Tympanoplasty
What is tympanoplasty in ear surgery?
tympanoplasty is a surgical procedure that repairs a perforated eardrum or ear damage. This involves reconstructing the wall and the elements of the roof box, namely the roof and the bones. Depending on the size and location of the lesion, the procedure can be performed either through the external ear canal or through a retro-auricular approach (small scar behind the ear). The lesion tissue can be removed using an operating microscope, a graft can be placed to repair the roof, and the ossicles can be fixed. Tympanoplasty is performed in cases where spontaneous healing has not occurred.
What are the goals of surgery?
The goals of tympanoplasty surgery are:
Close the eardrum and repair the injuries
Improving hearing quality
have frequent ear infections
In case of cholesteatoma, enlarge the ear cavity to facilitate the operation and postoperative monitoring.
In most cases, the eardrum heals without any side effects. However, tympanoplasty, like any surgical procedure, can cause complications such as bleeding, dizziness, tinnitus or reversible loss.
What are the indications for tympanoplasty?
In the following cases, tympanoplasty is recommended:
Long-term eardrum perforation
Repeated infections (ear infections)
Partial deafness and chronic inflammation of the ear
Irreversible hearing loss and/or hearing loss
The middle ear ossicles deteriorate
Cholesteatoma
Tympanoplasty closes the eardrum, heals lesions, improves hearing, reduces the risk of infection and most of the time allows normal swimming without a protective cap. Depending on the size and location of the lesion, it can be carried out either through the external ear canal or through a retro-auricular approach (small scar behind the ear). The operating microscope is used to extract injured tissue, place a graft to repair the eardrum and possibly repair the ossicles (by autograft or artificial prosthesis). Tympanoplasty is a procedure for adults and children, and the procedure for children begins at age 7.
How is a perforated eardrum diagnosed?
The clinical examination of the ear, carried out with an otoscope, makes it possible to diagnose a perforation of the eardrum. Most often, eardrum perforations are caused by one (or more) ear infections or trauma. Ear pain, hearing loss, ringing, dizziness, ear discharge, nausea and vomiting are some of the symptoms. A tympanoplasty may be considered if the perforation does not resolve spontaneously within a few weeks. Tympanoplasty is a surgical procedure that repairs a perforated eardrum or ear damage.
How does the surgery take place?
Tympanoplasty is a surgical procedure that repairs a perforated eardrum or ear damage. The steps of the tympanoplasty procedure are as follows:
The procedure is carried out under general anesthesia.
Depending on the size and location of the lesion, the surgeon makes a small incision in the external ear canal or in the retroauricular groove (posterior route).
The surgeon takes tissue from the patient (cartilage, temporalis fascia or perichondrium) to carry out the graft.
Repair of the eardrum: The surgeon cleans the edges of the perforation, places the graft to close the hole and, if necessary , fixes the ossicles.
The surgeon closes the incision with stitches.
After the operation, the patient is monitored to ensure that healing is progressing correctly.
What is the duration of the intervention?
The duration of the procedure varies from thirty minutes to two hours, depending on the severity of the lesion.
What are the surgical consequences?
Pain: Pain medication may be prescribed to relieve pain.
Bandage: A bandage is placed on the operated ear for a few days.
Wick: A wick is placed in the external ear canal to prevent bleeding and promote healing.
Rest: It is recommended to rest for a few days after the operation.
Work stoppage: A work stoppage of 3 weeks to 1 month is generally prescribed.
Activities: It is recommended to avoid strenuous physical activities, air travel and swimming for a few weeks after the operation.
Hygiene: It is crucial to maintain good ear hygiene and not bathe or shower during a few days after the operation.
Medical follow-up: Follow-up visits are scheduled to monitor healing and ensure everything is going well.
What are the advantages ?
Tympanoplasty is a surgical procedure that has several advantages:
In 80 to 90% of cases, the holes in the eardrum are closed.
Improved hearing ability.
Prevent ear infections. Avoid potential complications of chronic ear discharge. Avoid complications of cholesteatoma, such as meningitis, facial paralysis, brain abscesses and complete deafness.
The operation is carried out under local anesthesia, which avoids general anesthesia and allows a faster recovery of the everyday life.
Butterfly cartilage transplantation to the eardrum in children is carried out in an easy way, which reduces the time of surgery and reduces painful consequences for the child.
What are the risks ?
Tympanoplasty is a surgical procedure that carries risks, like any procedure. The risks and precautions to take during tympanoplasty are as follows:
Risk of failure to close or partially close the perforated eardrum.
Risk of non-recovery of hearing or worsening of hearing
Risk of transient dizziness due to damage to the inner ear.
Risk of bleeding.
Risk of tinnitus.
Risk of reversible or irreversible hearing loss.
Risk of infection.
Risk of pain.
Risk of inflammation.
Risk of allergic reaction to anesthesia or transplant.
Risk of perforation of the tympanic membrane.
Risk of retraction of the tympanic membrane.
Risk of graft necrosis.
Risk of graft falling.
Risk of inflammatory reaction of the middle ear.
Risk of facial paralysis.
Risk of meningitis.
Risk of brain abscess.
Risk of complete deafness.
However, the procedure known as tympanoplasty allows in 80 to 90% of cases to close the perforation of the eardrum and avoid the potential complications of chronic discharge from the ear.
How is recovery going and how long does it last?
Recovery time after tympanoplasty varies depending on the complexity of the procedure and how quickly the patient heals. The following should be considered for recovery:
Pain: After the operation, some pain may occur, but usually it is moderate and can be relieved with medication painkillers.
After the operation, dizziness may occur, but it is usually transient and disappears quickly.
For a few days, a bandage is applied to the ear that was operated on.
Wick: A wick is placed in the external ear canal to help with healing and prevent bleeding.
Work stoppage: Generally, a work stoppage of three weeks to one month is permitted.
Activities: It is recommended to avoid strenuous physical activities, air travel and swimming for a few weeks after the operation.
Medical follow-up: Follow-up visits are scheduled to monitor healing and ensure everything is going well.
After tympanoplasty, recovery is usually rapid and patients can return to normal daily activities after a few weeks. However, to avoid complications and promote rapid healing, it is crucial to follow the doctor's instructions.