Tympanoplasty
When Is Tympanoplasty Recommended?
Tympanoplasty is advised for patients with the following symptoms or conditions:
- Persistent ear pain.
- Hearing loss.
- Tinnitus (ringing or beep-like sounds in the ear).
- Vertigo (difficulty maintaining balance).
- Nausea or vomiting caused by vertigo.
What Is Tympanoplasty?
Tympanoplasty is a surgical procedure to repair a damaged tympanic membrane (eardrum). It is performed to:
- Restore the structure and function of the eardrum.
- Correct damaged middle ear bones (malleus, incus, stapes) if necessary.
This surgery is often required when chronic infection, trauma, or other factors impair the eardrum’s ability to heal naturally.
Structure of the Tympanic Membrane:
The eardrum consists of three layers:
- Outer epithelium.
- Middle layer of collagen fibers.
- Inner epithelium.
Small perforations may heal independently, while larger defects often require surgical repair.
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Causes of Eardrum Damage
- Insertion of foreign objects into the ear canal.
- Blunt trauma or injury.
- Explosion-related shock waves.
Types of Tympanoplasty
The procedure is classified into five types based on the extent of damage:
- Type I: Repairs eardrum perforation.
- Type II: Addresses perforation and erosion of the malleus; involves grafting onto the incus or malleus remnants.
- Type III: Used when ossicles (except the stapes) are damaged; graft is placed directly on the stapes.
- Type IV: For cases where ossicular damage extends to the stapes arch; grafting is done around or onto the stapes footplate.
- Type V: Performed when the stapes footplate is immobile.
Pre-Procedure Preparation
Preparation varies depending on the type of tympanoplasty. Preoperative steps include:
- Comprehensive evaluation, including:
- Audiogram (hearing test).
- Microscopic ear examination.
- Otoscopy.
- Fistula test (if dizziness or perforation history exists).
- Detailed instructions on fasting and medications.
- Stopping anticoagulants or blood-thinning medications before surgery.
The Tympanoplasty Procedure
- Incision and Exposure:
- A cut is made in the ear canal to lift the eardrum. For larger perforations, an additional incision may be necessary.
- Scar Tissue Removal:
- Scarred tissue is excised using microhooks or a laser.
- Graft Placement:
- A graft (usually taken from tissue behind the ear or a vein) is positioned beneath the eardrum.
- A gelatin sponge is used to support the graft and prevent displacement.
- Closure:
- A sterile patch is placed over the ear canal to protect the repair.
Post-Procedure Care
- Hospital Stay: Most patients can leave within 2–3 hours post-surgery. Complicated cases may require observation.
- Medications:
- Antibiotics to prevent infection.
- Anti-allergic drugs for pre-existing allergies or colds.
- Restrictions:
- Avoid nose-blowing or water entering the ear.
- Rest and follow-up as advised.
Follow-Up:
- First follow-up: 3–4 weeks post-surgery to assess graft condition.
- Hearing evaluation: 4–6 weeks post-surgery.
Return to Activities:
- Light activities: 6 days post-surgery.
- Heavy activities: 4 weeks post-surgery (after a doctor’s evaluation).
Risks and Complications
- Graft failure (incomplete healing).
- Middle ear adhesions.
- Narrowing of the ear canal.
- Hearing loss (rare).
- Cholesteatoma (abnormal skin growth in the middle ear, rare).
- Tinnitus: May persist or worsen temporarily after surgery but usually subsides.
Choose Expert Care
For safe and effective tympanoplasty, consult our experienced ENT specialists at Sahaj Hospital, Indore. With advanced techniques and personalized care, we ensure optimal outcomes for your hearing and overall ear health.
Book your appointment today for expert evaluation and treatment!