ENT

Tympanoplasty

Description

Tympanoplasty, also known as eardrum repair, is a surgical procedure to fix a perforated or opened tympanic membrane, or the small bones in the middle of the ear, caused due to a chronic infection or an external injury. Myringoplasty, tympanoplasty and ossiculoplasty are few of the most common types of eardrum repair and the recovery is quite quick, however, there may be some complications, which are rare.

A person who is having hearing difficulties or pain in the ear, feels a kind of sensation in one or both ears or suffered from a head injury that causes other hearing issues may get assistance from tympanoplasty. It can be caused due to ear infections, trauma or repeated surgery that has caused a hole in the eardrum. Such damage may result in complete hearing loss from one or both ear and further increase the infections, hence tympanoplasty is needed to recover from such conditions.

During the procedure

You will be given local or general anesthesia to numb the area of operation or to put you to sleep. The kind of tympanoplasty procedure will be chosen depending on the severity of the defect. If the perforation is small, a small incision will be made into the ear canal and the remaining eardrum will be uplifted away from the canal. The surgeon uses a microscope to enlarge the view of the structure to perform the operation.

However, if the hole is large, the incision is made behind the ear, which brings the entire ear forward and gives the surgeon a full access to the perforation. The perforated remnant is then rotated forward to get a clear view of the bones of hearing. The scar tissues are removed from a laser or micro hooks and the remaining tissues are taken from the tragus, the back of the ear or from a vein. Once done, an absorbable gelatin sponge is used to support the graft, which is then inserted under the remaining remnant and in the perforation to fill the gap. In order to place the graft in its place and prevent it from sliding, a very thin sheeting is placed over the graft, so that it won’t slide out when the patient sneezes. The incision is then closed with stitches and a sterile patch is positioned outside the ear canal.

Complications

Complications are rare in tympanoplasty but they do occur, if the surgery isn’t performed well. Possible complications or eardrum repair would be:

  • Graft failure
  • Recurrent perforation
  • Stenosis of the ear canal
  • Scarring in the middle ear
  • Hearing loss
  • Erosion or extrusion of the prosthesis
  • Facial nerve injury
  • Prosthesis dislocation
  • Cholesteatoma
  • Infection
  • Tinnitus (sensation or noises in ear)

Post operative care

Once the surgery is done, your ear will be filled with cotton packing and you will be moved to the recovery room. The packing needs to be present for 5-7 days and after that, a bandage will be placed to protect your entire ear.

You will be discharged from the hospital on the same day and will be directed well on how take care of your ear. Eardrops will be given which you need to apply by gently removing the packing and then replace it again.

You will be guided on how to take a bath to prevent water from entering in the ear.

Don’t blow your nose or pop your ears. Sneeze with your mouth open to soften the pressure from the ear.

Avoid places with crowds and eat proper diet to prevent from any kind of sickness.

You may experience some pain after the surgery, for which painkillers and medications will be prescribed.