Reconstruction of external auditory canal (meatoplasty) (eg, for stenosis due to injury, infection) (separate procedure)
CPT4 code
Name of the Procedure:
Reconstruction of External Auditory Canal (Meatoplasty)
(Eg, for stenosis due to injury, infection)
Summary
Reconstruction of the external auditory canal, or meatoplasty, is a surgical procedure designed to widen the ear canal. This process is often necessary for cases where the ear canal has narrowed due to injury, infection, or other conditions, causing problems with hearing and ear health.
Purpose
Medical Condition or Problem
This procedure addresses stenosis (narrowing) of the external auditory canal, which can be caused by trauma, chronic infections, congenital anomalies, or other pathological conditions.
Goals or Expected Outcomes
- To restore the normal width of the ear canal.
- To improve air conduction hearing.
- To facilitate better ear hygiene.
- To reduce infections and potential complications.
Indications
- Persistent ear infections (otitis externa).
- Significant hearing impairment due to canal narrowing.
- Pain or discomfort in the ear.
- Difficulty in drainage or build-up of ear wax (cerumen).
- Patient history of trauma or surgery leading to canal stenosis.
Preparation
- Fasting typically starts 6-8 hours prior to the procedure to prepare for anesthesia.
- Discontinue certain medications as advised by the doctor.
- Preoperative ear cleaning and any necessary diagnostic imaging, such as CT scans, may be required.
- Informing the medical team of any allergies, especially to anesthesia.
Procedure Description
- After administering anesthesia or sedation, the surgeon makes an incision around the narrowed part of the ear canal.
- Scar tissue or any other obstructive material is carefully removed.
- The ear canal is then reconstructed, potentially using grafts from nearby skin or cartilage.
- Sutures or surgical adhesives may be used to close the incisions and keep the canal open.
Tools, Equipment, or Technology
- Surgical scalpel, scissors, and other microsurgical instruments.
- Possible use of endoscopes for better visual guidance.
- Graft materials, if needed.
Anesthesia or Sedation
- General anesthesia or local anesthesia with sedation.
Duration
The procedure typically takes about 1 to 2 hours, depending on the complexity of the stenosis.
Setting
The procedure is often performed in a hospital operating room or a specialized surgical center.
Personnel
- Otolaryngologist (ENT surgeon)
- Anesthesiologist
- Surgical nurses and assistants
Risks and Complications
Common Risks
- Bleeding
- Infection
- Pain or discomfort in the ear
Rare Risks
- Perforation of the eardrum
- Damage to nearby structures such as facial nerves
- Regrowth of scar tissue, leading to restenosis
Management
Risks are typically managed through careful surgical technique, antibiotics for infection, and follow-up care.
Benefits
- Improved hearing
- Reduced risk of future infections
- Enhanced ability to clean and maintain ear health
- Typically realized within a few weeks after surgery, once healing occurs.
Recovery
- Post-procedure care involves keeping the ear dry and clean.
- Pain medication may be prescribed.
- Follow-up appointments are necessary to monitor healing.
- Full recovery usually takes several weeks.
- Restrictions might include avoiding water in the ear and refraining from heavy physical activity.
Alternatives
- Non-surgical treatments, such as ear drops or medications for infections.
- Hearing aids if the hearing loss is the primary concern.
- Pros: Less invasive and fewer immediate risks.
- Cons: May not address the underlying structural problem.
Patient Experience
During the procedure, the patient will be under anesthesia and should not feel pain. Postoperatively, there may be some discomfort, swelling, and a need for analgesics. Normal activities may resume gradually as healing progresses and follow-up evaluations confirm the success of the procedure.