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Excision aural glomus tumor; transcanal

CPT4 code

Name of the Procedure:

Excision of Aural Glomus Tumor; Transcanal

Summary

This surgical procedure involves removing a glomus tumor (a type of benign but potentially harmful growth) from the ear canal through the ear itself (transcanal approach).

Purpose

The procedure aims to eliminate the tumor causing symptoms like hearing loss, tinnitus, or discomfort in the ear. The primary goal is to restore normal ear function and prevent complications associated with tumor growth.

Indications

Patients may need this procedure if they experience:

  • Hearing loss
  • Persistent earache or discomfort
  • Tinnitus (ringing in the ear)
  • Dizziness or balance problems
  • Visible growth in the ear canal

Candidates should be otherwise healthy enough to undergo surgery and have a confirmed diagnosis of a glomus tumor.

Preparation

  • Patients may need to fast for several hours before the procedure.
  • Adjustment or temporary discontinuation of certain medications as advised by the physician.
  • Preoperative imaging tests, such as MRI or CT scans, to assess the tumor's size and location.
  • Routine blood tests and a physical exam.

Procedure Description

  1. The patient is placed under general anesthesia.
  2. The surgeon makes an incision within the ear canal (transcanal approach) to access the tumor.
  3. Specialized tools are used to carefully excise the tumor while preserving surrounding structures.
  4. Hemostasis is achieved, and the incision is closed.
  5. The ear canal is packed with a dressing to support healing.

Duration

The procedure typically takes 2-3 hours, depending on the tumor's size and location.

Setting

The procedure is performed in a hospital's surgical suite or an outpatient surgical center.

Personnel

  • An Otolaryngologist (ENT surgeon)
  • An anesthesiologist
  • Surgical nurses and assistants

Risks and Complications

  • Infection
  • Bleeding
  • Damage to nearby structures (e.g., facial nerve, inner ear)
  • Hearing loss
  • Tinnitus persistence or worsening
  • Recurrence of the tumor

Benefits

  • Removal of the tumor can alleviate symptoms like hearing loss and tinnitus.
  • Improved ear function and prevention of further complications.
  • The patient may start to notice improvements within a few weeks post-surgery.

Recovery

  • Patients may experience some discomfort and swelling, which can be managed with prescribed pain medications.
  • Follow-up appointments to monitor healing and remove the ear packing.
  • Restrictions on activities like heavy lifting or strenuous exercise for a few weeks.
  • Full recovery typically occurs within 4-6 weeks.

Alternatives

  • Watchful waiting: Monitoring the tumor without immediate surgery.
  • Radiation therapy: May be an option for patients unable to undergo surgery or if the tumor is inoperable.
  • Pros and cons should be discussed with a healthcare provider, considering factors like age, health status, and tumor characteristics.

Patient Experience

  • While under general anesthesia, the patient will be asleep and not feel anything during the procedure.
  • Post-procedure, mild to moderate pain and a sensation of fullness in the ear can be expected, which will improve over time.
  • Pain management includes medications and, in some cases, a prescription for antibiotics to prevent infection.

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