The bypass procedure is performed by ENT doctors to treat ear pathologies and eliminate hearing problems. It is quite simple to perform it, and safety is confirmed by many years of experience of otolaryngologists and patients. With chronic otitis media, shunting can significantly improve the patient's condition and speed up the process of recovery.
Shunting of the
Drum Partition This term is understood as a surgical procedure to establish a shunt in the region of the tympanic membrane. The shunt is a small tube that is put in order to keep the aeration of the hearing organ, to prevent accumulation of fluid or to provide long-term administration of medication in the ear.
Most often, the bypass is performed under laboratory conditions under local anesthesia. However, in young children, the procedure most often requires general anesthesia.
Indications for
Shunting is performed by accumulation in the tympanic cavity of exudate or purulent secretions, which can not be removed by conservative therapy or catheterization of the auditory tube. The main symptoms include the following symptoms:
- frequent occurrence of inflammation in the ear and the absence of the effect of conservative therapy;
- chronic fluid accumulation in the ear and progressive hearing loss;
- violation of the functions of an organ of balance against a background of chronic otitis media;
- speech disorder of the baby due to hearing loss;
- violation of patency of the auditory tube, associated with congenital anomalies;
- appearance of barotrauma of the tympanic membrane due to diving or air travel.
Also shunting is indicated in the following pathologies:
- Purulent form of otitis media at the preperforative stage. In this case, there is no hole in the tympanic membrane, and the person has severe pain syndrome.
- Purulent form of otitis media at the perforation stage. In such a situation, there is a lack of stable perforation, which creates difficulties with the excretion of pus and the introduction of drops.
- Exudative otitis media.
- Sensorineural hearing loss. In this case, shunting is performed for the administration of medication.
In the development of exudative otitis, shunting should be performed to remove accumulated fluid and improve the functions of the auditory tube. Indications include the lack of effect of conservative therapy.
Indications for operation
Operation
For shunting to be successful, it is very important to consult a qualified doctor and carefully prepare for the procedure.
Preparation of
Before performing the operation, the doctor performs an inspection. If necessary, the otolaryngologist can prescribe a number of additional procedures. To avoid uncomfortable sensations, the doctor applies anesthesia.
In young children, the procedure is performed under general anesthesia. This avoids unwanted head movements. Adults are usually given a local anesthetic.
Process
This procedure is included in the category of microsurgical operations and is performed by means of a special microscope. This tool significantly increases the area being treated and provides the surgeon with a full visual access to the hearing organ.
Before installing the shunt, the specialist performs a cut of the tympanic membrane. To do this, the epidermal zone of the tympanic membrane is cut and peeled, after which the muscle tissue is gradually cut and expanded. As a result, an oval hole is formed. It is neatly expanded to fit the vent tube. Then remove the liquid or pus.
Then proceed to install the shunt. This device has a small size and shape of the nut with extensions. This allows to reliably fix the shunt on the eardrum. The procedure lasts no more than half an hour.
Installation of the device helps to equalize the pressure in the tympanum. This ensures a normal air flow. The shunt is put temporarily - for a period of 2 months to 1 year. Then it is removed, as a result of which the opening in the membrane closes.
Shunting the tympanum
Recovery and aftercare
After surgery, the patient needs to stay in the hospital for several days. In the absence of complications, he is discharged. After the procedure, pain sensations do not usually arise. Some people experience mild discomfort in the ear region.
Individual patients complain of a feeling of nausea or intoxication. Similar symptoms are associated with the use of anesthesia. People may also show irritability, but it passes quickly enough.
After the operation is completed, the hearing is restored very quickly. To some people, all sounds sound too loud. In such a situation, the ENT doctor prescribes special medications. To avoid penetration of bacterial microorganisms into the middle ear, during bathing, you must protect your ear from water ingress.
How the tympanic septum looks like with the shunt
Treatment
Recovery of the patient directly depends on the tactics of treatment after the operation. The doctor may prescribe special medicines, depending on the characteristics of the recovery period.
Medically
During rehabilitation, a specialist can prescribe antibacterial or anti-inflammatory drops. Thanks to this, it is possible to prevent the development of complications.
Most commonly prescribed are:
- antibacterial drugs - otofa, tsipromed;
- combined agents - dexon, anauran;
- anti-inflammatory drugs - otinum, otypax.
Folk methods
It is strictly forbidden to use folk remedies during the restoration period. After consulting a specialist, you can use these products for otitis:
- Flavor bay leaf. To make a tool, a couple of spoons of ground raw material should be mixed with 200 ml of boiling water. After 2-3 hours the composition should be filtered. The resulting infusion is used in a warm form for washing the ears.
- Aloe and Kalanchoe. You need to take 1 leaf of each plant, crush it thoroughly, wrap it with gauze and place the resulting gruel in your ears. It should be done at night. Since the morning you can get the money.
- Leaves of geranium. To cope with shooting pains, a sheet of geranium must be washed and dried. After that, it is recommended to stretch it with your fingers and place it gently in the ear canal.
What can and can not be done
After installing the shunt, it is very important to protect the ears from water penetration. Especially dangerous in this respect are open water bodies. When taking a shower, you should cover your ear with cotton wool, after having saturated it with oil.
Also after shunting, doctors are not advised to sneeze or blow your nose, covering your nose and mouth. If you need to blow your nose, you need to close each nostril alternately. The effort must be minimal.
After installing the shunt, you need to visit the doctor every month and follow all his recommendations clearly.
How is the shunting of the septum seen in our video:
Alarming symptoms and complications
Shunting is considered a safe procedure. However, in some cases, it still provokes unwanted health effects. They include the following:
- After removing the shunt, the hole may not be tightened by itself. In this situation, the ENT doctor performs an additional procedure - the plastic of the tympanic membrane.
- After repeated inflammatory processes and surgical interventions, scars can develop. However, they usually do not provoke a serious hearing disorder.
- Sometimes inflammation in the middle ear develops after shunting. However, it usually has a more favorable course and is more easily amenable to drug therapy.
- With a premature dropout of the shunt, there is a risk of aggravation of the inflammatory process. In this situation, there is a need for a repeat operation.
References from physicians about the need for shunting:
However, it is important to consider that this procedure is capable of provoking unpleasant complications. Therefore, it is so important to adhere to all the prescriptions of the doctor.