Ear Membrane Surgery (Tympanoplasty)

Tympanoplasty or eardrum repair is a surgical procedure performed to repair the damage in the eardrum or tympanic membrane. The surgeon will perform the surgery when he/she observes a hole or perforations in your eardrum that does not heal within three months. They take a tissue graft, usually from behind the ear, and use it as a patch to repair the damage. 

Now that you’re clear on what tympanoplasty is, let’s understand whether you need it and how the procedure is done

 

Tympanoplasty - An Overview

Tympanoplasty or eardrum repair is a surgical procedure performed to repair the damage in the eardrum or tympanic membrane. The surgeon will perform the surgery when he/she observes a hole or perforations in your eardrum that does not heal within three months. They take a tissue graft, usually from behind the ear, and use it as a patch to repair the damage. 

Now that you’re clear on what tympanoplasty is, let’s understand whether you need it and how the procedure is done.

 

Doctors do a tympanoplasty when the eardrum (or tympanic membrane) has a hole that doesn't close on its own. It is done to improve hearing and prevent water from getting into the middle ear. Kids can get a hole in an eardrum from i

Infections that cause the eardrum to burst.

Why is the Procedure Done?

1. Surgeons perform a tympanoplasty to repair a hole that does not repair on its own. The purpose of the surgical procedure is to fix the membrane and improve your hearing. You may need tympanoplasty if you get a hole in your eardrum from:-
2. Ear infections, causing damage to the eardrum
3. Injuries, such as eardrum puncture, result from using objects like a cotton swab
4. Cholesteatoma (a skin-lined cyst that grows behind or within the eardrum)
5. Tympanoplasty tubes or ear tubes falling out
6. Otitis media (the infection in the middle ear due to accumulation of fluid)
7. Barotrauma (the difference in air pressure between the middle and outer ear)
8. A loud noise caused by a crash or explosion
9. Ventilation ( ear tuber ) that falls out or is removed.

 

1. In most cases, the eardrum repairs itself. However, you may need tympanoplasty to repair the damage in other cases. The following symptoms may require tympanoplasty surgery:-
2. Bleeding from the ear
3. Pain in the ear
4. Ringing in the ear
5. Fluid discharge from the ear
6. Nausea
7. Vomiting
8. Vertigo

 

Risks of Delaying Tympanoplasty

If left untreated, a perforated eardrum can result in:-

Hearing loss: You can develop temporary hearing loss until the tear is repaired. 

Middle ear cyst (cholesteatoma): A cyst composed of skin cells and other debris can develop in the middle ear due to a long-term tear in the eardrum. 

Middle ear infection (otitis media): Bacteria can enter the ear through a perforated eardrum, leading to chronic infections. 

Tympanoplasty Procedure

1. The procedure for tympanoplasty is as follows:-
2. The tympanoplasty surgery is performed under general anaesthesia (the patient is fully asleep).
3. The surgeon makes an incision behind the ear, moves your ear forward, and carefully exposes the eardrum. 
4. He/she then lifts your eardrum to examine the inside of the ear. 
5. The hole in the eardrum is cleaned, and he/she uses a laser or micro hook to remove the scar tissue from your middle ear. 
6. Your surgeon will take a piece of fascia (the tissue under the skin) from behind your ear and place this graft under the hole in the eardrum. 
7. He/she reconstructs the bones in the middle ear if needed (a procedure called ossiculoplasty). 
8. After completing the repair procedure, the surgeon closes the incision with absorbable stitches and places a large bandage over the surgical site. 
9.  
10. Let’s delve deeper into the types of tympanoplasty:-
11. Source: https://www.entlecture.com/hearing-loss/

 

1. Type I: Also known as myringoplasty, the procedure is performed to repair the tympanic membrane alone. There is no abnormality in the middle ear.
2. Type II: The surgeon repairs the eardrum and middle ear in this procedure by grafting the tympanic membrane to the incus. 
3. Type III: The procedure is performed when the malleus and incus have defects. It involves the placement of a tympanic membrane graft onto the stapes head. 
4. Type IV: The surgeon grafts the tympanic membrane directly to the movable stapes footplate. 
5. Type V: The repair involves the fixed stapes footplate in this procedure. 
6. Please note that the treatment selection is based on your condition and your doctor’s opinion.