Slide 2:
Safe Ear- Csom- tubotympanic. Central perforation. When the perforation is surrounded on all sides by a remnant of tympanic membrane. Here the annulus is intact. The intact annulus prevents the inward migration of outer canal skin epithelium which when it gains entry into the middle ear, becomes skin in the wrong place– cholesteatoma Cholesteatoma can lead to life threatening complications. Since this does not occur in a central perforation ear case, its called a safe ear
Slide 4:
Workup of a Ear Case: Examination under microscope Pus for culture and sensitivity Patch test Pure tone audiogram Mastoid xray
Slide 5:
Treatment for a dry inactive safe ear: If the patch test shows adequate hearing recovery, myringoplasty If the patch test shows inadequate hearing recovery due to ossicular disruption- tympanoplasty with ossicular reconstruction
Slide 6:
Types of myringoplasty: Onlay Underlay Interlay.