Hartmann Ear Polypus Forceps — CSOM Granulation Removal

Hartmann Ear Polypus Forceps — CSOM Polyp Avulsion

Aural polyps arising from chronic suppurative otitis media (CSOM) are vascular granulation-tissue tags that protrude from the middle ear through a tympanic-membrane perforation into the external canal — they obscure the operator’s view of the underlying pathology, they cause persistent otorrhoea that does not respond to topical drops, and they sometimes hide a cholesteatoma. The Hartmann ear polypus forceps is the instrument with which the polyp is grasped and avulsed under microscopic vision.

The technique

The forceps is advanced through the Hartmann speculum to the polyp base, the jaws are closed on the polyp, and the forceps is rotated slowly so the polyp twists off the underlying mucosa — direct cutting is avoided because the polyp base may be attached to a cholesteatoma sac or to the ossicular chain. Twist-avulsion delivers the polyp with its blood supply intact for histology, and the bleeding base is then suctioned and topical adrenaline 1:1000 is applied.

What the histology decides

Simple granulation polyp → topical aural toilet and ciprofloxacin drops. Cholesteatoma → mastoid surgery referral. Carcinoma (rare) → ENT-oncology pathway. The forceps that delivers an intact polyp gives the pathologist the specimen those decisions depend on.