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Official Description

Tympanic neurectomy

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

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.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The tympanic neurectomy procedure is indicated for patients experiencing excessive saliva secretion from the parotid gland, which can lead to complications such as parotid fistulas. This condition may arise from various underlying issues, including neurological disorders or damage to the nerves that control salivary secretion. The procedure aims to alleviate the symptoms associated with these conditions by targeting the tympanic nerve, which is involved in the regulation of salivary flow.

  • Excessive Saliva Secretion This condition can result in discomfort and complications, necessitating surgical intervention.
  • Parotid Fistulas These abnormal connections can develop due to excessive salivation, leading to further complications that require treatment.

2. Procedure

The tympanic neurectomy procedure involves several critical steps to ensure successful access and excision of the tympanic nerve. Initially, the surgeon approaches the tympanic nerve through the ear canal. This begins with an incision in the canal, allowing for the creation of a tympanomeatal flap. This flap is essential as it provides access to the tympanic cavity where the nerve is located. Once the flap is created, the surgeon carefully exposes the tympanic nerve at the point where it enters the tympanic cavity. This exposure is crucial for the subsequent step, which involves the excision of the tympanic nerve itself. After the nerve has been successfully removed, the tympanomeatal flap is replaced to restore the integrity of the ear canal. Finally, the incision made in the ear canal is closed, completing the procedure.

  • Step 1: Incision in the Ear Canal The procedure begins with an incision in the ear canal to facilitate access to the tympanic nerve.
  • Step 2: Creation of Tympanomeatal Flap A tympanomeatal flap is created to expose the tympanic cavity, allowing for visualization of the tympanic nerve.
  • Step 3: Exposure of the Tympanic Nerve The tympanic nerve is carefully exposed at its entry point into the tympanic cavity, preparing it for excision.
  • Step 4: Excision of the Tympanic Nerve The tympanic nerve is excised to alleviate the symptoms associated with excessive salivation.
  • Step 5: Replacement of Tympanomeatal Flap After the nerve excision, the tympanomeatal flap is repositioned to restore the ear canal structure.
  • Step 6: Closure of Ear Canal Incision The final step involves closing the incision made in the ear canal to complete the procedure.

3. Post-Procedure

Post-procedure care following tympanic neurectomy is essential for ensuring proper recovery and minimizing complications. Patients may experience some discomfort or pain in the ear canal, which can be managed with prescribed analgesics. It is important for patients to follow up with their healthcare provider to monitor for any signs of infection or complications related to the surgical site. Additionally, patients may be advised to avoid water exposure in the ear canal during the initial healing phase to prevent infection. Recovery time can vary, but most patients can expect to resume normal activities within a few weeks, depending on their individual healing process and any specific instructions provided by their healthcare provider.

Short Descr REMOVE MIDDLE EAR NERVE
Medium Descr TYMPANIC NEURECTOMY
Long Descr Tympanic neurectomy
Status Code Active Code
Global Days 090 - Major Surgery
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 1 - 150% payment adjustment for bilateral procedures applies.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 1 - Statutory payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Hospital Part B services paid through a comprehensive APC
ASC Payment Indicator Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P5E - Ambulatory procedures - other
MUE 1
CCS Clinical Classification 26 - Other therapeutic ear procedures
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
LT Left side (used to identify procedures performed on the left side of the body)
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Pre-1990 Added Code added.
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