What is Tympanoplasty?
Tympanoplasty is a surgical procedure designed to repair a perforated tympanic membrane (eardrum) or the small bones of the middle ear. A perforated eardrum can occur due to chronic ear infections or, less commonly, trauma.
Benefits of Tympanoplasty
When the eardrum is perforated, it can lead to reduced hearing and increased susceptibility to ear infections. Tympanoplasty restores hearing and helps resolve recurring infections by repairing the damaged eardrum.
Why is Tympanoplasty Performed?
While small perforations in the eardrum often heal on their own, large or persistent defects require surgical intervention. Eardrum perforations can be caused by:
- Trauma (e.g., objects in the ear, slap on the ear, or explosions)
- Severe ear infections
- Insertion of foreign objects into the ear canal
- Surgery for ear tubes
- Chronic infections or injury from barotrauma
Tympanoplasty aims to repair the perforated eardrum and, in some cases, address issues with the small bones of the middle ear.
How is Tympanoplasty done?
Pre-surgery preparation includes a comprehensive physical examination and diagnostic tests such as:
- Audiogram (hearing test)
- History of hearing loss, vertigo, or facial weakness
- Microscopic examination
- Blood and urine tests
- Fistula test (if there's a history of dizziness or a marginal perforation)
The surgery can be performed under local anaesthesia or general anaesthesia, depending on the case.
During the procedure
- The surgeon lifts the eardrum, like a trapdoor, to access the perforation.
- A tympanic membrane graft (usually taken from the patient’s own tissue or synthetic material) is placed behind the eardrum to patch the hole.
- The graft is supported with dissolvable packing material that gradually breaks down over the next 2-3 weeks, allowing the eardrum to heal naturally.
Post-surgery
Once the packing dissolves, the graft typically integrates, and normal hearing is restored. However, the graft may sometimes fail, requiring further treatment.
Recovery after Tympanoplasty
- Hospital Stay: The surgery is typically outpatient, so patients can go home the same day.
- Pain and Medication: Antibiotics and mild pain relievers are prescribed to manage any discomfort.
- Time to Return to Work: Most patients can resume work after 5-6 days of rest.
- Graft Healing: After approximately 3 weeks, the packing is removed, and the doctor will check if the graft has fully healed.
Post-Operative Care and Precautions
After the surgery, it's important to follow these guidelines to ensure proper healing:
Do's:
- Keep water out of the ear (use cotton and petroleum jelly while showering, or wear a shower cap).
- Keep the ear dry and avoid swimming or air travel.
- Follow-up appointments to monitor healing and graft success.
Don'ts:
- Do not blow your nose. If you need to cough, do so with your mouth open to avoid pressure on the ear.
- Avoid crowded places and contact with individuals who have cold symptoms to prevent infection.
- Dry stitches behind the ear gently if they get wet.
Risks and Complications
Though Tympanoplasty is generally successful, there is a risk of graft failure in about 2-4% of cases. Other possible complications include:
- Recurrent perforation if the underlying condition persists.
- Persistent infections or discomfort if the graft doesn't fully heal.
Conclusion
Tympanoplasty is a highly effective surgery for repairing eardrum perforations, restoring hearing, and preventing recurrent ear infections. With proper aftercare and follow-up, most patients experience a full recovery and enjoy improved ear health.