69145 Excision soft tissue lesion, external auditory canal

Name of the Procedure:

Excision of Soft Tissue Lesion, External Auditory Canal
Common Name: Ear Lesion Removal
Technical Terms: Excision of Cutaneous or Mucosal Lesions of the External Auditory Canal

Summary

The excision of a soft tissue lesion in the external auditory canal involves surgically removing abnormal tissue, such as a growth or cyst, from the ear canal. This outpatient procedure is typically straightforward and performed to relieve symptoms or prevent further complications.

Purpose

This procedure addresses lesions in the external auditory canal that may cause symptoms such as pain, itching, or hearing loss. The primary goal is to remove the lesion completely, alleviate discomfort, and prevent recurrence or complications.

Indications

• Persistent or recurrent lesions in the ear canal
• Symptoms such as ear pain, discharge, itching, or hearing loss
• Suspicion of malignant or pre-malignant growths
• Patient's lesion has not responded to other treatments or poses a risk if left untreated

Preparation

• Fasting: Typically, patients are asked not to eat or drink for several hours before the procedure, especially if general anesthesia will be used.
• Medication Adjustments: Patients may need to stop taking certain medications, such as blood thinners, prior to the procedure.
• Diagnostic Tests: A physical examination of the ear, hearing tests, or imaging studies like CT scans may be conducted to assess the lesion.

Procedure Description

1. Anesthesia: Local anesthetic is commonly used, though general anesthesia may be administered if needed.
2. Preparation: The patient is positioned and the ear cleaned and sterilized.
3. Incision and Excision:
   • A small incision is made around or near the lesion.
   • Specialized surgical instruments are used to carefully remove the lesion.
   • The wound is examined to ensure complete excision of abnormal tissue.
4. Closure: The incision is closed with sutures and the area is dressed to protect and aid healing.

Duration

The procedure typically takes about 30 minutes to an hour, depending on the lesion's complexity.

Setting

Performed in an outpatient clinic, a specialized surgical center, or occasionally in a hospital setting.

Personnel

• Surgeon: An otolaryngologist (ENT specialist)
• Nurse: Assists with preparation and post-procedure care
• Anesthesiologist: If general anesthesia is used

Risks and Complications

• Common: Pain, swelling, minor bleeding, and infection
• Rare: Hearing loss, dizziness, tinnitus, damage to surrounding structures, and recurrence of the lesion

Benefits

• Relief of symptoms such as pain, itching, and hearing loss
• Prevention of potential complications
• Minimal downtime, with many patients returning to normal activities within a few days

Recovery

• Post-Procedure Care: Area must be kept clean and dry; antibiotic ointments may be prescribed.
• Instructions: Avoid inserting any objects into the ear and follow-up for suture removal if necessary.
• Recovery Time: Usually 1–2 weeks, with most patients resuming normal activities within a few days.
• Follow-up: A follow-up appointment to ensure proper healing and no recurrence.

Alternatives

• Observation: Monitoring small, asymptomatic lesions.
• Non-Surgical Treatments: Topical medications or minor procedures like cryotherapy.
• Pros and Cons: Alternatives may be less invasive but might not be as effective in completely removing lesions.

Patient Experience

• During the Procedure: Minimal discomfort with local anesthesia; if general anesthesia is used, the patient will be asleep.
• After the Procedure: Mild pain and swelling managed with over-the-counter pain relief; detailed care instructions provided to ensure comfort and healing.