Name of the Procedure:

Radical Excision of External Auditory Canal Lesion with Neck Dissection
Common name: Radical Excision of Ear Canal Lesion with Neck Dissection Medical term: Radical Excision of External Auditory Canal Lesion with Cervical Lymphadenectomy

Summary

Radical excision of an external auditory canal lesion with neck dissection involves surgically removing a tumor or abnormal growth from the ear canal, along with dissection and removal of lymph nodes in the neck. This procedure treats aggressive or advanced lesions that may have spread.

Purpose

• Medical Condition: Treats tumors or abnormal growths in the external auditory canal, especially when there is a risk of spread to lymph nodes in the neck.
• Goals/Outcomes: Complete removal of the lesion and affected lymph nodes, preventing recurrence and spread of the disease, and improving survival rates.

Indications

• Presence of a visible or diagnosed tumor in the external auditory canal.
• Symptoms like ear pain, hearing loss, or discharge.
• Biopsy-confirmed malignancy.
• Enlarged or suspicious lymph nodes in the neck.

Preparation

• Instructions: Patients may need to fast for 6-8 hours before the surgery.
• Medication Adjustments: Patients may need to stop certain medications, like blood thinners, before the procedure.
• Diagnostic Tests: Includes imaging studies like CT or MRI scans, blood tests, and sometimes a biopsy for histopathological examination.

Procedure Description

1. Anesthesia: General anesthesia is administered to ensure the patient is asleep and pain-free.
2. Incision: A circular incision is made around the lesion in the ear canal.
3. Excision: The lesion is carefully excised along with clear margins to ensure complete removal.
4. Neck Dissection: An additional incision is made in the neck to access and remove affected or suspicious lymph nodes.
5. Closure: The incisions are sutured, and sometimes, drainage tubes are placed to prevent fluid build-up.

• Tools & Equipment: Scalpel, surgical scissors, retractors, surgical microscope.
• Technology Used: Sometimes intraoperative navigation or imaging might be utilized.

Duration

The procedure generally takes around 3 to 6 hours, depending on the extent and complexity.

Setting

Typically performed in a hospital's operating room.

Personnel

• Head and Neck Surgeon
• Surgical Assistants and Nurses
• Anesthesiologist
• Pathologist (for intraoperative frozen section, if required)

Risks and Complications

• Common Risks: Bleeding, infection, pain, scarring.
• Rare Complications: Facial nerve damage, hearing loss, cerebrospinal fluid leak, difficulty swallowing, long-term lymphedema in the neck.

Benefits

• Effective removal of the lesion and potential metastasis.
• Improved long-term prognosis and lower risk of recurrence.
• Relief of symptoms and improvement in quality of life, with benefits noticeable after recovery.

Recovery

• Post-Procedure Care: Pain management with prescribed medications, follow a soft diet, keep the incision clean.
• Recovery Time: Initial recovery in 1-2 weeks, complete recovery may take several weeks.
• Restrictions: Avoid heavy lifting and strenuous activities initially.
• Follow-Up: Regular follow-up appointments for wound inspection, hearing assessments, and imaging studies.

Alternatives

• Radiation Therapy: Could be an alternative or adjunct, but less effective alone for advanced lesions.
• Chemotherapy: Used in combination with surgery or radiation for particularly aggressive malignancies.
• Pros and Cons: Surgery offers immediate removal but comes with higher risks; radiation and chemotherapy have less immediate risks but possibly lower efficacy in some cases.

Patient Experience

• During Procedure: Under general anesthesia, the patient will not feel or be aware of the procedure.
• After Procedure: Patients may experience pain, swelling, and numbness in the ear and neck areas. Pain management strategies include medications and ice packs.
• Comfort Measures: Adequate pain management and support from medical staff play crucial roles in recovery.