tympanoplasty - tympanoplasty surgery

tympanoplasty - tympanoplasty surgery

Tympanoplasty or eardrum patching is one of the most common surgical procedures in Turkey, and it is performed in Turkey's hospitals with the best experienced hands.

What is myringoplasty?

Tympanoplasty is a surgery to repair the eardrum (tympanic membrane). The tympanic membrane is the membrane that separates the outer ear from the middle ear. Any rupture in it as a result of trauma or trauma affects the quality of hearing. The patient may have to perform tympanoplasty. This membrane vibrates in response to sound. It transmits vibration to the small auditory ossicles (hammer, anvil, and stirrup), which contributes to the transmission of sound vibrations to the inner ear and improves the quality of hearing. Therefore, if it is perforated, the quality of hearing will decrease, and there will be a clear passage for fluids to enter the middle ear, which causes unforeseen complications.

Tympanoplasty can be performed in children and adults. Tympanoplasty repairs the hole in the eardrum and reduces the risk of further health problems such as vertigo, mastoiditis (inflammation of the bone behind the ear), and in severe cases, permanent hearing loss.

Why is tympanoplasty performed?

Doctors perform tympanoplasty when the eardrum (or tympanic membrane) ruptures and forms a hole that does not close on its own.
Tympanoplasty is performed to improve hearing And prevent the entry of water into the middle ear.

A hole in the eardrum forms for several reasons, including:

  • Inflammation of the middle ear which causes a ruptured eardrum.
  • An ear vent tube (part of treatment for otitis media) that has fallen out or been removed.
  • Sudden exposure to loud sounds.
  • Severe trauma to the head causes perforation of the tympanic membrane.
  • Insertion of foreign bodies into the ear, such as perforation of the eardrum, while cleaning the ear with cleaning sticks.
  • Cholesteatoma, a tumor inside or behind the eardrum.

Although most perforations heal spontaneously, those that persist after dry ear treatments, ear drops, or tympanoplasty should be considered for surgical repair. Most of the time, the eardrum can repair itself.
So in the beginning, doctors closely monitor a child's eardrum perforation (especially in the case of a perforated eardrum). Otitis media in children) instead of fixing it immediately.

They may wait years to repair a perforated eardrum in a young child. This allows the ear to grow large enough to help prevent complications after surgery. We may also delay tympanoplasty if the child has persistent problems with ear infections.

A picture showing the sections and anatomy of the ear
The tympanic membrane is the connection point between the outer and middle ear, and its vibrations are transmitted through the hearing bones for analysis in the inner ear.

How should we prepare for tympanoplasty?

Before tympanoplasty, the child will have a hearing test. This allows doctors to compare the results with hearing tests taken after surgery.
Your health care provider will tell you what and when your child can eat and drink before tympanoplasty. Your child's stomach must be empty on the day of the operation.

You can help prepare your child and reduce his or her fears of tympanoplasty by talking about what to expect during and after tympanoplasty.

Endoscopic images showing the difference between a normal eardrum and a tympanic membrane in the context of otitis media
The difference between a normal eardrum and a tympanic membrane in the context of acute otitis media

Steps of myringoplasty

Tympanoplasty will be performed by an ENT surgeon. Tympanoplasty is performed in a hospital under general anesthesia. An anesthesiologist will monitor the patient carefully and make him sleep safely and comfortably.

During tympanoplasty, the perforation in the eardrum is repaired. The tympanic graft (also called graft) can be made from the patient's own tissue (from his cartilaginous tissue) or the graft can be artificial.

The surgeon will place packing material behind and over the eardrum to keep the graft in place. This material dissolves over several weeks.

The procedure to repair a perforated eardrum usually takes 30 minutes to two hours.

indicate the latest Studies To the effectiveness of myringoplasty and its success in improving hearing (albeit slightly) in the long term and getting rid of the disturbing symptoms of perforation of the eardrum.

