CPT® Code 69676

The procedure described by CPT® Code 69676, known as tympanic neurectomy, is a surgical intervention aimed at addressing excessive saliva secretion originating from the parotid gland, which can lead to the formation of parotid fistulas. The tympanic nerve, which is a branch of the glossopharyngeal nerve, plays a crucial role in this process. This nerve begins its course within the skull, exiting at the jugular foramen, and subsequently passes near the glossopharyngeal ganglion before re-entering the skull through the tympanic canaliculus. Once inside the tympanic cavity, the tympanic nerve forms a plexus in the middle ear, which is essential for its function. The nerve then travels through a canal into the middle cranial fossa, where it exits adjacent to the greater petrosal nerve, ultimately becoming the lesser petrosal nerve. The surgical approach for tympanic neurectomy involves accessing the tympanic nerve through the ear canal. This requires incising the canal and creating a tympanomeatal flap to expose the nerve as it enters the tympanic cavity. The excision of the tympanic nerve is performed at this point, after which the tympanomeatal flap is repositioned, and the incision in the ear canal is closed. This procedure is significant for patients suffering from conditions related to excessive salivation and associated complications.