Tympanoplasty

Tympanoplasty is the operation to restore the anatomical structures and normal function of the middle ear.

Depending on the disease of the middle ear, tympanoplasty is divided into the following forms:

Myringoplasty

It a surgery performed to repair a hole in the eardrum with a graft, when the remaining anatomical structures of the ear are normal.

Ossiculoplasty

In addition to restoring the tympanic membrane, it also refers to the reconstruction of the middle ear ossicular chain which has been disrupted or destroyed. Depending on the damage, this is done by using the same bones (transposition) or with foreign grafts (titanium prostheses), which successfully replace the bones of the ear eroded by chronic otitis.

Tympanomastoidectomy

It is a combination surgical treatment of both a tympanoplasty and a mastoidectomy. It involves extensive surgical repair when the disease extends to the tympanic cavity and mastoid air sacs (cholesteatoma).

What are the indications for tympanoplasty?

There are many indications. The most common reasons for surgery are the following:

• Perforation of the tympanic membrane (inflammatory or traumatic etiology) causing hearing loss and frequent episodes of otorrhea (chronic otitis media)
• Atelectasis (retraction) of the tympanic membrane
• Disruption/erosion of the middle ear ossicles
• Cholesteatoma
• Middle ear dysplasia
• A basic requirement for a successful surgery is the normal functioning of the Eustachian tube.

What should I expect postoperatively?

Postoperative pain is usually minimal and lasts for 2 to 3 hours. The patient remains in the Clinic for one day. The next day, the head bandage is removed and he/she is discharged. Postoperatively, administer painkillers and oral antibiotics for 7 to 10 days are given, as well as ear antibiotic drops that should be instilled into the ear for a total period of 1 month. The sutures are removed after 1 week in the clinic, while in the 2nd week, the gauze is also removed from the external auditory canal.

What are the postoperative instructions?

Postoperatively, for a period of at least 1 month, the patient should avoid the following:

• Avoid water into the operated ear
• Weight lifting and intense sports activity
• Sneezing
• Travel by plane
• Persistent cough
• Forceful nose blowing
• Constipation

What are the most common complications?

Graft rejection is the most common complication. In these cases, restoration can be done with a revision operation. However, it is important to limit the factors that led to the failure of the first operation, such as Eustachian tube dysfunction and inflammatory conditions of the ear and nose.

Rarer complications are facial nerve palsy, postoperative tinnitus and/or hearing loss, and taste disturbance.

Postoperative cholesteatoma formation (recurrence) is also a rare complication that can be treated with a revision operation.