Photo of tympanoplasty and the shape of the eardrum before and after the operation
A picture of the eardrum before and after the operation

Risks of eardrum grafting

There is a very small risk of bleeding or infection after tympanoplasty. Other risks include:

  • taste dies
  • ringing in the ear
  • Weird taste in the mouth
  • The most common complications are Tympanic perforation failed to healWhether this happens depends on the size and location of the hole, the health of the ear, and the method of operation chosen.
    This condition occurs in 8% of difficult cases. Most patients can then repeat tympanoplasty, which is often successful.
  • Most patients feel that their hearing improves after successful tympanoplasty, but hearing loss can usually persist due to scar tissue formation or persistent Eustachian tube problems, rarely Hearing deteriorates After tympanoplasty, conductive, sensorineural, or mixed hearing loss may occur, as can tinnitus if hearing worsens.
  • A change in the sense of taste can occur after tympanoplasty surgery due to damage to the taste nerve that passes near the eardrum and is responsible for the taste sensation on the side of the tongue. Loss of taste on the side of the tongue can occur in 10% of ear procedures and lasts for a few months, rarely. be permanent.
  • Dizziness and vertigo are common after tympanoplasty, but they are often brief and rarely persistent.
  • Facial nerve paralysis is a very rare complication of tympanoplasty, as the facial nerve runs through the middle ear and is rarely injured during tympanoplasty. A facial nerve monitor is used during medial and lateral tympanoplasty, which reduces the incidence of these complications.

How can parents help after myringoplasty if it is done in children?

To help a child after tympanoplasty, parents should:

  • Follow your doctor's instructions.
  • Give the child pain relievers when needed.

Parents must also make sure that the child avoids:

  • Inserting water into the ear
  • Heavy lifting
  • Do vigorous and contact sports
  • Any activities that may cause changes in pressure (swimming, diving, air travel)

Most children can return to normal activities two days after tympanoplasty.

The following instructions will help you know what to expect in the days following tympanoplasty. Do not hesitate to Connection If you have questions or concerns, Bimaristan Center Is your family in Turkey.

What after tympanoplasty and myringoplasty?

There are some restrictions on activities until the wound behind the ear heals. Your child should limit activities for the first seven to 10 days after tympanoplasty, and avoid exertion or active play. After that, a slow increase in activity is recommended.

A slight fever may occur after repair of a perforated eardrum and can be treated with simple antipyretics.
Most patients experience mild to moderate pain for a few days after a ruptured eardrum is repaired, and the doctor will often give pain relievers.

Nausea and vomiting are common after eardrum repair, especially in children who undergo this type of middle ear surgery and anesthesia.
The doctor may give you antibiotics to make sure that the middle ear infection has cleared up and that the perforation or fluid has not returned.

Ear care after tympanic repair

During the first week after tympanoplasty, there may be some bloody discharge from the ear. Bleeding after surgery and tympanoplasty is to be expected.
A small cotton ball can be used at the ear hole for drainage, and there may be some oozing from the wound behind the ear. This is not dangerous.
However, if it persists, increases, changes color, or an unpleasant odor is observed, please see the specialist who performed the operation.

Removal of the headband is usually done 24 hours after the eardrum graft procedure. Children can wear the headband as desired after the first night of rest.

The ear must be kept dry, and the patient can shower and wash his hair 3 days after the eardrum has ruptured. Earplugs or a cotton ball should be used when showering/washing the hair.

It should be noted that if tympanoplasty is performed to improve hearing, there may not be a noticeable change until 8-12 weeks after tympanoplasty.

Avoid blowing from the nose for two weeks after tympanic membrane grafting, and sneezing should be done with the mouth open to avoid pressure on the tympanic membrane and the removal of the tympanic patch due to pressure.

Picture of a child doing wrong ear cleaning habits
Many people’s ear cleaning habits, doctors should educate them about its harmful effects to avoid tympanoplasty - eardrum grafting

Sources:

  1. HealthDirect
  2. OneHealthCare
  3. CHOP

Common Questions

The rupture of the tympanic membrane leads to hearing impairment and infection of the middle ear that may resolve on its own without treatment and may require treatment with perforated tympanoplasty.

As in children, it is a thin membrane that separates the outer and middle ear due to trauma or infection, which may heal without medical intervention and may require a surgical procedure.

Acute pain in the ear is the most common symptom, itching inside the ear, purulent or bloody secretions, hearing impairment and dizziness, which may resolve on its own after a few weeks.

It takes about two to three months after the augmentation.

The rap operation may be performed without surgery and without the need for general anesthesia by laser. Studies indicate that the success rate of these operations reaches 61% and is considered a suitable option for those who cannot tolerate general anesthesia, and it is considered one of the latest treatment methods.

The color of the drum is gray, pink or translucent.

The price of tympanoplasty in Turkey is between 4000-6000 (maximum price) USD.

The success rate of tympanoplasty in Turkey is about 75%, according to the latest published studies.

In most cases, the symptoms will reduce significantly, and the hearing may improve (but it often takes several months to improve), but the oozing, pain and secretions will decrease (the secretions will have an unpleasant odor in the absence of a cholesteatoma and the success of the tympanoplasty), and the symptoms of inflammation will disappear after the operation.

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