.
  5. Surgeon closes the incision and applies a dressing over the ear.

After tympanoplasty:

  1. Patient wakes up in the recovery room and is monitored for any immediate complications.
  2. Patient may experience pain, dizziness, or temporary hearing loss in the days following surgery.
  3. Patient follows post-operative instructions, such as taking prescribed medications and avoiding strenuous activities.
  4. Patient attends follow-up appointments with the surgeon to monitor healing and assess hearing improvement.
  5. Patient may undergo additional hearing tests to evaluate the success of the surgery in restoring hearing function.

What to Ask Your Doctor

  1. What is tympanoplasty and why do I need it?
  2. What are the risks and potential complications associated with tympanoplasty?
  3. How experienced are you in performing tympanoplasty procedures?
  4. What is the success rate of tympanoplasty in patients with similar conditions to mine?
  5. What is the recovery process like after tympanoplasty and how long will it take?
  6. Will I need any follow-up appointments or additional treatments after the surgery?
  7. Are there any lifestyle changes I should make before or after the surgery to improve the outcomes?
  8. What should I do if I experience any unusual symptoms or complications after the surgery?

Reference

Authors: Fahy R, Corbett M, Crotty T, Chadwick L, Keogh I. Journal: J Laryngol Otol. 2023 Dec;137(12):1326-1333. doi: 10.1017/S0022215122001992. Epub 2022 Sep 12. PMID: 36093951