Excision external ear; complete amputation
CPT4 code
Name of the Procedure:
Excision External Ear; Complete Amputation
Common Name(s): Ear amputation, External ear removal
Summary
An excision of the external ear involves the surgical removal of the complete outer portion of the ear due to severe trauma, cancer, infection, or congenital deformity.
Purpose
The procedure is typically performed to address severe infections, malignant tumors, or traumatic injuries that cannot be treated by less invasive means. The primary goal is to remove the diseased or damaged tissue to prevent further complications and improve the patient's overall health.
Indications
- Malignant tumors (e.g., squamous cell carcinoma, melanoma)
- Severe trauma to the external ear
- Chronic infections unresponsive to treatment
- Congenital deformities requiring reconstruction
Preparation
- Pre-procedure fasting (usually 8 hours before surgery)
- Medication adjustments as directed by the physician (e.g., blood thinners may need to be stopped)
- Preoperative imaging studies (CT scan or MRI) to assess the extent of the lesion
- Blood tests to evaluate the patient’s overall health
Procedure Description
- Anesthesia: General anesthesia is administered to ensure the patient is completely unconscious and pain-free during the procedure.
- Incision: A surgical incision is made around the ear.
- Tissue Removal: The entire external ear is carefully excised, ensuring all diseased or damaged tissue is removed.
- Hemostasis: Blood vessels are cauterized or ligated to prevent excessive bleeding.
- Closure: The incision site is closed meticulously with sutures.
- Dressing: A sterile dressing is applied to the surgical area to protect it during the initial stages of healing.
Duration
The procedure typically takes about 3 to 4 hours, depending on the complexity of the case.
Setting
This surgery is performed in a hospital operating room equipped for major surgical procedures.
Personnel
- Surgeon
- Surgical nurse
- Anesthesiologist
- Operating room technician
Risks and Complications
- Infection at the surgical site
- Excessive bleeding
- Adverse reactions to anesthesia
- Scarring
- Asymmetry or cosmetic concerns
- Hearing loss (if the inner ear structures are affected)
Benefits
- Removal of diseased, damaged, or infected tissue
- Prevention of further spread of malignancy or infection
- Improvement in overall health and potentially life-saving
Recovery
- Post-procedure hospitalization for monitoring (usually 1-2 days)
- Pain management with prescribed medications
- Strict adherence to wound care instructions
- Follow-up appointments for suture removal and to monitor healing
- Possible cosmetic reconstruction at a later stage
- Expected recovery time ranges from several weeks to a few months
Alternatives
- Partial ear excision: Only the affected portion of the ear is removed.
- Radiation therapy: For certain cancers where surgery is not possible.
- Chemotherapy: For treatment of malignant tumors.
- Reconstructive surgery: As a subsequent procedure to improve cosmetic appearance.
Patient Experience
During the procedure, the patient is asleep (under general anesthesia) and will not feel any pain. After surgery, there will be some discomfort and pain, managed with medications. The patient may experience swelling, bruising, and a period of adjustment to the change in appearance. Regular follow-up appointments are crucial to ensure proper healing and address any complications promptly.