Các nắp tympanomeatal được thay thế. Một ống tympanostomy được đưa vào các màng tympanic nếu ống eustachian chức năng là vẫn còn nghèo để ngăn chặn tràn dịch tai giữa hoặc một phần khác của màng tympanic từ retracting (Hình 3-48). • Một lớp của Gelfoam được đặt trên màng tympanic và hối lộ. | 72 Surgical Atlas of Pediatric Otolaryngology The tympanomeatal flap is replaced. A tympanostomy tube is inserted into the tympanic membrane if eustachian tube function is still poor in order to prevent middle-ear effusion or another portion of the tympanic membrane from retracting Figure 3-48 . A layer of Gelfoam is placed over the tympanic membrane and graft. Two strips of Adaptic gauze impregnated with antibiotic ointment are inserted into the external canal. Figure 3-48 A tympanostomy tube is inserted into the tympanic membrane. Postoperative Care The postoperative care is the same as that described in Chapter 2 under Postauricular Approach. Myringoplasty and Tympanoplasty 73 REFERENCES 1. Saito H Kazama Y Yazawa Y. Simple maneuver for closing traumatic eardrum perforation by micropore strip tape patching. Am J Otol 1990 11 427 30. 2. Paparella MM. Otologic surgery in children. Otolaryngol Clin North Am 1977 10 145-51. 3. Sheehy JL Anderson RG. Myringoplasty a review of 472 cases. Ann Otol Rhinol Laryngol 1980 89 331-4. 4. Koch WM Friedman EM McGill TJI et al. Tympanoplasty in children. The Boston Children s Hospital Experience. Arch Otolaryngol Head Neck Surg 1990 116 35-40. 5. Smyth GD. Tympanic reconstruction. Otolaryngol Clin North Am 1972 5 111-25. 6. Shih L de Tar T Crabtree JA. Myringoplasty in children. Otolaryngol Head Neck Surg 1991 105 74-7. 7. Tos M Orntoft S Stangerup SE. Results of tympanoplasty in children after 15 to 27 years. Ann Otol Rhinol Laryngol 2000 109 17-23. 8. Vrabec JT Deskin RW Grady JJ. Meta-analysis of pediatric tympanoplasty. Arch Otolaryngol Head Neck Surg 1999 125 530-4. 9. Bluestone CD Klein JO. Otitis media in infants and children. WB Saunders 2001. p. 313-7. 10. Potsic WP Winawer MR Marsh RR. Tympanoplasty for the anterior-superior perforation in children. Amer J Otol 1996 17 115-8. 11. Lempert J. Endaural antauricular surgical approach to the temporal bone principles involved in this new approach. Summary report of 1 780 .
