What Is Tympanoplasty Surgery?
Tympanoplasty is the cleaning of inflammation in the middle ear and mastoid bone and the repair of the eardrum and the hearing system of the middle ear.
Depending on the extent of the existing disease, the surgery may be performed only as repair of the hole in the eardrum (myringoplasty), repair of the ossicular system that provides sound transmission in the middle ear together with membrane repair (tympanoplasty), removal of inflammation that has progressed into the mastoid bone (mastoidectomy), or a combination of these surgeries (tympanomastoidectomy).
This Blog Is for Informational Purposes Only:
In order to provide you with better service and work with greater focus, we have chosen to deal only with nasal surgeries. Therefore, our clinic has been serving as a rhinoplasty clinic since 2017, and only rhinoplasty surgeries are performed. Apart from this, we do not provide general Ear, Nose, and Throat examination and treatment services. This blog is for general informational purposes, and we have shared our theoretical suggestions and recommendations regarding tinnitus. We recommend contacting our colleagues who deal with this subject for the follow-up and treatment of tympanoplasty surgery.
When Is Tympanoplasty Surgery Performed?
In cases where the problem is limited to a hole in the eardrum, if inflammation is not observed when the ear is merely protected from water, if there is no significant hearing loss, and if hearing does not decrease over time, tympanoplasty surgery performed to close this hole is generally intended to improve the patient’s quality of life by eliminating the need to protect the ear from water and to prevent hearing loss that may develop over time, and it is performed according to the patient’s preference.
If recurrent ear discharge is observed despite protecting the ear with the perforated membrane from water and/or there being no source of infection in the nose and sinus region, closing the hole in the membrane is a medical necessity both to improve quality of life and to prevent the progression of hearing loss and the development of complications related to inflammation. In patients with significant hearing loss, problems in the sound-transmitting ossicles should also be corrected during the same surgery if possible; if this is not possible, the sound transmission system should be repaired using various surgical techniques, cartilage, bone grafts, or middle ear prostheses.
If inflammatory tissue called cholesteatoma, which progresses by eroding bone, is detected in the middle ear and mastoid bone, this inflammation must be removed surgically as soon as possible. In patients with cholesteatoma, preserving or repairing the hearing system is the second priority, and the main objective is to remove the inflammation before facial paralysis, hearing loss originating from the inner ear, or intracranial complications such as meningitis and brain abscess develop.
Surgical Technique
When deciding on the surgical technique, the condition of the disease, the location of the hole on the membrane, the structure of the ear canal, whether the mastoid bone will be treated during surgery, and the preferences of the surgeon and ultimately the patient are influential.
Although very different surgical techniques are applied in the middle ear and mastoid bone under a microscope during surgery, what the patient and relatives can see regarding the surgery is limited to the incision in the skin, so questions are frequently asked about this subject.
Tympanoplasty surgery may be performed through incisions made through the ear canal, inside the ear, or behind the ear. While surgery through the ear canal may be performed to repair only a small hole in the membrane, an incision inside the ear is preferred for holes in the middle and posterior parts of the membrane, and an incision behind the ear is preferred for holes in the anterior part of the membrane and in cases where intervention in the mastoid bone is required. The preference of the surgeon who will perform the surgery is the main determining factor in this matter.
The tissue most commonly used in repairing the eardrum is the sheath of the temporal muscle. Since this tissue is close to the surgical field, it can easily be obtained during surgery. The membrane of the cartilage in front of the ear canal or prepared materials such as appropriately processed sterile pieces of brain membrane may also be used.
When a repair is required to provide sound transmission due to damage to the hearing ossicles, many different materials such as prostheses made of various materials, pieces obtained from the cartilage in front of the ear canal, and the middle ear ossicles themselves may be used by positioning and shaping them.
After Surgery
Patients can generally be discharged from the hospital on the first day after surgery after their dressings are changed. In surgeries where no intervention is performed on the mastoid bone, the special sponges inside the ear are generally removed after 10-14 days, and patients are advised to protect their ears from water and use ear drops containing antibiotics and cortisone to prevent infection and reactions in the surgical area. Recovery in this group is completed within 3-4 weeks. In general, it is necessary to avoid influenza-like infections and impacts and not travel by air during the first month. In these patients, the technical and functional success rate of the surgery is generally quite good, depending on the extent of the pathology and the preoperative hearing level.
In patients whose mastoid bone is treated during surgery, various dressings must be applied for periods that vary according to the type of surgery performed. Recovery takes longer in this group. The hearing gain achieved in these patients is generally lower compared with the other group.
Especially when cholesteatoma is located close to the facial nerve and inner ear, the bone in these areas cannot be drilled in order not to damage the nerve and hearing, and disease may remain at the cellular level.
Since the risk of cholesteatoma recurrence is high in patients with this condition, follow-up examinations should be performed at regular intervals after surgery. In patients in this group, interventions to repair the hearing transmission system may be performed when cholesteatoma recurs in small foci or during a second-look control surgery to be performed 6-12 months later.
Frequently Asked Questions
What Is Tympanoplasty?
Tympanoplasty is a surgical procedure performed to repair the eardrum damaged due to chronic middle ear diseases and, when necessary, the hearing ossicles in the middle ear.
In Which Conditions Is Tympanoplasty Performed?
This surgery may be performed for chronic middle ear inflammation, eardrum perforation, recurrent ear infections, and middle ear problems that cause hearing loss.
Does Tympanoplasty Treat Chronic Middle Ear Inflammation?
Yes, tympanoplasty may help bring chronic middle ear inflammation under control. The purpose of the surgery is to eliminate the infection, repair the eardrum, and improve hearing.
How Is Tympanoplasty Surgery Performed?
During surgery, the eardrum is repaired using the patient’s own tissue or suitable graft materials. When deemed necessary, the hearing ossicles in the middle ear may also be reconstructed.
How Long Does Tympanoplasty Surgery Take?
Although the duration of surgery varies according to the scope of the procedure, it is generally completed within 1 to 3 hours.
What Is the Recovery Process Like After Tympanoplasty?
Patients can generally return to their daily lives within a few days. Complete recovery and evaluation of hearing may take several weeks to several months.
Does Hearing Improve After Tympanoplasty?
In many patients, significant improvement in hearing may be achieved by repairing the eardrum and correcting the middle ear structures. Results may vary according to the severity of the disease.
Are There Risks Associated with Tympanoplasty?
As with every surgical procedure, there may be risks such as infection, bleeding, dizziness, tinnitus, or failure to achieve the expected level of improvement in hearing.
What Should Be Considered After Tympanoplasty?
It is important to protect the ear from water after surgery, avoid blowing the nose forcefully, avoid strenuous physical activities, and not neglect follow-up examinations.
Does Tympanoplasty Have a High Success Rate?
Yes, when performed in appropriately selected patients by experienced surgeons, tympanoplasty has a high success rate and is considered an effective method in the treatment of chronic middle ear diseases.
Note: This blog is for informational purposes, and only rhinoplasty surgeries are performed in our clinic
