12 April 2011

TYMPANOPLASTY ( Surgical Repair of the Perforated Eardrum)


Tympanoplasty is a microsurgical procedure on the eardrum and middle ear bones to restore the middle ear hearing mechanism.
  • # Myringoplasty - Repair of a tear in the eardrum
    # Tympanoplasty with ossiculoplasty - Simultaneous repair of a tear in the eardrum and correction of a defect in the bones (ossicles) of the middle ear
    # Tympanoplasty with mastoidectomy - Simultaneous repair of a tear in the eardrum and eradication of bony infection in the area behind the ear
Reasons for Procedure
Tympanoplasty is usually done to repair a tear in the eardrum. The procedure can also help to:
  • - Restore hearing and treat certain types of deafness
    - Prevent infection of the middle ear
Risk Factors for Complications during the Procedure
  • - Large tears
    - Chronic middle ear disease that may require mastoidectomy to be performed at the same time
What to Expect
Prior to Procedure - Before surgery, your doctor will check to be sure that you do not have an ear infection.
During Procedure - Anesthesia (Usually local)
Description of the Procedure
A small incision is made behind the ear to obtain tissue from the temporalis muscle fascia. This tissue is grafted to the eardrum to cover the hole. Other materials may be added to hold the graft in place. If the bones of the middle ear need to be repaired, this is done as well.
A small pack may be left in position in the ear canal, and removed a few days after surgery. Stitches will be left in the ear for a week, and then removed.
Picture of an anteroinferior perforation of the right tympanic membrane temporalis fascia graft is inserted under the posterior tympanomeatal flap and advanced underneath the tympanic membrane to patch the perforation. oralis fascia graft is inserted under the posterior tympanomeatal flap and advanced underneath the tympanic membrane to patch the perforation.
How Long Will It Take?
1-2 hours (sometimes longer if mastoidectomy or ossicular reconstruction needs to be done)
Will It Hurt?
Anesthesia prevents pain during the procedure.
Average Hospital Stay
Tympanoplasty is usually done on an outpatient basis. However, if your surgery includes bone repair (ossiculoplasty), you may stay overnight in the hospital.
Postoperative Care
To insure proper healing, avoid the following:
>> Blowing your nose hard.
>> Sneezing.
>> Exposing your ear to water. Ask your doctor how to wash your hair and shower for the first few weeks after surgery.

What is Ossiculoplasty?
An ossiculoplasty is a surgical procedure designed to repair damaged bones of hearing (the ossicles) with carefully designed artificial bones. Various artificial bones are available to repair different forms of damage.The ossiculoplasty surgery may be per-formed either through an incision hidden behind the ear or through an incision made in the ear canal
It will take several weeks after surgery to determine if the tympanoplasty was a success. Complete recovery takes about 4 weeks.
Call Your Doctor If Any of the Following Occurs
- Redness, swelling, increasing pain, excessive bleeding, or discharge at the incision site
- Increasing fluid draining from the ear
- Odor from fluid draining from the ear
- Signs of infection, including fever and chills
What are the potential complications of these surgeries?
Although we anticipate excellent results from these surgeries, as with any surgery there are certain complications that may occur."These complications are very rare, but we feel the patient should be aware of them" .Anytime one operates on the ear there is always a small risk of increased hearing loss due to damage to the inner ear. In addition, if there is damage to the inner ear, the patient may have temporary post-operative dizziness. The nerve that supplies the facial muscles passes through the ear. Although we take great efforts to identify and avoid this nerve, it can be damaged during surgery leading to a facial weakness. In addition, a fine nerve that supplies taste to the anterior one-quarter of the tongue runs through the middle ear. This nerve is often damaged due to chronic infection, however, it also may be damaged due to surgery

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