By Richard J. Wiet
Specializes in prevention and security in ear surgical procedure. It provides criteria of care by way of specialists, and the way to prevent issues and take care of them in the event that they happen, for all universal ear surgical procedure methods, and provides info re:indications and contraindications for surgery.
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Additional info for Ear and temporal bone surgery: minimizing risks and complications
Communication with the anesthesia team is important in assuring a stable baseline before operative manipulation is undertaken and to make sure neuromuscular blockade (if it is employed) is not excessive. j Which Operative Procedures Should Be Monitored? The seventh and eighth nerves are the cranial nerves most frequently monitored. Common procedures in which the seventh nerve is monitored include acoustic neuroma removal, cholesteatoma removal, implantation of ossicular or cochlear prostheses, tympanomastoidectomy, parotid tumor removal, microvascular decompression of the seventh nerve, and posterior fossa or cerebellopontine angle tumor removal, as warranted.
EOAEs are further categorized into transient evoked OAEs (TEOAEs) and distortion product OAEs (DPOAEs), which occur in response to acoustic stimulation. SOAEs appear to be present in most normalhearing individuals19,20 and TEOAEs can be obtained from nearly all ears with normal hearing and may be absent with a hearing loss of 35 dB or greater. 21 j Auditory Brainstem Response The ABR is a well-accepted method of evaluation of the auditory pathway as well as an accurate method of establishing auditory thresholds in newborns, infants, and young children.
The following sequence is shown: with no masking the unmasked threshold is 50 dB; when 15 dB masking is presented to the left ear, the patient ceases to respond to the 50 dB tone (the unmasked threshold). The masker then is maintained at the 15 dB level and the test tone is increased to 55 dB, at which point the patient responds. The test tone remains at 55 dB and the masking level is raised by 5 dB steps to determine if a plateau may be accomplished. After several increments to a masker level of 30 dB, the masked threshold remains 55 dB and is thus considered to be the actual threshold for this patient at this frequency.