Consent Flashcards
Hole in the Eardrum & Myringoplasty
How does the ear work?
The ear is made up of the outer, middle and inner ear. Sound travels through the outer ear and reaches the eardrum, causing it to vibrate. The vibration is transmitted through three tiny bones (the malleus, incus and stapes) in the middle ear. The vibration then enters the inner ear, where nerve cells produce signals that are carried to the brain, where they are interpreted as sound.
DRAW PICTURE
Hole in the Eardrum & Myringoplasty
What image will you sketch for pt?
What are the steps invovled in discussing consent for Myringoplasty (7 mins)!!
Step 1 Explain what the how the ear hears (draw)
Step 2 explain what a perforation is (draw)
Step 3 What problems can develop with a hole in the eardrum?
Step 4 About the procedure- Non-surgical management
Step 5 Benefits of myrigoplasty
Step 6 What does the surgery involve?
Step 7 Discuss alternatives
Step 8 What are the risks?
Step 9 What happens after the procedure?
Step 10 How long will I stay in hospital?
Step 11 What is the recovery period?
Step 12 What is the success rate?
Step 13 What else should I expect after surgery?
Step 14 Follow up care
Risks and complications for Myringoplasty
Altered taste: One of the nerves responsible for taste runs close to the eardrum and may occasionally be damaged during surgery. This can cause an abnormal taste on one side of the tongue, which is usually temporary. Permanent taste disturbance is uncommon.
Dizziness: This is common for a few hours following surgery. The dizziness can last for months or even years if the inner ear is damaged during surgery, but this is rare.
Hearing loss: In most people, the hearing improves or stays the same after surgery. Rarely, severe deafness can happen if the inner ear is damaged.
Tinnitus: Sometimes you may notice an extra noise in your ear after surgery, especially if the surgery causes your hearing loss to worsen. This is called tinnitus and is uncommon.
Facial weakness: The nerve which moves the muscles of the face runs through the ear. There is a slight chance of temporary facial weakness after ear surgery. However, permanent weakness of the face following a myringoplasty operation is very rare. Facial weakness affects the movement of muscles in the face, making it difficult to close your eye, smile and raise your eyebrows. The weakness can vary, from mild to total paralysis. It may develop immediately after surgery or there may be a delay. Recovery can be complete or partial.
Allergic reaction: The ear dressings contain medication to prevent infection. Some patients may develop a skin reaction to the ear dressings. If your ear becomes itchy or swollen, ask your surgeon for advice.
Complications of general anaesthetic: The operation is usually performed under a general anaesthetic. Complications include blood clots in the legs (deep vein thrombosis) or lungs (pulmonary embolism), heart attack, chest infection, stroke and death. The pre-assessment team and anaesthetist will explain to you what happens during a general anaesthetic and the associated risks that are relevant to you.
Risks and complications for Myringoplasty
Altered taste
Dizziness
Tinnitus
Facial weakness
Allergic reaction
Complications of general anaesthetic
