Tympanoplasty Procedure

Tympanoplasty is surgery performed to restore normal hearing in a patient who has experienced an eardrum perforation. The eardrum, or tympanic membrane, is a thin layer of tissue which protects the middle and inner ear. Perforations can be caused by chronic infections or an injury. While small perforations usually heal on their own, large ones may cause lingering problems that can be resolved through tympanoplasty.

Types

• Several types of tympanoplasty can be performed, depending on the repairs that need to be done. The most common is tympanoplasty with ossiculoplasty, in which the surgeon repairs a perforation in the eardrum and also corrects any middle ear bone defects. If no bone problems have been diagnosed, a less complicated tympanoplasty procedure called myringoplasty is performed to repair the eardrum perforation.

Anesthesia

• Tympanoplasty is performed under local or general anesthesia, depending on the severity of the defect. Pediatric patients commonly have general anesthesia because they are less likely to stay calm during the entire one to two hours the surgery usually lasts. Some adult patients prefer to have general anesthesia as well.

Procedure

• During a tympanoplasty procedure, the surgeon makes a small incision behind the ear and draws tissue from the muscle fascia. This tissue is grafted to the eardrum to cover the perforation. The surgeon adds materials to hold the graft in place and repairs middle ear bones if necessary. A small pack may be placed inside the ear and removed within one to two weeks. The stitches inserted during surgery are removed after a week.

Recovery

• Most tympanoplasty patients can go home within two to three hours after surgery. Patients undergoing more complicated surgeries may need to stay overnight. All tympanoplasty procedure patients receive prescriptions for antibiotics and are advised to take pain relievers as needed. Complete recovery usually takes about four weeks, during which the individual is directed to keep water away from the ear and avoid blowing his nose, flying, heavy lifting or working out.

Success Rate

• Uncomplicated tympanoplasty or myringoplasty have varying rates of success, according to a review of studies published in a 2008 issue of Current Opinion in Otolaryngology and Head and Neck Surgery.
  While multiple studies show a success rate from 60 to 99 percent for adults, the success rate for children is only 35 to 94 percent. The lower success rate for pediatric patients may be associated with frequent upper respiratory tract infections and middle ear infections, poor function of the Eustachian tube (the tube that connects the middle ear to the throat) and inconsistent postoperative care.