Tympanoplasty
A tympanoplasty is a surgical procedure to reconstruct the tympanic membrane (eardrum) or the ossicles (small bones in the middle ear). The procedure is performed via an incision made into the ear canal. The eardrum can become perforated in the event of a chronic infection or trauma. A small perforation in the tympanic membrane will typically heal on its own. However, larger perforations may require surgery. A tympanoplasty is a procedure in which a small hole in the tympanic membrane, otherwise known as the eardrum, or the bones of the middle ear, is repaired.
Procedure
Before the Procedure
- A hearing test will be required before your ENT specialist schedules tympanoplasty surgery to assess your baseline hearing abilities. The test results will be compared to the results of a hearing test performed after you have recovered from surgery to determine the degree of improvement surgery allows.
- You will be scheduled for a preoperative appointment with the ENT specialist, who will conduct tests to ensure you are healthy enough for surgery.
- The ENT surgeon will provide a detailed pre-surgery checklist. These instructions will specify when you should stop eating or drinking, what medications you can take on the day of surgery, and general information about what to expect. Because tympanoplasty surgery is done under general anesthesia, your stomach should be empty on the morning of surgery unless you are instructed to take prescription medications with a small sip of water.
- If you are an adult undergoing tympanoplasty, make arrangements for a family member to drive you to and from the hospital, as you will not be able to drive after undergoing surgery.
During the Procedure
- Tympanoplasty is a specialized procedure for repairing a perforated eardrum in order to protect the middle ear, reduce the risk of bacterial growth, and improve hearing impairments caused by the perforation. An ENT surgeon performs this procedure in an operating room.
- An anesthesiologist will put you completely to sleep with general anesthesia. Depending on the severity of scar tissue formation, the size of the perforation, and any complications, the surgery can take anywhere from 30 minutes to 2 hours or more.
- Your surgeon will approach the area through the ear canal(endaural approach) or a small incision behind the ear(postauricular approach). Excess scar tissue formed in the middle ear as a result of the injury is carefully removed to allow a clear view of the perforation. As the surgeon proceeds with the procedure, it will be determined what additional interventions, if any, will be required to ensure optimal healing.
- A graft is frequently required to close a perforated eardrum completely. Grafts are frequently made from autologous (your own body's) materials, which are usually taken from the same surgery site. After the graft has been successfully placed, other areas, such as the middle ear bones, are evaluated. In severe cases of recurrent middle ear infections, the middle ear bones may become too damaged and must be replaced with a prosthetic. The two common prosthetics used include:
- 1. Partial ossicular replacement prosthesis (P.O.R.P)
- 2. Total ossicular replacement prosthesis (T.O.R.P)
- The type of prosthesis used will be determined by the extent of bone damage seen during surgery.
- After all necessary surgical steps have been completed, the incision will be closed with sutures. As the anesthesia wears off, you will be sent to the recovery room, where you will be watched for several hours.
After the Procedure
- The total recovery time following tympanoplasty varies from person to person. Most of the children and adults should be able to go home.
- You may be given an antibiotic and pain medication to keep infection and pain at bay while the new eardrum heals.
- You will have a follow-up appointment after one week to determine how well you are healing, to make sure there is no infection, and to remove the stitches placed during surgery. If there are no risks and complications, you may be released to return to school or work during this appointment, but it is important to closely follow aftercare instructions as it can take up to 3 months for total healing.
- Once the internal packing material has had time to dissolve, a hearing test will be conducted to determine how well your hearing has improved. This is often scheduled between 8 to 12 weeks after surgery, depending on how the ear is healed. You should avoid swimming or air travel until you recover.
Benefits
Tympanoplasty is a surgical procedure that repairs a perforated eardrum or damaged middle ear bones. The benefits of tympanoplasty include the following:
- Improved hearing: Tympanoplasty can improve hearing by repairing the eardrum or middle ear bones, which can restore sound transmission to the inner ear.
- Prevention of further hearing loss: If left untreated, a perforated eardrum or damage to the middle ear can lead to further hearing loss. Tympanoplasty can prevent this from happening.
- Reduced risk of infection: A perforated eardrum can increase the risk of ear infections. Tympanoplasty can repair the eardrum and reduce the risk of future infections.
- Relief from symptoms: Perforated eardrums can cause discomfort, pain, and ringing in the ear. Tympanoplasty can relieve these symptoms.
- Improved quality of life: Better hearing and reduced symptoms can improve a person's quality of life by allowing them to participate more fully in social, educational, and professional activities.
Risks
Tympanoplasty is performed in and around the ear, and it carries additional risks in addition to the usual risks of infection and bleeding. Possible complications of tympanoplasty surgery include:
- Hearing loss – Tympanoplasty is a procedure that helps restore normal hearing. However, some hearing loss (which is more common with ossiculoplasty) may persist after the procedure. If the hearing is restored to within 10-15 decibels of normal, the operation is considered successful.
- Facial nerve injury and paralysis – The facial nerve runs close to the surgical site and injury may occur. This can cause temporary facial muscle weakness and loss of taste sensation on one side of the tongue.
- Tinnitus – About 2-3% of patients will experience some tinnitus (ringing in the ear) following surgery. This is usually temporary and resolves with time.
- Loss of graft – Because this procedure involves grafting with your own tissue, this tissue will rarely survive long enough for the eardrum hole to heal completely. Another operation may be required in this case. Because this surgery has such a high success rate, re-operation also has a high success rate.
Care at Medicover
At Medicover, Our ENT specialists are equipped with knowledge of advanced technologies and have vast experience in performing tympanoplasty with a mission to bring international standards in the field of comprehensive ENT services. Our patient-friendly environment that prioritizes patient safety and comfort has made us the best ENT care hospital. The ENT department has a track record of successfully completing some of the most complex procedures.
