Name of the Procedure:

Radical Excision of External Auditory Canal Lesion; Without Neck Dissection

Summary

This surgical procedure involves the complete removal of a lesion or abnormal tissue located in the external auditory canal without performing a neck dissection. It aims to eliminate abnormal or cancerous growths while preserving as much normal tissue as possible.

Purpose

This procedure addresses various conditions such as benign tumors, malignant lesions, or other abnormal growths in the external auditory canal. The primary goal is to remove the lesion to prevent its spread or alleviate symptoms, thereby protecting the patient's hearing and ear function.

Indications

• Presence of a benign or malignant tumor in the external auditory canal
• Persistent, abnormal lesion or growth noted on examination
• Symptoms such as pain, hearing loss, or ear discharge that indicate a problematic lesion
• Previous biopsy confirming the nature of the lesion

Preparation

• Patients may need to fast for a specified period before the procedure (usually 6-8 hours).
• Anticoagulant or antiplatelet medications might need to be adjusted or paused.
• Preoperative imaging studies (CT or MRI) and blood tests.
• A thorough medical history and physical examination are conducted.

Procedure Description

1. The patient is administered general anesthesia to ensure comfort and immobility during the procedure.
2. An incision is made around the ear to access the external auditory canal.
3. Specialized surgical tools are used to carefully excise the lesion, removing it entirely while preserving the surrounding normal tissues.
4. Hemostasis (control of bleeding) is achieved, and the incision is sutured closed.
5. The removed tissue is sent to the pathology lab for further examination.

Duration

The procedure typically takes about 1 to 3 hours, depending on the size and complexity of the lesion.

Setting

This surgery is usually performed in a hospital operating room or a specialized surgical center.

Personnel

• Otolaryngologist (Ear, Nose, and Throat surgeon)
• Anesthesiologist
• Surgical nurses
• Pathologist (for analyzing removed tissue)

Risks and Complications

• Infection at the incision site
• Bleeding or hematoma formation
• Damage to surrounding structures, including potential hearing loss
• Scarring
• Recurrence of the lesion
• Reactions to anesthesia

Benefits

• Removal of the lesion can prevent its progression or spread.
• Alleviation of associated symptoms such as pain or hearing impairment.
• Pathological examination can confirm the nature of the lesion and inform further treatment.

Recovery

• Immediate postoperative care involves monitoring for any complications in a recovery room
• Pain management with prescribed analgesics.
• Instructions to keep the ear dry and clean
• Follow-up appointments to monitor healing and remove sutures, if necessary.
• Full recovery may take several weeks, with limited physical activity to avoid strain on the surgical site.

Alternatives

• Monitoring the lesion with regular check-ups when the risk of malignancy is low.
• Radiation therapy or chemotherapy for certain types of malignant lesions.
• Less invasive surgeries or laser treatments, depending on the lesion's nature and size.
• Each alternative has its own risk profile and potential benefits that should be discussed with the healthcare provider.

Patient Experience

Patients will be under general anesthesia during the procedure and hence will not feel pain. Postoperatively, patients may experience discomfort, swelling, and temporary hearing impairment which can be managed with medications and care. Full recovery might include slight inconveniences, but these usually resolve as healing progresses.