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Tympanoplasty - Purpose, Contraindications, Risks, Preparation, and Procedure

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Tympanoplasty is a surgical procedure to correct the tympanic membrane. Read below to know more in detail.

Published At December 28, 2022
Reviewed AtMarch 14, 2023

What Is Tympanoplasty?

Tympanoplasty is a surgical procedure done to repair holes in the eardrum known as the perforated eardrum, which may not close on its own. It is an inpatient procedure done under general anesthesia and takes more than two hours to complete. The aim of this procedure is not only to close the hole but also to improve the hearing of the patient. Tympanoplasty is a safe procedure to eradicate the diseases of the middle ear and to restore hearing and middle ear function.

What Is the Purpose of a Tympanoplasty?

Ear infections and accidental injury during the placement of ear tubes can cause a perforated eardrum. A tympanoplasty is needed when the hole has not closed on its own, even after three months post occurrence.

The surgery aims to fix the membrane, improve hearing, and provide relief to the patient. Following tympanoplasty, the patient can continue with swimming which is normally avoided in cases of holes in the ear.

What Are the Contraindications of Tympanoplasty?

Tympanoplasty is a procedure done under general anesthesia, and the surgeon will assess the condition to analyze if tympanoplasty is required or not. Tympanoplasty is contraindicated in patients with active ear infections, and caution should be taken while operating the working ears. Other options are considered if an individual is unsuitable for general anesthesia.

Patients with the following conditions have a higher risk of anesthesia:

What Are the Potential Risks of Tympanoplasty?

The tympanoplasty risks bleeding and infection following the surgery, as seen in the case of any other surgeries. However, since the tympanoplasty is done in a comparatively small area, thus the complications are relatively rare. The complications can be limited by following the post-surgical instructions.

Other potential risks from tympanoplasty are:

  • Dizziness.

  • Failure of the graft.

  • No improvement in the hearing even after the surgery.

  • Tinnitus (ringing sound in the ear).

  • Strange taste in the mouth.

  • Fever more than 100.4 degrees Fahrenheit.

  • Increased pain.

As the tympanoplasty is done under general anesthesia, there is always risk associated with it in the surgery, including heart and breathing problems. The anesthesiologist will review these complications prior to the surgery.

How to Prepare for Tympanoplasty?

If undergoing a tympanoplasty, one should follow the instructions given by the surgeon. As tympanoplasty is an invasive procedure, it is important for a surgeon to know about any ongoing medications and other supplements, as well as any last-minute snacks or drinks that can interfere with safety during the surgery.

The parent of the child undergoing surgery should prepare the child in a way that is developmentally appropriate for their age. The child should be given some idea about the procedure without giving them unnecessary details that can scare them.

  • What to Wear - It is best to wear a dress that is loose-fitting, comfortable, and easy to remove. The hospital will provide a gown to wear during the procedure. Carry clothes with buttons or zips to avoid putting the dress over the head for easier access to surgical dressing post-surgery.

  • Food and Drinks - Food and drinks will be restricted before surgery as it involves giving general anesthesia. The fasting time depends on the age of the patient. Adults are generally advised to avoid food and drinks from the night before the surgery. This is also applicable to children over the age of one year. Clear liquids may be taken till two hours before the surgery.

  • Pre-op Lifestyle Changes - Before the surgery, try to follow a healthy lifestyle that will speed up the recovery process. Eating well, getting good sleep, quitting harmful habits such as smoking and consumption of alcohol, and keeping other comorbidities under control, like diabetes and hypertension, will prepare the body to withstand the anesthesia and the operative stress.

What to Expect on the Day of Surgery?

If an individual is anxious about tympanoplasty, knowing the procedure will help to find ease.

Before the Surgery - The anesthesiologist will do a pre-operative analysis, and the patient should be frank with them about any medications and symptoms such as fever, cold, and supplement usage. The last time food or drink was consumed.

During the Surgery - The surgeon will make an incision behind the ear or directly approach the ear canal. After lifting the eardrum, the surgeon will close the hole using a graft of the patient’s cartilage, a connective tissue graft, or a synthetic material graft. Packing is placed around the graft to keep it secure. The average time taken for the surgery is around two hours.

If the middle ear bones are damaged, a prosthetic device can be inserted to replace them.

After the Surgery - The patient will be allowed to return home on the same day or the next day of the surgery in case there are no complications following the surgery. Once discharged from the hospital, it is important to follow the doctor’s instructions, even at home. One should avoid strenuous exercise, straining, and heavy lifting for at least two weeks. Also, one should not travel by airplane after the surgery until the doctor says yes. Keep the head in an elevated position while sleeping to reduce the swelling. Also, it will take for the hearing to return to normal after the surgery, so one needs to wait patiently until complete recovery.

Recovery - Following the surgery, the surgeon will plan a follow-up one week after the surgery to check for signs of infection and remove stitches. Follow-ups will be scheduled to check for healing and remove any packing material that does not dissolve on its own.

Conclusion

Tympanoplasty is a surgical correction of the hole in the eardrum and is successful in most cases. Even though the surgery is not complicated, each has its complications. Consult an ENT (ear, nose, and throat) specialist when one starts noticing any symptoms related to the ear to avoid complications from that condition and receive treatment at the right time.

Dr. Syed Peerzada Tehmid Ul Haque
Dr. Syed Peerzada Tehmid Ul Haque

Otolaryngology (E.N.T)

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