White matter is formed with neurons that have myelinated axo…
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White mаtter is fоrmed with neurоns thаt hаve myelinated axоns
Operаtive Repоrt PREOPERATIVE DIAGNOSIS: Left tympаnic membrаne perfоratiоn POSTOPERATIVE DIAGNOSIS: Left tympanic membrane perforation PROCEDURE: Left tympanoplasty INDICATIONS FOR OPERATION: This male patient sustained a tympanic membrane perforation 20 years ago after diving into a pool. He was now seeking repair. DESCRIPTION OF PROCEDURE: After induction of anesthesia, the table was rotated 180 degrees, and the left ear was prepped and draped in sterile fashion. An operating microscope was then used to inspect the left ear. A large central perforation encompassing approximately 50 percent of the tympanic membrane was visualized. Malleus was clearly visualized and appeared intact. Using 1 percent lidocaine with 1:1,000 epinephrine injection, four-quadrant canal injection was performed. Next, the patient was rotated away, and a postauricular incision was made. Temporalis fascia was harvested and kept aside. A T-shaped incision was made on soft tissue, and Lempert elevator was used to elevate the canal walls again. A freer was used to elevate the canal walls again, and the previously made canal wall incisions were identified. The vascular flap was then raised. Canal wall skin was elevated to the level of the annulus, which was then elevated. The middle ear space was entered through the mucosa using a Rosen. The chorda tympani nerve was identified and preserved. The tympanic membrane was then raised off the chorda tympani nerve and malleus. Gelfoam® was placed in the anterior-most aspect of the middle ear space, and the fascia was then laid into place. Tympanic membrane was laid down over the fascia. The vascular flap was laid back down, and the postauricular incision was closed with Vicryl sutures. PSO ointment was applied to the middle ear space, and at this point, the left ear was cleaned. Sterile dressing was then placed over the ear, and the patient was taken to the recovery room. First-Listed Diagnosis: First-Listed Procedure: Hint: this code requires a modifier Add'l Procedure: