What is a tympanoplasty?
Tympanoplasty is the surgical treatment of middle ear problems and diseases. Mainly, the intervention consists of repairing the eardrum membrane in order to close its perforation.
The eardrum is a fundamental part of the auditory process. As such, the eardrum is a membrane located in the middle ear, separating it from the outer ear. Thanks to its vibration, the eardrum can transform the sound waves that reach the brain through the external ear.
The objective of tympanoplasty is to reconstruct the eardrum membrane and its transmission mechanism, as well as to achieve a good position, stability and mobility for the eardrum. Tympanoplasty is usually performed under general anesthesia and lasts between two and three hours.
Why is tympanoplasty performed?
Tympanoplasty is performed when there is damage or a perforation in the eardrum of a person, a fact that reduces the hearing ability of the sufferer, besides making him/her more prone to suffer ear infections.
There are several causes of damage to the eardrum:
- There is a severe ear infection
- The patient has suffered a trauma
- Something has been inserted into the ear canal.
- Surgery has been performed to place tympanostomy tubes.
Normally, the specialist will wait at least six weeks before recommending surgery once the perforation or damage to the eardrum has been identified. Tympanoplasty may be performed in the following cases:
- The hole or opening in the eardrum is large.
- There is a chronic ear infection and antibiotics are not working.
- There is a build-up of tissue around the eardrum.
These problems may affect the small bones behind the eardrum. If this happens, an ossiculoplasty can be performed.
What does tympanoplasty consist of?
Tympanoplasty is performed under general anesthesia in both adults and children, although in some cases local anesthesia with sleeping medication is used. Once the patient is asleep, the tympanoplasty process begins, which normally lasts between two and three hours.
There are several different approaches to tympanoplasty, although most procedures are performed with an incision in the back of the ear.
Whenever possible, grafts are used for reconstruction of the eardrum, with temporal fascia being the tissue of choice for specialists.
Image of the parts of the ear
Preparation for tympanoplasty
Once the existing problem in the eardrum has been identified and diagnosed, the specialist will wait at least six weeks before recommending whether or not to repair the eardrum. Once the decision to perform the surgery has been made, the patient should discuss with the specialist and his team in an interview his/her medical history, what medications or products he/she is allergic to, and what drugs are being taken.
In turn, the following guidelines should be followed:
- Do not eat or drink
- If you feel discomfort before the operation, tell the specialist, since it is likely that the operation will be postponed.
Care after tympanoplasty
Once the surgery has been performed, the patient will be admitted to the hospital. The length of hospital stay varies according to each case, although it is usual for the patient to be able to go home in a few hours.
The patient may experience discomfort in the ear, such as dizziness, numbness in the face or even bleeding in the treated area.
To protect the ear after surgery, the patient will have ear plugs placed in the ear for the first five to seven days. Occasionally, a dressing is used to completely cover the ear.
After surgery, the patient should follow the following recommendations firmly:
- Avoid getting water in the ear. When showering or washing the hair, the patient should put a cotton ball in the ear and cover it with petroleum jelly.
- He/she should not stretch the ears suddenly or blow his/her nose. If sneezing is necessary, it should be done with the mouth open.
- Swimming and air travel should be avoided.
In the case that the ear makes some secretion, they should be cleaned gently. Drops may be recommended in the first week. Shortly after the surgery, it is possible to notice sharp pains or popping in the ear, although the patient should not worry, as this is completely normal. It is also important to avoid colds, so it is recommended to avoid crowded places.
Alternatives to tympanoplasty
Nowadays, the only alternative to tympanoplasty is to avoid the intervention, performing an exhaustive follow-up of the state of the ear.
If the perforation in the ear is dry and does not ooze, a wait-and-see attitude can be adopted, although it is true that the perforated ear is more likely to suffer from infections and hearing loss, so surgery is recommended.
In the case of chronic suppuration, the risk of hearing loss and other less frequent complications such as mastoiditis, facial paralysis or meningitis make surgery necessary. On the other hand, if there is a hearing loss but the eardrum is in good condition and intact, the alternative is to use and fit a hearing aid.