A gelatin foam pledget saturated with anesthetic is placed in the middle ear, serving to anesthetize the mucosa. Malleus and incus mobility are checked by vision and palpation always with the same instrument to retain the same feel (Fig. 15-2). The malleus
FIGURE 15—1 External ear canal incisions.
must be visualized from the underside of the drum, pushing the drum aside with a No. 20 suction in one hand and palpating with the other. This is done to exclude other forms of ossicular pathology, such as malleus or incus fixation. A fixed malleus can be a cause of residual conductive hearing loss.
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